I feel angry after reading On Becoming a Counsellor (A Basic Guide for Non-Professional Counsellors) – Eugene Kennedy and Sara C Charles (Newleaf, 1990). Okay, this is an old book, the version I’m referring to published in 1990 (first published 1977), but unfortunately these same attitudes are still around.
In On Becoming a Counsellor the authors place much emphasis on being aware of the psychiatric diagnosis of the person they are trying to understand. They state that ‘Non-professionals should have some knowledge of the major classification found in the DSM-111-R [Diagnostic and Statistical Manual of Mental Disorders]’ (p.134), and they go on to say: ‘Counsellors, especially those who have not had extensive training, can only improve their chances of being truly helpful by acquainting themselves as thoroughly as they can with the ever developing insights of contemporary diagnosis.’ (p.138).
I have no quibble with the idea that it would probably be useful for helpers to gain knowledge of the diagnostic categories that psychiatrists use. This might help in understanding the experiences of clients who are, or have been, psychiatric patients (in England or the USA) and to consider how such stigmatising labelling might be affecting them. However, I believe it is unhelpful, even dangerous, to try to fit a client into a diagnostic category (or to accept unquestioningly a diagnosis given by a psychiatrist). This could lead to generalisations about the individual, misinterpretations of the client’s speech or behaviour in the light of the diagnosis, and seeing an ‘illness’ rather than a person (none of which is beneficial to either a client or a counsellor!).
Examples of what (in my opinion, though obviously not the view of the authors) is wrong with putting people into these categories are apparent throughout this book. The authors talk about ‘paranoids’, ‘obsessive-compulsives’, ‘hysterics’, ‘antisocial personalities’, ‘schizophrenics’, ‘borderlines’, ‘narcissists’, ‘depressives’. I started giving the page numbers where each of these terms had been used but I gave up because this terminology appeared on so many pages! It’s as if the person has become no more than a diagnostic label! Moreover, once the person has disappeared beneath a set of symptoms, the authors then make sweeping generalisations, through which they encourage helpers to view particular clients. Here are just a few examples:
‘Histrionic personalities have enormous difficulty with love and intimacy, with the substance of what it means to share deeply with another person.’ (p.245). ‘Antisocial personalities may sound sincere in expressing regret but this may be discounted; it is a feeling of which they are incapable.’ (p.260). ‘Antisocial persons do not feel much at all.’ (p.263). ‘Schizophrenics experience great difficulty in relating to others. They have few friends and they seem to distrust other people.’ (p.274). ‘Paranoids generate a kind of suspiciousness that keeps other people on guard’ (p.283). ‘The almost unique pressure exerted by borderlines can seem as heavy and stifling as the weight of the sea. Narcissists require proper identification because of the severe complications they can introduce into, for example, the already challenging work of marriage counselling. (p.295). ‘Obsessives ask questions but they are not really looking for answers’. Likewise, ‘Obsessives like to throw counsellors off guard, to get them to explain something they have said or to defend some other aspect of their professional activity’ (p.231).
Counsellors are warned to prepare in advance for the possibility that persons coming for help will test out their reactions right from the start (p.99). This may take the form of asking questions about the counsellor’s training, expertise or credentials. We are told that questions such as these should either ‘be accepted and not responded to directly’, or a counsellor may say, ‘You really want to get some information about me, don’t you?’ or ‘It seems important for you to examine my credentials.’ (p.99/100). But surely it is only right and sensible that a client might want to ensure at the outset that the person to whom they are going, and paying, for counselling is suitably experienced and qualified. Why should a counsellor perceive this as an attack? Why on earth shouldn’t the counsellor be happy to answer these questions?
On the one occasion when I went for counselling (which, unfortunately, turned out to be a very off-putting experience), I think my counsellor must have been reading books such as this one. When I first met her, I asked some questions about the kind of counselling (psychodynamic) she was offering. My questions were dismissed with, ‘Talk about you, not me. That’s what you’re here to do.’ And then she fell into a long silence (which greatly puzzled me as I had never come across this before). Fine, talking only about me if the counselling was already underway, but, hey, wait a minute. I thought this was supposed to be a brief, initial discussion before proceeding. Never having had counselling, I needed to know more about her approach before going ahead. Somehow I had (quite unintentionally) got off on the wrong footing with her from the beginning. She seemed defensive and annoyed with me. (Perhaps I was sitting in her chair).
In a section about ‘hostile clients’ the authors say: ‘Clients who enter the room and seat themselves in the chair that is obviously meant for the counsellor give a clear message that can’t be ignored.’ (p.99). I’m left wondering what a chair that is ‘obviously meant’ for the counsellor looks like, compared with a chair that is ‘obviously meant’ for the client, and why a counsellor should read hostility into a client who can’t see, or understand, that the chairs are and ‘need’ (?) to be different.
The authors tell us how certain clients are ‘good at making other people feel’ in a certain way. For example, ‘These people [“paranoids”] have the power to make us uneasy … They make other people argumentative and resentful.’ (p.283). We are told that as helpers we should keep asking our self, ‘What is this other person doing to me?’ I agree that we need to be aware of feelings in ourselves that might arise with a particular client, but I think it would be better to ask our self, ‘Why am I feeling like this?’ instead of thinking, ‘This client is making me feel like this. Oh yes, I know why. She is a chronic schizophrenic and that’s what these schizophrenics do.’ If we keep thinking clients are ‘making’ us feel a certain way, perhaps it is ourselves we need to be taking a closer look at. (Not that I have any room to talk, I’ve just realised. All the way through reading this book I kept breaking off to say to my husband, ‘These authors are making me feel so angry!’).
By the time I’d finished reading this book there was steam coming out of my ears. I decided to move on to another library book, one which I ‘knew’ wouldn’t upset me because it was written by Carl Rogers. Surely there’d be nothing in A Way of Being that would be disagreeable to me. Yes, well… I’ll save Carl Rogers for my next post.