Foundations of Christian Counseling: Client Expectations

Introduction

When clients decide to enter counseling, the task of finding a counselor is a daunting one. When searching websites or online directories, it can feel like a crapshoot. If you make the choice to enter counseling with me, a Licensed Professional Counselor, who practices from a Christian perspective, what might you expect? And as importantly, what are some specifics you should think about when choosing a counselor?

Christian Counseling

I presume that if you choose to work with me, then you are most likely seeking a counselor who works from a Christian perspective. My claim to be a Christian counselor, however, does not in-and-of-itself clarify everything clients might want to know. I hold a Reformed Orthodox view of Christianity, so I’m neither Catholic nor Neo-Orthodox in my Christian beliefs. I believe the Bible is the inerrant Word of God, and that salvation comes through faith alone in Jesus Christ. That means from a counseling perspective, I will draw heavily on Biblical principles as we work through any concerns you bring into counseling. I will want to explore your own understanding of your faith and how much of a role it plays in your life. In addition I will want to understand how you size up your personal relationship with God. There are certain premises I hold if counseling from a Christian perspective is to progress as it should.

Some Basic Premises

I believe that every concern and struggle we face as part of the human condition has something to say about our relationship to God. Moreover, our struggles in life can be addressed through our relationship to God. This does not mean that because we encounter problems in life there is ipso facto something wrong with our relationship to God. It does mean that we have to look to God to see what he is trying to tell us while we are in the midst of our struggles. Many times clients simply want problems resolved quickly, that is fixed. From a Christian perspective, everything we face has meaning and a purpose to it. A Christian approach to counseling does not make light or minimize your struggles and pain. It seeks to place such experiences in proper perspective.

We all engage life with a set of beliefs and values. Hence, working with me as a counselor means we will explore what beliefs an values you hold, particularly as they surface in relation to the concerns you bring to counseling. Individuals tend to be more or less aware of the beliefs and values they hold until they encounter difficulties in life. Clarifying one’s foundational beliefs and core values can help one understand why one acts or reacts the way one does when faced with life’s challenges

From a Christian perspective, exploration of one’s core set of beliefs and values must take place in light of one’s faith and relationship with God. I believe the more fully and more deeply we develop our relationship with God, the better perspective we will have on life and how to engage both its blessings and struggles. What I hope that a Christian perspective to counseling provides for people is Biblical knowledge that they can use to face any kind of difficulties and struggles that life throws at them.

Questions Clients Should Ask

How do I know if we will work good together?

This question revolves around the therapeutic relationship and the therapist-client fit. It is a question that all clients should consider. I offer all clients a free consultation for the first session. Although it’s no guarantee, it gives clients an opportunity to know me, see how I work, and a glimpse into how our work together will proceed. Each therapist and client has his or her worldview that will shape the way work proceeds from session to session. As a counselor who works from a Christian perspective, I let my worldview be known upfront. Hence I hope clients seek me out because they want to work with a therapist who holds such a worldview. In the first meeting both I and prospective clients can get a good sense as to how well we might work together. If a particular client decides that working with me is not a good fit for him or her, I can gladly offer referrals for other counselors if the client wants that information.

Are you simply emphasizing Biblical knowledge and theology while making the concerns I bring into counseling of secondary and tertiary importance?

Absolutely not. This is an excellent question and one that clients should ask of all therapists, regardless of their Spiritual or philosophical worldview. Clients’ presenting concerns are always front-and-center to our working together. Clients have the right to know what worldview I hold and how I understand the human condition and the struggles and difficulties human beings encounter in life. I will not set aside my worldview anymore than I would ask clients to set aside theirs.

Are you merely trying to proselytize clients to the Christian faith or to a particular brand of theology?

The square answer to this question is no. As a professional counselor, I’m here to help people work through the life struggles they bring into the counseling office. Because this question surfaces at times is the reason that I put forward my worldview upfront. People should know that in contacting me they are approaching a counselor who is a Christian, and that my worldview does inform and frame the way I work. I’m neither trying to play tricks on people nor am I trying to smuggle my worldview into the backdoor to spring it on anyone. If clients want to understand more about my faith, they are free to ask, and we can have that discussion if clients so wish.

How do you see Christianity as a way to help me with the concerns I bring to counseling?

That question calls for entire blog post, essay, or even a book length discussion in-and-of-itself. I believe in my core that the struggles we face in life unfold in God’s providential control over our lives. The problems we encounter, the pains we experience, and the difficulties that come our way can all be worked through by developing our relationship with God in a manner that helps us know him more fully and more deeply. Rather than discounting our concerns, a Christian perspective not only views an individual’s problems and pain as real, but it also provides a way to put our lives before God into proper perspective. I make no bones about it, a Christian perspective to counseling is a Spiritual approach.

