Intensive Counselling
John Heron
1978, revised edition 1998
See also my:
Foreword
Part II of this manual is a revision of the original 1978 text. It lists
counsellor interventions under eight different aspects of intensive counselling,
and concludes with my account of the primary qualities that distinguish
effective intensive counselling. Part I is a more recent model of counsellor
interventions. It starts with a four-part grid which relates both the client's
content cues, and the client's process cues, to the counsellor prompting
the client to be active, and to the counsellor being active while the client
is receptive and responsive. This is followed by an overlapping account
of counsellor interventions, simply listed under 'Working with content'
and 'Working with process', and taken from Chapter 7, 'Cathartic Interventions'
in my book Helping the Client: A Creative, Practical Guide, London:
Sage, 1990.
Part I
1. Diagram of the four-part grid
|
CONTENT CUES
The client's story: word/image/idea
|
PROCESS CUES
The client's energy: body/breath/sound
|
|
Client cue: What client is invited to
say |
Client cue: What client is invited to
do |
| Counsellor
prompts
Client
to be
active |
Evasive talk or analytic talk:
how feeling, how being in the body
find agenda critical incident
Stated problem: critical incident
Stated occlusion: imagine critical incident
Critical incident: scan: forward or back
earliest available memory
Critical incident: literal description
Literal description: psychodrama
Psychodrama: shift level within it
Monodrama: play internal parts
Association: thought
critical incident
follow chain of memories
verbalize insight/re-evaluation
positive affirmation and reprogramming
action planning and goal setting:
Slip of tongue: repeat, associate
Sudden aside: repeat, associate
Self-deprecation: contradiction
Evasive pronoun: first person
Evasive verb: responsible verb
Dream: literal description in present tense
psychodrama
monodrama: play all dream symbols
Lyrical cue: recite, hum or sing |
Rapid speech, shallow tone:
slow down speech, deepen tone
Distress-charged sound on word/phrase:
repeat, increase, associate
Sudden deepening of the breath:
repeat, increase, associate
hyperventilate
Eyes closed or evasive:
make eye contact
Distress-charged movement:
repeat, exaggerate, find sound/words
Distress-charged rigidity:
exaggerate, find sound/words
contradict, find sound/words
Matching or mismatching: treat alike
Chronic archaic/defensive tone of voice:
exaggerate, find its words
Chronic archaic/defensive body armour:
amplify kinaesthetic micro-cues
stress positions
mobilization
hyperventilation
regression positions
frozen need expressions
spatial quadrants and polarities
Pensive cue: verbalize thought, image |
|
Client cue: What practitioner says |
Client cue: What practitioner does |
| Counsellor:
acts
while
Client
is
receptive
and
responsive |
Stated problem: hypnosis,
suggestion
Psychodrama: negative accommodation
positive accommodation
Negative talk: mirror with awareness
Emergence of hurt child's story:
affirm validity of the client's hurt, affirm their need for discharge
and healing, their deserving of time, the past need for their defenses,
the safety of this situation, the present redundancy of their defenses,
the deep worth of their inner child, the value of this work of healing
and their courage in doing it..... |
Chronic archaic/defensive body armour and
intermittent rigidities:
light holding, light contact/massage
light vibration/pulsing
loosen muscle groups
light/strong pressure on tense areas
gentle opening/extension of joints
long leverages, psychodynamic osteopathy
energy passes with hands, breath, eyes
Eyes evasive: seek eye contact |
2. From Helping the Client
Working with content. This means working
with what the client is saying, with their stated difficulty, with meaning,
story-line and imagery. The content may start out anecdotally evasive or
analytically defensive; may evolve into talking about some real difficulty
or problem area; and culminate in working on some traumatic scenario.
1. From analysis to incident. You ask a client
who is busy analysing a current difficulty or problem in their life to
describe a specific, concrete critical/traumatic instance of it. You gently
persist until the client gets there. Then:
2. Literal description. You ask the client
to describe the traumatic incident in literal detail, not analyse it or
talk about it but summon the story-line through vivid recall of sights
and sounds and smells, of what people said and did. Distress is lodged
in imagery of all kinds, and is drawn up by its evocation. And to increase
this effect:
3. Present tense account. You ask the client
to describe the incident in the present tense, as if it happening now.
You keep them to the texture of the scene, the imagery, in the present
tense, maybe going over it several times, and with discreet questions edge
them to the distressed nub of the matter. Working with process cues (see
below) evident during the description will help a lot. Catharsis may occur
at any point. What is certain is that the threshold of catharsis is lowering:
the person is getting closer to feeling the distress.
4. Psychodrama. As the distress emotion comes
to the fore through literal description of a critical incident, you invite
the client to re-enact the incident, that is, to re-play it as a piece
of living theatre: they imagine they are in the scene and speak within
it as if it is happening now.
