Common Counseling Mistakes (part 1)

Counseling is a learning process where an objective and empathic listener provides unconditional acceptance and confidentiality that allows the hurting person to have space, time, and safety to examine personal issues, grieve over their losses, and embrace private pain.  It is also a place where defenses are challenged, maladaptive belief systems are examined and opportunities are provided for corrective emotional experiences.  The counselee is encouraged to take responsibility for his or her own behavior and is helped to make better decisions that would bring more fullness of life.  The goal of counseling is to help the counselee become what he or she is potentially capable of becoming.

While at Alliance Graduate School of Counseling, I had the privilege of studying under Dr. John Cheydleur.  In his book Called to Counsel* (Tyndale, 1999), Dr. Cheydleur addresses 12 specific counseling mistakes that lay counselors and non-professional Christian counselors tend to make.  He also suggests ways to avoid or correct these mistakes.  I will summarize his 12 points here:

1.  Patronizing or Cliché Responses 

A cliché response is a stereotypical expression that has lost its original meaning and impact through overuse.  

Example: 

Counselee:  I really struggle with my work.  I feel like I give all my time and energy, but I just don’t feel that my boss cares about me and my family.

Counselor:  I think you are just too discouraged – you have to keep in mind that sweet is the pleasure after pain.

A patronizing response is an attempt to encourage the counselee by emphasizing the positive.  It puts the counselee higher than he is or higher than what he thinks he can achieve.  The problem is that this is not how he sees himself at that moment (even though what the counselor sees or has observed may be true.) 

Example:

Counselee:  I want to quit my job.  It is very difficult; I don’t think I can bear the pressure they are putting on me.

Counselor:  I know it is difficult, but you can do it.  Don’t you remember you were able to complete the project that no one else at your job could do? 

Explanation:  On the cognitive level these responses makes sense to the well-meaning counselor.  However, psychologically the counselee gets confused because of the incongruence of how others perceive him and how he actually feels deep inside.  For the counselee, it deepens his struggle.  Some counselees would learn to hide by riding on to the encouraging comment and keeping a mask that shows that he is strong enough to face the challenges of life instead of admitting his insecurities and fears.

On a superficial level, these responses seem caring of the counselor, but on a psychological level, they are an attempt to control and limit the counselee’s feeling and expression of painful emotions.  Because of the inability of the counselor to understand how to help the person go deeper in examining the problem, they cut the counselee from the opportunity to express him or herself that could bring some emotional healing.

How to correct these mistakes: 

Instead of cutting the person off with patronizing or cliché responses, let the person talk.  And show that you care by reflecting not only the content, but also the emotion with which the person is struggling.

2.  Questions and Probes Too Soon

In good counseling practice, the counselee needs to be able to hear what he feels and thinks about his situation.  By bombarding the client with too many questions (probes), the counselor appears to be an expert on an awareness level, but on the psychological level, the counselor is very controlling and overly anxious.  By stacking questions, the counselor prevents the client from discussing areas that are important to him.  Another problem that arises from asking too many questions is that the counselor might lead the counseling in the direction the client is not yet ready to face. Probing too soon also inappropriately narrows the focus of the interview.

How to correct this mistake: 

Instead of asking so many questions, the counselor should:

·         Pay attention and listen

·         Slow down and allow the client to talk freely

·         Reflect and clarify statements to keep on track with the counselee’s process.

3. Giving Advice Instead of Lending Information

A major mistake commonly made by new or untrained counselors is to confuse the necessary process of introducing new information to the client with the negative process of giving advice.

When we give advice, we assume the role of an expert. (i.e.  “Follow what I say because I know what is best for you.”)  We assume (incorrectly) that we completely understand the person, his feelings, fears, hesitations, the nature of his struggle, and the obstacles he will face when following through with our advice. 

Reasons why counselors should NOT give advice:

·         Most of the time when receiving advice the person feels coerced to follow you and may come to resent you for making him do certain things. 

·         Some counselees actually like this because they are so dependent on other people thinking for their lives that they don’t want to take time to ponder it on their own.  Through advice giving, the counselor can just reinforce their tendency to not own their own thoughts and feelings in a way that is required to make a personal decision.  The counselor can empower them to blame others for their lives.  Later you hear them say, “I just followed your advice.  Look what happened…”  (and they are implying, “How do you feel now? You made a mess of my situation.”)

·         Others will listen to the advice of the counselor, but will not do it.  When asked why, they will present an alibi, like what if it will not work?

How to correct this mistake: 

·         Evaluate the receptivity of the client before giving new information.

·         Avoid using “you should” statements.

·         Always try to give the counselee two or three alternatives so that he has to choose for himself what he thinks is the best alternative.

