I had a parent who cancelled services for a client and I must say that I was very concerned. I wasn’t concerned because of pride – because services were cancelled with me, specifically – or because the parent just didn’t want services, it was because I recognized that the client would not get the help that they needed. This recognition made me feel sad and empathetic to the client. However, in situations such as this one, the parent makes the decision.
I recognize the countertransference, of course. I recognize that it was twofold for me. As a parent, I am constantly worried about ways that I may negatively impact my children, especially unconsciously. No parent is perfect and we all struggle with our own worries and flaws constantly. With this situation, I recognized that the parent was projecting the parent’s own feelings and needs onto the client, rather than worrying about the client’s needs. As a counselor, I recognize that oftentimes, clients and their families do not believe in the value of therapy and just will not see any benefits in it. Sometimes clients or their loved ones may also not be in the mental or emotional space to participate in counseling. I am sure that these are situations that many counselors deal with often. I wonder just how many are emotionally impacted by situations such as this one, also how many would actually admit to themselves the emotions they experience.
Pride can be a two-part emotion. It can allow us to feel deep satisfaction for things we have done or achieved and it can also allow us to be resistant to change or external forces. In the times I have worked with minors, I, myself have been someone resistant to this population because in a many ways, children’s opinions seem to be over-ridden by their parents often. I have recognized that as mental health is not always viewed as an important issue to be addressed, assistance is oftentimes not sought out or provided. Also, cultural identities have a direct impact on the availabilities of mental health services to minors. Parents have a direct impact on whether their children receive assistance and the quality of the assistance, if any is provided. I have found that although the counselor works mainly with the client, for therapy to be successful, it also seems that the counselor has to have a positive relationship with the parent to facilitate a successful therapeutic relationship.
Branca Sà Pires noted in the Journal of the Society for Existential Analysis, 2016, Vol 27, Issue 1, in the article titled Therapy with Children and Adolescents In The Phenomenological-Existential Tradition: Community-Based Clinical Interventions that parents are indeed essential to the therapeutic work with children and adolescents because they can either promote or inhibit the process. In reviewing some of the research, some of the articles, especially regarding working with younger minors, used language which included phrases like “advising the parents on how to care for their children”. I think that this makes the parents feel more judged and make them more resistant to therapy. I think using words and phrases such as these almost seem like we the counselors are the experts on their children. This should not be the case. We may be experts on various subjects, but we all know that symptoms, thoughts, and behaviors vary across clients. Also, if we approach the parents in this way, I believe that this invokes pride in the parents and creates resistance as they are the constants in the clients’ lives.
In adult clients, pride can be useful depending on the way it is framed. If clients are prideful and feel that they do not need assistance and do not want to participate in the therapy, then this will negatively impact any progress that could be made. Pride used as a defense mechanism can also be indirectly explored by clinicians to establish why clients are unwilling to participate. Pride can also be used a positive emotion to encourage clients to take pride in the progress they have made; they can be encouraged to take pride in the healthy decisions they have made to change their lives in a positive way. Pride may even be used to encourage clients even if it appears in a positive or negative way to validate the client. A counselor may say to a client, “I know it has to be hard to come here today, not knowing what to expect, but still being willing to put yourself out there and try”. Reframing any resistance from clients and validating the difficulties of their experience may change the way they choose to participate in therapy. Using pride to also validate the choices they have made can also encourage them to be willing to make even more positive choices in their lives.
One of the supervisor I have had the opportunity to work with, reminded me that sometimes, a client or the parent may not be in the mental space or time in their life to be receptive to counseling. This has been a lesson I have used when meeting new clients. Some clients may come voluntarily to counseling but they may still be very resistant and oftentimes, these clients will not come continuously or just may stop showing up. Sometimes clients may come to counseling but once they start facing their issues, they may find that they are not ready to deal with their problems. As counselors, we want to help the clients that come through our doors, but the reality is that they may not necessarily want help.
Clients who express resistance force the counselor to consider different ways to engage them. They challenge the counselor to consider different ways to build trust and manage the therapeutic relationship. Lynne Shallcross discussed in the October 2010 article, Success Stories with Challenging Clients the importance of putting the therapeutic relationship in perspective and recognizing that clients are not always necessarily resistant intentionally. Resistance maybe a defense to protect clients, especially when considered from a psychodynamic perspective. John Sommers-Flanagan noted in in Shallcrosss’s article, it is expected that clients come into therapy and immediately share their personal struggles with a stranger. Ironically, if clients are not as forthcoming as we, the counselors may like, the clients maybe described as being resistant to the clinicians or the therapy. Sommers-Flanagan also importantly pointed to the ever-present power dynamic in the therapeutic relationship. If the clients appear to be resistant, how does the clinicians’ approach change to manage this? How far (within reason) will counselors go to develop an effective therapeutic relationship or to meet the clients where they are so that therapy may progress?
I have been asked the question a few times – by clients who have never been to or had any kind of experience with therapy – what happens after the counseling process is over? This question helps me to realize that even in present times, there are still so many misconceptions about therapy and the process and the expectations. There are all kinds of stigmas attached to therapy which can cause confusion for clients; for example, some clients come to counseling expecting to be told how to fix their problems. For some clients, their services maybe limited and counseling may be a very short time in their lives. For clients such as these, pride can be a form of self-defense. As clinicians, we must do the most with the limited time we may have with our clients and find ways to break through the pride and defense to help clients get the most out of the therapy. We also may find that some clients may not be ready for therapy and we may experience difficulty, or are unable to break through the pride. Hopefully, this does not invoke our own personal pride at what may seem like a failure.
Therapy can be a beautiful process when both client and counselor are actively engaged in the process. The times when the therapeutic relationship happens like this, we are reminded of why we do what we do. However, when we experience difficulties, it is those times, that we have to push through and remember why we do what we do also, when we have forgotten that feeling. Sommers-Flanagan mentioned in times like these, shifting focus to indirect communication can be helpful and taking an interest in whatever is going on in the clients’ world. Sommers-Flanagan also remind us to not take it personally when clients do not share any interest or joy in therapy. It is not about us. Remembering these things may lower any frustrations we may experience with clients.
Charmaine Perry is a counselor who works mostly with adults and couples in central New Jersey. Her passion is mental health and writing and finding ways to incorporate these two fields to advocate for mental health services for African and Caribbean Americans.