-
You ask them to express fully in the re-enactment
what was left unsaid, suppressed or denied at the time, and to say it directly
to the central other protagonist (for whom you can usefully stand in).
Catharsis can powerfully occur at this point.
-
This is original, archetypal theatre: the person
re-creating dramatic incidents from their own life in a way that enables
them to abreact the painful emotion which they suppressed at the time.
The past is often full of pockets of unfinished emotional pain which can
be discharged by this simple and classic technique - the use of which requires
good training.
-
There are two points of shift where clients typically
resist because each one gets closer to the distress: first, the move from
analytic talking about a problem to literal description of an actual instance
of it; second, the shift from this description of the scene to dramatically
talking to someone in the scene. You will need gentle persistence in helping
your client to break through at these two points of resistance. This kind
of persistence needs to be both caring and quietly unrelenting.
5. Shifting level. If the psychodrama is about
an incident later in the client's life, when they are making a charged
statement to the central other, such as 'I really need you to be here',
you quickly and deftly asks 'Who are you really saying that to?' or 'Who
else are you saying that to?' At this point, at the heart of the psychodrama,
they can very rapidly shift level to a much earlier situation and become
the hurt child speaking to its parent. They continue to use the same line
but in relation to a more basic agenda. Often the catharsis dramatically
intensifies as the deeper level is reached.
6. Earliest available memory. Instead of asking
the client to think of a recent critical incident of a current difficulty,
do a psychodrama on it and shift level within the psychodrama to an earlier
and more basic incident, you can simply ask for their earliest available
memory of that sort of incident, and work on that with literal description
and psychodrama. Depending on how it goes and how early it is, you may
get them to shift level inside that psychodrama too. Distresses line up
in chains of linked experiences going right back to the start of life.
However, there's no need always to shift level to earlier incidents. It
may be appropriate to defuse the incident you happen to be working with.
7. Hypnotic regression. When the client states
a current difficulty, you invite them to lie down with eyes closed, and
then count them down from 10 to 1 into deeper and deeper states of relaxation,
and further into their past toward early incidents at the start of the
chain linked with the current difficulty. They recount what memories surface.
Follow through with psychodrama and/or process work.
8. Scanning. When the client states a current
problem, you invite them to scan along the chain of incidents, all of which
are linked by the same sort of difficulty and distress. They evoke each
scene, then move on to the next, without going into any one event deeply.
They can start with the earliest incident in the chain which they can recall
and then move chronologically forward. Or they can move chronologically
backward from the most recent incident. This loosens up the whole chain
and brings the more critical incidents to the fore to be discharged.
9. Imagining reality. When the content indicates
that there is some trauma lodged in an incident which the client knows
has happened but cannot recall (e.g. circumcision), you can suggest that
they simply imagine the event without worrying whether it really was like
that. Follow through with nos. 2 to 4 and process work. Hypnotic regression
is another possibility here, of course.
10. Eschatological drama. When the client is
talking about feeling cut off from other realms, from the sacred and the
divine, you suggest that they talk directly to these realities, saying
whatever they need to say. This can be very cathartic, with a re-evaluation
of the relationship, leading into further transpersonal work.
11. Slips of the tongue. When a word or phrase
slips out that the client didn't intend to say, you invite them to repeat
it a few times, and to work with the associations and/or process cues.
This invariably points the way to some unfinished business.
12. Monodrama. The client is invited to play
both sides of an internal conflict which may be between the claims of two
different roles they have, or more basically between their internal oppressor
and their internal victim. There are two chairs, one for each side of the
conflict, and the client moves from chair to chair, speaking the lines
for each of their internal protagonists. This is certainly consciousness-raising,
and can become rapidly cathartic if you work skilfully with the process
cues on either side of the conflict.
13. Contradiction. The client is invited to
use statements and a non-verbal manner that contradict, without qualification,
their self-deprecating, self-denigrating statements and manner. In full
contradiction, both statement and manner (tone of voice, facial expression,
gesture - arms well out and up, posture) are self-appreciative and unqualified.
In partial contradiction, their statement is self-deprecatory but their
manner is totally self-appreciative: it's the irony of this that is cathartic.
In double negative contradiction, both statement and manner are exaggeratedly
self-deprecating: the caricature implodes into catharsis.
-
Contradiction challenges head on the external
invalidation and oppression which the child has internalised to keep their
distress and their power suppressed and denied so that they can conform
and survive. You need to work deftly to help the person get it going in
all its appropriate modes, verbal and non-verbal; then it rapidly opens
up into laughter, followed, if you are quick on the cues, by deeper forms
of catharsis.
14. Validation. At certain times, you can gently
and clearly affirm the client, their deep worth, their fine qualities,
their deeds, in a way that releases a lot of grief about the denial of
all these fundamental truths in their childhood.
15. Giving permission. In early stages, the
client often still feels the force of the old conditioning that tells them
they are not allowed to discharge their distress. You can help this by
gently giving them verbal permission and encouragement as they falter on
the brink of release.