·         It is always good to process the counselee to see their perspective on the issue.

I will be discussing other common counseling mistakes in upcoming posts  . . .

*Cheydleur, John R. 1999. Called to Counsel. Wheaton. Illinois: Tyndale

Difficulties of Seeking Counseling in the Philippines (cont.)

Another reason that counseling is difficult in the Philippines is because of a general ignorance. Families are not educated about the mental condition of someone who is in need of psychological help, nor do they know how to properly care for them. The prominent cultural reaction to someone with Bipolar I disorder is that the person is demon possessed. I remember a family insistently called different pastors to cast demons out of a family member who was clinically diagnosed with Bipolar I. I don’t negate the possibility of demonic influence on a person’s behavior. Tthe problem is when we see psychological issues as purely spiritual. Misdiagnosis and improperly prescribed treatment can prolong the suffering of the individual. I have seen neighbors whose love-ones who are suffering from a nervous breakdown, drug abuse, or schizophrenia. The family lacks the information and knowledge about the situation of the suffering person so the afflicted individual receives inhuman treatment from those who are supposed to love and care for him. Often these people are isolated and placed in an iron cage or chained, so that they cannot wander around and harm someone else or be harmed. These people are treated like a prison in a “bartolina”. Often they must sleep is an upright position because of the lack of space. They don’t have access to the bathroom. They are given a bath by having someone using a hose to sprinkle them. And maybe worst of all, they are not given time to talk and bond with their families.

Filipinos are supernaturalistic in their beliefs and convictions. They see everything that happens to them as events over which they have no control. The fatalistic tendency is to accept situations as being from God or other spirits so whatever they do will not change the situation.

The extreme poverty in the Philippines makes counseling inaccessible to many people. The minimum wage (which is a normal wage for blue collar workers) is about $6 per day. I see clients from all walks of life. In order to make the service affordable, I use a sliding scale that corresponds to the monthly wage of the family. The first instinct might be that counseling should be free, but it is important for people to take responsibility for their problems, and part of that responsibility is shouldering a cost, even if it is a very small amount. This gives the client a sense of control and ownership, as well as personal power.

Why is it hard for Filipinos to seek counseling/psychotherapy?

Though there are a lot of emotional needs and struggles with anxiety within the culture, Filipinos tend to be resistant to the idea of seeking professional help for several reasons:

First of all, seeking help from a psychotherapist is more painful than the existing emotional and psychological pain that is privately experienced by the person (or the family caring for someone who is struggling). The stigma attached to seeking professional help by those who are struggling can sometimes cause more pain. Gossip is also very influential within the culture and going to a counselor would make one the focus of that gossip. The Filipino’s cultural values of shame “Hiya” and self-protection “Amor Propio” are two of the biggest factors preventing Filipinos from seeing a counselor or psychotherapist.

Secondly, individuality and individuation are not part of the Filipino psyche. Filipinos are group oriented people. They take their identity from the group and do not want to be seen as different, nor do they want to bring a bad reputation to the group and risk being ostracized. Within the culture the diagnosis of one person might easily be assumed to other members of his or her group. If a child is suffering with schizophrenia, it is not uncommon to hear others called the family a “schizophrenic family”. The diagnosis can also affect other family members, causing discrimination and stereotypes which would mean loss of opportunity. The brother of a lady who was getting married was diagnosed with schizophrenia. When the family of the fiancé knew about it, they decided to cancel the wedding.

Third, the cultural expectation is looking for a magical touch. The vast majority of Filipinos are Roman Catholic and they seek healing through contact with religious relics and expect instantaneous healing. Many impoverished people spend all of their money to make pilgrimages to holy sites to obtain healing. Or they visit an Albularyo who mix some herbs and chant to dispense healing. In the same way, most people do not seek counseling until they are very desperate. Then they come expecting to be magically healed. A client expects to be given advice from the counselor and to come out of the counseling session with their problems solved. Psychotherapy does not really work this way.

The first meeting with a counselor is just intake and getting to know the client so they can set the goal for psychotherapy. It is not until at least the second session that they start to address the problem in a thorough way. When counseling requires more than two sessions, I notice that a number of clients will not follow through with the set appointment and may eventually drop out – unless they are still struggling with the same issue. Most of the time, when clients experience a little relief, they consider themselves healed. So instead of following through with the agreed treatment plan, they stop until problems recur. For example: I was treating a lady for panic disorder for 4 sessions. She stopped coming to counseling because she was no longer experiencing any panic attacks. But the treatment plan was based on Cognitive Behavioral Therapy and was supposed to last for 8 - 12 sessions. A year later she came back and told me that she was having panic attacks again. She asked me to see me for only two sessions, because she did not have time for counseling.