16. Freeing attention. When the client's talk
indicates that their attention is sunk, caught up in verbally acting out
or acting in, distracted or fascinated by their distress, you interrupt
this to get some attention free and ready for balance by: physical process
work (see below), describing the immediate environment, the use of contradiction,
describing recent pleasurable experiences, moving around in or changing
the arrangement items in the room. Then see what's on top (next).
17. What's on top. When the client has got
some free attention and is starting to get into balanced attention, you
ask them "What's on top?", that is, what recent (or remote) experience
comes spontaneously to mind, however irrelevant or trivial it may appear
to be. Then work as in nos. 2 to 8, or it may be that the next one, no.
18, happens quite quickly.
18. Free association down the pile. This is
content determined, but it is evidenced by a particular kind of process
cue, the pensive cue. As the client is working on, or describing one event,
another and often earlier one suddenly comes to their mind. They may ignore
it unless you spot its arrival via the pensive cue - the slight pause and
sudden reflective look. Unlike scanning (above) which is directed association
along an explicitly identified chain of distress-linked events, this is
free association along a chain or down the pile of interlinked chains.
This may lead to a primary working area for the session.
19. Dreams. One useful way of leading your
client, is to inquire about their recent dreams, or about repetitive nightmares.
You can work with these just as you would with a real life incident: literal
description, psychodrama, shifting level, free association, and so on.
You can also invite your client - in order to grasp how the dream symbolises
the relation between different parts of their psyche - to become each main
item or person in the dream in turn, and to let each one speak to the others
and say what it wants. Pick up the accompanying process cues.
20. Quick asides. Sometimes associated material
comes up as a quick aside, which is something the client says that seems
to lie a bit outside the mainstream of what they are talking about. They
also tend to sweep on past it as if it were not important. You pick up
on the aside and invite them to go into it, associate to it, and so on.
This is invariably fruitful, but you will need a little persistence, if
the client is defensively impatient and wanting to get on with their surface
theme.
21. Lyrical content. When the client mentions
recall of a poem, a piece of music or a song, you invite them to recite
it, hum it or sing it. This can be powerfully cathartic and full of associated
material.
22. Catching the thought. Again, though it
is evidenced by a pensive cue, it is the content that is important. As
the client is working - describing an incident, doing a psychodrama, during
a pause in catharsis - a sudden thought comes to them, and they have switched
briefly to the cognitive mode - some re-appraisal of an event, insight
into its effects, re-evaluation of its meaning. The pensive cue alerts
you to invite them to verbalise all this. This fully expressed re-structuring
of awareness is the real fruit of the catharsis, not just the release itself.
23. Integration of learning. After a major
piece of cathartic work that has generated a good deal of insight and re-evaluation,
you prompt the client to formulate clearly all they have learnt, and to
affirm its application to new attitudes of mind, new goals and new behaviours
in their life now. At this point cathartic work finds its true raison d'etre.
Working with process. This means working
with how the client is talking and being, that is, with tone and charge
and volume of voice, with breathing, use of eyes, facial expression, gesture,
posture, movement. Here, again, I emphasise training and supervised practice.
24. Repetition with amplification and/or contradiction.
The client can never totally deny or contain their distress. It continually
has brief outcrops in the surface texture of their behaviour, as if it
is always struggling to get out, however defensively unaware of it they
have had to become. And it also has a more constant grip on some of the
muscular mechanisms of their behaviour and bodily being. There are four
classes of cues that they can repeat, amplify and/or contradict.
24.1. Distress-charged words and phrases. You
pick up on these words or phrases not because of their meaning but because
of their emotional charge. Indeed the meaning may sometimes seem quite
irrelevant to the work in hand. And you must distinguish between a normal
expressive emphasis and a distress charge. It is words with the latter
that you invite the person to repeat, perhaps several times, and perhaps
louder, and even much louder. This repetition and amplification may start
to discharge the underlying the distress. Or it will bring it nearer the
surface and loosen up associated material - so you watch for pensive cues.
Particularly potent at the heart of a psychodrama, when the individual
is expressing the hitherto unexpressed to some central other protagonist
from their past.
24.2. Distress-charged mobility. While the
client is talking, and unnoticed by them, their underlying distress starts
to move some part of their body: the feet and legs start a kicking or jerking
motion; the hands and arms start a small stabbing, slapping, thumping,
scratching, twitching or wringing motion; the pelvis and thighs start a
small bouncing or rotating movement; the trunk, head and neck start swaying,
bending, rotating; the head starts shaking or nodding; there is a sudden
deepening of the breath.
-
You pick up on this mobility and invite the person
to develop it and amplify it and follow it into the underlying feeling.
When the exaggeration is well under way, ask them to find the sounds and
words that go with the movement. This can rapidly undercut more superficial
content they are busy with and precipitate earlier, more basic and even
primal material. The effect is particularly powerful when you encourage
your client to develop a sudden involuntary deepening of the breath into
quite rapid deep breathing into the emerging feeling, with an accompanying
crescendo of sound.
-
Picking up on distress-charged words and movements
needs to be light and deft, with only a brief time gap between the cue
and the intervention. The beginner's error is to have too big a time gap,
and then to ask the client why they produced that bit of movement or said
that word in that tone. 'Why?' questions like this are fatal: they inappropriately
throw the client into the analytic mode, and interrupt the emerging energy
of the distress, which will soon reveal itself and what it is about if
the person is simply encouraged to get into action.
-
So for bits of distress-charged movement, the
sequence is: get the action well exaggerated and energized, then find the
sound that goes with the movements, then the words. Later on in the pauses
invite the person to identify the context: who are they saying this to,
what situation from their past are they re-enacting.
24.3. Distress-charged rigidity. The underlying
distress temporarily locks some part of the client's body into a rigid
state: the breathing becomes tight, restricted and shallow; the legs are
rigid, the muscles locked; the thighs close tightly together; the arms
are held tight to the sides of the body, or crossed tightly; the fists
are tightly clenched, the arms rigid; the hands are firmly clasped; one
hand or both hands tightly hold the head, or cover the eyes, or have fingers
pressed over the mouth; head, neck and trunk lock together in one rigid
posture; etc.
-
Again, you invite the client to exaggerate the
rigidity, get the distress energy right into it, then maybe find some sounds
and words that articulate it, then identify its context. At any point the
rigidity may break up into mobile catharsis. Or you may encourage them,
after some time in the exaggerated rigidity, to put energy into the opposite
mobility, finding appropriate sounds and words - and this may loosen up
the discharge. So a tight fist and rigid arm is first exaggerated into
even greater tension, then converted into rapid thumping on a pillow. You
will need to encourage you client not to throttle back the sound, and behind
that the long-repressed words.
-
Whether the body cues are mobile or rigid, they
may either match the content of what the person is saying, or they may
mismatch it. So a clenched fist may accompany a statement of being irritated
with someone, or a statement about having had a wonderful time with someone.
In either case, amplify the body cue, then find the words within the action.
In the case of a mismatch, experience shows that the body cue rather than
the statement is telling the truth of the matter.
24.4. Chronic archaic-defensive cues. Cues in
the previous three entries are intermittent: they crop up in and among
the content of what the client is saying, they come and go, sometimes at
a great rate of knots. But there is a class of process cue that is permanent,
chronically entrenched in the client's behaviour. The class includes three
species.
24.4.1. Chronic archaic-defensive tone of voice.
The client persistently talks, whatever the content, with a tone of voice
that pleads or complains or whines or self-effaces (this one may lower
the volume too) or distances or irritates. The locked-in childhood distress
is acted out through the tone and perhaps also the volume. This may extend
into the chronic use of speech redundancies such as 'ums' and 'ers', 'you
knows' and 'you sees', and stutters.)
24.4.2. Chronic archaic-defensive posture and/or
gait. The client stands or walks in terms of permanently distressed adaptation
to an early oppressive environment - the stance or walk is embarrassed,
self-deprecating, mincing, cautious, ready for flight, defiant, or stubborn,
or whatever other emotional posture the child adopted to survive.
-
As before, you can invite the person to exaggerate
the tone (24.4.1), or posture or gait (24.4.2), get energy into it, then
find out what it seems to be saying, and to whom and in what context -
which will lead over into a psychodrama with more process work and, of
course, catharsis. Or once amplified, the rigidity can be contradicted,
and the contradiction, or opposite behaviour, can be amplified and worked
with.
24.4.3. A third type of chronic archaic-defensive
cue is more covert. It's a rigidity of muscular tone, or a rigidity that
afflicts the free and full use of a group of muscles, anywhere in the body.
It's what Reich called character armour. It's a more subtle, not so obvious,
psychosomatic rigidity: it may be evident in defensive posture and gait,
but only to the trained eye. Its purpose is primarily to maintain a constant
inhibition of the physical expression of strong pockets of repressed grief,
fear and anger. Again, you can propose that the client physically amplify
and/or physically contradict this type of rigidity.
-
To amplify, they can be invited to adopt a stress
position, that is, to put a muscle group into sustained contraction, until
the physical discomfort of doing so is strongly felt. If they go into the
physical pain with deep breathing and sound, it may implode with catharsis
of the underlying emotional pain.
-
To contradict, they can be invited to hyperventilate,
that is, to breathe deeply and vigorously with sound on the outbreath;
to kick and thrash the legs, to thrash the arms, to thrash the pelvis,
shake the head, all this with sound and when lying down on a mattress;
to squat and pound pillows with the fists vigorously, with sound; to stand
and tremble the whole body and jaw, with sound; and so on.
-
This activity needs to be sustained, and to get
to the right frequency of vigour. It may then become strongly cathartic,
or loosen up images and material that can be worked with in other ways.
This can be used as a kind of gymnastic retraining for catharsis, re-establishing
muscular and behavioural pathways for the release of distress.
25. Acting into. This is just a special case of
physical contradiction. The client is already feeling the distress, wants
to discharge it, but is held back by conditioned muscular tension. You
suggest they act into the feeling, that is, creates a muscular pathway
for it, by vigorous pounding for anger, or trembling for fear. If they
produce the movements and sound artificially, then very often real catharsis
will take over.
26. Hyperventilation. Already mentioned, under
(24.4.3) just above, hyper-ventilation requires a special reference. It
is a rapid breathing which becomes defensive if it is excessively fast
or too slow. There is a frequency which opens up the emotionality of the
whole psycho-physical system, if it is sustained long enough. It can be
used to lead the client into discharge from scratch, by working on basic
character armour. Or it can be used to follow a mobile body cue, especially
a sudden deepening of the breath. To prevent tetany and excessive dizziness,
have the client do it in many cycles, with pauses in-between. When carried
on for a sufficient period of time, this is a very direct and powerful
route to primal and perinatal experiences, which may also be interwoven
with transpersonal encounters.
27. Physical pressure. When the client is just
struggling to get discharge going, or has just started it, or is in the
middle of it, you can facilitate release by applying appropriate degrees
of pressure to various parts of the body: pressure on the abdomen, midriff
or thorax, timed with the outbreath; pressure on the masseter muscle, some
of the intercostals, the trapezius, the infraspinatus; pressure on the
upper and mid-dorsal vertebrae timed with the outbreath, to deepen the
release in sobs; pressure against the soles of the feet and up the legs
to precipitate kicking; extending the thoracic spine over the practitioner's
knee, timed with the outbreath, to deepen the release of primal grief and
screaming; and so on. The pressure is firm and deep, but very sensitively
timed to fit and facilitate the client's process. Anything ham-fisted and
unaware of what their energy is doing, is intrusive. Handle with care and
skill.
28. Physical extension. As the client is moving
in and out of the discharge process, you can facilitate the release by
gently extending the fingers, if they curl up defensively; or by gently
extending the arms; or by drawing the arms out and away from the sides
of the body; or by extending an arm while pressing the shoulder back; or
by gently raising the head, or uncurling the trunk; and so on. All these
extensions are gentle and gradual, so that the person can yield and go
with them.
29. Surrender posture. Sometimes the full release
of grief needs a surrender posture. If the client is kneeling, and grief
is on the way up and out, gently guide their trunk forward until their
head rests on a cushion on the floor, arms out to the side, palms facing
up to either side of the head, fingers unfurled. After the intense sobbing
subsides, raise the person gently up again to catch some thoughts and insights;
then down onto the cushion again when another wave of grief comes through.
30. Vertical and horizontal. When doing body
work with your client, start with standing positions, and as the process
cues emerge, shift directly to work lying down. A well-timed change from
the vertical to the horizontal can facilitate catharsis.
31. Relaxation and light massage. This is an
alternative mode of contradicting physical rigidity. You relax the client
and give gentle, caressing massage to rigid areas. Catharsis and/or memory
recall may occur as muscle groups give way to the massage.
32. Relaxation and self-release. This is yet
another way of undoing physical rigidities that lock in distress. You relax
the client and invite them to 'listen' for movement micro-cues within their
muscles in every part of their body. The micro-cue is a continuous buried
impulse to move against the distress-charged rigidity. It is normally blocked
and suppressed by the rigidity. But they amplify the micro-cues and start
gently to stir and move their body (and perhaps their voice) in unfamiliar
ways, until they break right out of the rigidity into catharsis.
33. Physical holding. You reach out lightly
to hold and embrace the client at the start, or just before the start,
of the release of grief in tears. This can greatly facilitate the intensity
of sobbing. Can be combined with aware pressure on their upper dorsal vertebrae
at the start of each outbreath. Holding their hands at certain points may
facilitate discharge. When discharging fear, they can stand within your
embrace, and your fingertips apply light pressure on either side of their
spine.
34. Pursuing the eyes. By avoiding eye contact
with you, the client is often also at the same time avoiding the distress
feelings. You gently pursue their eyes by peering up from under their lowered
head. Re-establishing eye contact may precipitate or continue catharsis.
35. Regression positions. When process cues
suggest birth or pre-natal material, you can invite the client to assume
pre-natal or birth postures, start deep and quite rapid breathing and wait
for the primal experiences to re-run themselves. May lead into deep and
sustained cathartic work in the primal mode. If so, you need to keep leading
them to identify the context, to verbalize insights, and at the end to
integrate the learning into their current attitudes and life-style. Regression
positions may be less ambitious like lying in the cot, sitting on the potty,
sucking a thumb.
36. Seeking the context. When the client is
deeply immersed in process work and in catharsis, you may judge it fitting
to lead them into the associated cognitive mode, asking them to identify
and describe the event and its context, to verbalize insights, to make
connections with present-time situations and attitudes.
37. Holding up a mirror. You can lightly precipitate
the discharge of embarrassment in laughter by mimicking, with loving, not
malicious, attention the various self-deprecating and self-effacing behavioural
cues the client is producing. If followed through deftly, with both content
and process, may pave the way for much deeper catharsis.
38. Use of water. All these varieties of process
work may usefully be done when the client is immersed in water, or lying
on a waterbed. The stimulus of water may precipitate pre-natal and birth
material.
39. Psychotropic drugs. Mescalin, LSD, can
be powerful abreactive drugs if the client is properly facilitated when
under their influence. See Grof's classic work Realms of the Human Unconscious
(Grof, 1976).
40. Transpersonal process cue. Sometimes the
client spontaneously assumes a posture or makes a gesture that has transpersonal
significance, like one of the consciousness-changing postures in oriental
yogas. You can ask them to repeat it, stay with it and develop it, maybe
finding the words that go with it. This may generate a good deal of insight
and be incidentally cathartic. It may also be the start of transmutative
work (see Chapter 8).
41. Ending a session. At the end of a cathartic
session, it is necessary for you to bring the client back up out of their
cathartic regression into present time, by chronological progression at
intervals of 5 or 10 years, by affirming positive directions for current
living, by describing the immediate environment, by looking forward to
the next few days, etc.
Part II
By intensive or non-permissive counselling, I mean the kind of counselling
of the client that picks up every relevant cue and hones in precisely on
accessible distress material the client may tend to shy away from. It is
the sort of counselling the teacher uses with beginners when working with
a client in front of the group, since the client is not yet in a position
to be effectively self-directing. It is also an important option open to
experienced co-counsellors at the request of the client to help the client
deal with chronic patterns and occluded or avoided material. Intensive
counselling has the following features - which overlap and interact:
-
It enables the client to get attention out, get ready for work.
-
It picks up relevant verbal and non-verbal cues in the client and converts
them into suggestions for client work.
-
It enables the client to get right into distress material and stay with
it, to hold a direction discharging uncomfortable distress feeling, to
go back in again.
-
It enables the client to shift level, to cut from the superficial presenting
restimulation to its genesis in early material.
-
It enables the client to catch and verbalise sudden thoughts and insights,
to re-evaluate past events, to express understanding of how past trauma
and present problems have been interlocked.
-
It enables the client to appreciate, celebrate, delight in her being.
It enables the client to action-plan for sensitive, rational, distress-free
living now and in the future.
-
It enables the client to come back into present time, away from distress.
-
It has certain primary qualities, outlined below.
What follows is a sample of verbal behaviour analysis of typical sorts
of counsellor interventions under each of the above headings. This sort
of analysis is in many ways misleading. Bunching the verbal behaviours
under the different headings gives no idea of how a real sequence of counsellor
interventions will move around creatively among the different headings.
Again, the form of words to be chosen for any one intervention has many
subtle variations: there are many different ways of expressing the same
basic intervention. The analysis can give absolutely no indication of the
great importance of timing and tone of voice. Headings 1 - 4 all interweave
and overlap in practice. Despite all this, experienced co-counsellors have
found it useful to do this kind of behaviour analysis as a backdrop to
practical training in intensive counselling. I am indebted to participants
in several recent advanced co-counselling and teacher training workshops
for help in compiling the following.
1. Enabling the client to get attention out, get ready for work
-
"Describe my face ... the room ... what you can see out of the window ..."
-
"Describe your journey here ..."
-
"Do some celebratory movement (OR body shake with sound release OR some
meditation exercises OR relaxation and reverie) ..."
-
"What did you have for breakfast ..."
-
"What good experiences have you had over the past week ..."
-
"What would you like to celebrate about yourself today ..."
-
"Describe some pleasant places you know ..."
-
"What are for you the simple pleasures of life ..."
-
"Tell me about some minor, trivial upsets over the last few days ..."
2. Picking up verbal and non-verbal cues
-
"Say that again ... and again ... louder ..."
-
"Say again ..."
-
"Repeat that slip of the tongue ... and again ... louder ..."
-
Echo the client's word/phrase/statement and give free attention.
-
"Say that without qualifications ..."
-
"Try saying '...' (give contradiction, qualification-free statement) ...lightly
and brightly ... with your arms out ... and add a 'Hurrah' on the end ..."
-
"Try contradicting that ..."
-
"Repeat that in the first person singular 'I ...'"
-
"Say it directly to him 'You ...'"
-
"Say just one word to him ... What's the one word you need to say to him
..."
-
"What's the statement behind your question ...?"
-
"Say that again and change 'Have to ...' to 'Choose to ...'"
-
"Say that again and change 'Can't ...' to 'Won't ...'"
-
"What movement goes with what you have just said ..."
-
"Express that non-verbally ..."
-
"What are you thinking ... What's the thought ..."
-
Just look at and give attention to the client's gestures, movements, postures.
-
Mimic the client's non-verbal patterns.
-
"Exaggerate that movement (gesture, posture, facial expression) ...Let
it go ...What sound goes with it ?...What is it saying? ... To whom? ...
What have you got in your hand? ... What's your hand doing? (etc)"
-
"Try contradicting that movement (gesture, posture, facial expression)
..."
-
Offer client a non-verbal contradiction: "Try this (movement, posture,
etc)"
-
"Stay with that breathing ...deepen it...faster...let sound come with the
out-breath..." (See also below).
3. Enabling the client to get right into material and stay with it
-
"Describe the scene in the present tense and in the first person ...What's
happening in it ?...What are people saying and doing?... What are the sights,
sounds, smells?..."
-
"Describe the scene again ...Go over it all again ..."
-
"Enter the scene, imagine you are in it now ...What do you really need
to say to X that you didn't say at the time, that express the feelings
cut off and denied at the time ?...Speak to X directly as if he is here
... and again ...louder ..."
-
"Try saying '...' to X". Offer a statement based on client cues.
-
"Stay with that feeling... Accept it ...Own it ...Work with it ..."
-
"Try saying '...'" Give the client a self-acceptance statement that affirms
the hurt child within, the distress feeling, the frozen need, e.g. 'Daddy,
I'm ten years old and I need your love'.
-
"Act into that feeling ..." E.g. of anger, fear; show the client how. The
client may need an anger training session to help loosen up repressive
controls on sound and movement.
-
"Imagine you are killing off X ... Act into it ... " Counsellor does negative
accommodation to elicit primitive rage: agonise on the floor and time screams
to coincide with client blows on the cushion. Encourage client to stay
with it until the rage is really out.
-
Give the client a powerful well-aimed anti-chronic pattern direction, and
keep bringing her back to it. In general, when the client is using a verbal
direction, movements, or a statement to some key figure, and this is producing
copious discharge, keep bringing the client back to it again and again
- as long as it works - so that she doesn't veer away from it and close
up prematurely.
-
Use physical interventions to symbolise client statements about psychological
pressure or social pressure: so that the client can get more readily into
the psychosomatic reactions to such pressure. So press on shoulders when
the client is working on "Get off my back ..." with respect to old oppressive
authority.
-
Use other members of the group to create psychodramas which either recreate
the bad scene, or enable the child within to fulfil a frozen need, to do
now what in the repressive past was never allowed. Both can aid catharsis.
-
"Loosen up your breathing, let your breathing go, release the restriction
..."
-
"Stay with that breathing ...let it develop ...let it go ...a little faster
...find the sound on the out breath ...louder ...". The skilled body work
counsellor can combine this with physical interventions. Encourage the
client to stay with, go back into, start over again, these physical processes
as long as they produce copious discharge. Working with the breath will
often produce a shift of level. So this is also part of the next category.
4. Enabling the client to shift level, to get to key early experiences
-
"What's your earliest available memory of that type of situation?..." When
the client is talking about some current problem.
-
"Scan over your life from the beginning and pick up instances of that type
of situation ..."
When the client is talking about a current problem or pattern, invite
her to use the regression with reverie technique to get down to its early
genesis.
-
"Try having a phantasy about it ... Imagine freely what is going on ...".
This for some inaccessible occluded event the client wants to work on.
She may suspect it occurred, or have positive information from others that
it occurred, but cannot recall it.
-
"Who are you really saying that to ?.. First thought ...". When
the client is discharging on some statement she is making to someone in
psychodrama about some situation in her adult life.
-
"Who are you doing that to?... First thought ...". When the client is exaggerating
and acting into some non-verbal cue (movement, gesture, etc) you have picked
up, while she was talking about some adult life situation.
-
Invite the client, at the appropriate moment, to do active body work: to
hyperventilate, let out the sound, thrash the limbs, the head - on a mattress,
extended over a stool, standing. This will often precipitate early distress.
Can be combined with physical interventions from a skilled body work counsellor.
-
Invite the client to lie down, relax, enter reverie and verbalise, then
counsellor applies massage, from light and gentle to deeper and more probing
as material starts to surface out of the reverie.
-
Invite the client to use regression positions: thumb sucking, on the potty,
in the cot with knees up and thighs open, at the breast, lying curled up
dependent in mother's arms, and so on.
-
Invite the client, at the appropriate time, to do birth work, re-enact
birth. Then follow through into infancy and childhood. You can start with
a current life problem of the client, invite her to trace instances of
that problem backwards through time to early childhood, then re-enact birth,
and see the problem echoed in the birth-script. Or re-enact birth, and
bring the client forward at five or ten year intervals, picking up memories
of life situations that echo the birth-script.
5. Enabling the client to catch and verbalise thoughts and insights
-
"What's on top? ... What's coming up?... What do you want to work on ?..."
-
"What are you thinking? ... What's the thought? ..." A fundamental intervention
for all those innumerable moments when little behavioural cues show that
a sudden thought, awareness, insight, memory, re-evaluation, has arisen
in the client.
-
"First thought ..." Another fundamental intervention, to be used after
many questions put to the client.
"Who are you really saying that to ?... First thought ..."
-
"What incidents/associations are coming to mind about that? ..."
-
"What are your early memories of that? ..."
"What are you realising about then and now?..."
-
"How did you 'choose' to survive then? ... Is that 'choice' still with
you? ..."
-
"What scripting did you pick up from that experience? ..."
-
"Scan over your life for instances of acting out that script"
6. Enabling the client to celebrate herself
-
"What would you like to say/celebrate/appreciate about the real you"
-
"Say it to them ... into their eyes ...". Indicate the other group members.
-
"Say '...'". Give the client a celebratory statement.
-
Validate and appreciate the client.
-
Invite members of the group to validate and appreciate the client.
-
Invite the client to celebrate herself in movement.
7. Enabling the client to action-plan for rational living
-
"What's your immediate plan to step outside that pattern/compulsion/piece
of scripting? ..."
-
"What's your rational choice about it ?... When you think clearly about
it, outside old distress and old scripting, what plan do you come up with
?..."
-
"What intelligent plan makes the fear rattle and shake within you ?..."
-
"What risks are you going to take about it ?..."
-
"How are you going to give more expression to the real you over the next
few days and weeks? ..."
-
"What joyful activities are you going to introduce into your life ?..."
-
"How are you planning to make your life a celebration? ..."
8. Enabling the client to come back into present time, away from distress
-
As in 6. above on celebration. But also:
-
"Describe that Kleenex box/vase of flowers/picture on the wall ..."
-
"What can you see around you? ... Outside the window ?..."
-
"What can you hear right now ?..."
-
"What are some of your favourite foods/flowers/music ?..."
"What are you looking forward to doing over the next few days? ..."
-
"Run through the twelve times table backwards ... What is thirteen times
seventeen? ..."
-
"Are you here, back in present time? ..."
Finally here are what seem to me to be some of the primary qualities
of really effective intensive counselling
-
Timing. The interventions move swiftly, surely, right on the mark,
entering the chink in the armour just at the right moment. Sometimes they
work with immediate client cues. Sometimes they seem to come out of the
blue. Timing is of the essence.
-
Deftness. The interventions are light, elegant, quick, with nothing
lugubrious and heavy about them.
-
Non-attachment. The counsellor isn't attached to her interventions,
doesn't feel possessive about them, doesn't feel they must work, that the
client must respond to them. They are given away freely, without attachment.
The counsellor rejoices when they work, doesn't worry when they don't.
-
Trial, success and error. If one thing doesn't work, the counsellor
quickly tries something else. The counsellor has no certain knowledge about
what is going on in the client, what the client needs. From the client,
there are hints, clues, signs. In the counsellor there are theoretical
presuppositions, guesses, conjectures, tentative hypotheses, generalisations
based on prior experience. Trial, success and error bridge the gap. The
counsellor tries something out. Sometimes it works, sometimes it doesn't.
-
Midwifery. The counsellor is helping give birth to an autonomous
being. It is liberation work: launching a person into intelligent and sensitive
self-direction. Client autonomy is paramount. Intensive counselling is
helping from without a person who is struggling from within to loosen the
chains. The client is never crowded, pushed or rushed in her work.
-
Caring. The client, the true person, gives birth to himself in response
to being loved, cared for, deeply respected.
-
Free attention/empathy. The counsellor is tuned in to where the
client is coming from; has an imaginative grasp of the total gesture of
the client' being in space and time; has a global sense of how he construes
and responds to his world both at the conscious and the unconscious levels.
-
Acceptance. In one way or another the counsellor accepts, doesn't
negate, deny, repress, invalidate, the feelings of the client.
-
Transcendence. The counsellor is always outside the client's compulsive,
distressed estimate of his own distress, difficulties and problems. For
every piece of compulsive misery and heaviness and self-deprecation, she
has a surprisingly light, elegant direction instantly on offer.
-
Firmness. The counsellor holds gently but uncompromisingly to interventions
that hone in on core material. She never lets go of them prematurely, but
enables the client to stay with it, and hang in there for the full period
of unloading.
Copyright John Heron, November 1998
South Pacific Centre for Human Inquiry
11 Bald Hill Road, R.D.1 Kaukapakapa, Auckland 1250, New Zealand
email:jheron@human-inquiry.com,
jnheron@xtra.co.nz
www.human-inquiry.com
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