What about clients who are not Christian?

I work with clients who hold various worldviews. Again they should know where I’m coming from as a Christian, but our work together will take on a more secular tone given that I want to try to meet them where they are in their life journey. If clients who are not Christians want to discuss my faith and beliefs, then as previously stated, I’ll most definitely have that conversation with them, as well as offering them referrals to others with whom they can explore the Christian faith.

I’m a Christian, but what if I don’t agree with your theology?

No two individuals agree on everything. As in any counseling approach, we will discuss in the process of therapy any therapeutic impasses or ruptures that occur while we’re working together. I highly encourage clients to be open about what they like and do not like about our sessions together. Disagreements are not only welcomed, but highly encouraged because such work is part and parcel of the counseling process.

Conclusion

This short blog barely scratches the surface of not only what counseling entails, but also in particular what a Christian perspective to counseling will entail. Along that thematic line, I have future plans to author some blogs that are titled Foundations to Christian Counseling, each blog with a different subtitle that focuses on a theme described in the subtitle. For example, this specific blog addresses client expectations. I hope through this series of articles to more fully explicate what a Christian approach to counseling involves.

John V. Jones, Jr, Ph.D., LPC-S/April 14th, 2021

PROFESSIONAL COUNSELING

Group Therapy for Social Anxiety

Introduction

Anxiety disorders are common among the population. When the various types of anxiety disorders are taken all together, they represent one of the largest reasons that people enter therapy. For those counselors who work in a private practice or agency setting, they will most likely deal with clients who experience various types of anxiety disorders, better described as phobias.

Although there are a variety of strategies for treating anxiety disorders, the primary way in which phobias are treated in counseling situations is through what is called exposure treatments. Individuals are directly exposed to, that is must encounter, the phobic situation that leads to their severe anxious responses, responses that can and often do entail panic attacks. For example, if a person has a severe phobia regarding dogs, then therapy will involve helping the individual be in the close proximity of a dog, even to the point of developing the ability to pet a dog. The best way for individuals to conquer severe phobias of elevators is simply to get on an elevator and ride it up and down over and over again.

Because therapy entails supporting individuals to physically engage that which causes their phobic reactions, such treatments are called exposure. Individuals expose themselves to that which they fear the most. The basic premise of exposure treatment is that once people are in the presence of the feared phobic object or situation, they can learn to stay in its presence, seeing that what they fear the most will not occur. While being exposed to phobic stimuli, individuals who experience anxiety disorders will be asked not to utilize compensatory and avoidance strategies that they normally use to curb their anxiety. The longer they can stay in the presence of the object or contexts that lead to their phobic reactions, they will see that their anxiety will begin to dissipate because what they catastrophize about the phobic situation does not come true.

Research results indicate that exposure treatments for phobias are highly effective. In fact, in most cases, unless people engage such exposure treatments, they rarely will overcome their phobias to the point that they can better function in the presence of what leads to their fears. It is not that some people cannot overcome their anxieties apart from exposure treatment. It is just highly doubtful that they can. Even if they do, it takes a much longer time to overcome such fears, and the relapses tend to be quicker and more numerous where exposure treatment is not used.

Social Anxiety

Social anxiety, also called social phobia, has at its roots the fear of negative evaluation by others. To some extent, most of us have experienced the fear of negative evaluation in social settings, but for individuals who struggle with social anxiety, the fear of negative evaluation reaches the extent that their functioning becomes severely impaired. For example, individuals will avoid and cease attending situations that involve social gatherings, especially social situations in which they do not know most of the people present. They may enter a social situation but stay close to a friend or friends whom they know, and then hang out on the perimeters of the social context so as to avoid interacting with people whom they don’t know. Such avoidance strategies are called compensatory strategies because they allow individuals to find ways to curtail their anxieties. While curtailing anxiety is not necessarily a bad thing, compensatory strategies prevent individuals from engaging experiences that they would prefer to engage. The ultimate compensatory strategy for social anxiety is when individuals consistently turn down social invitations, thereby avoiding social interaction all together.

The problem with such strategies is that many people do not feel good about turning down social invitations. It is something that they would actually prefer to do if they weren’t so anxious about the social contexts they must engage. The aim of therapy for social anxiety is not to turn people into party animals where they are the life of the party. The goal of such work is simply to help clients reach their own comfort levels, deciding to what degree they want to become more relaxed in social outings.

Many times social anxiety is cast in the discussion of introversion and extraversion. Nothing could be further from the truth. Introversion and extraversion have nothing to do with social anxiety. There is nothing wrong with being an introvert, irrespective of how our society highly regards extraversion. The aim of therapy is not to help one evolve from being an introvert to and extravert. Introverts as well as extraverts can function comfortably in social situations. The aim of therapy is to help individuals become more comfortable in social gatherings where their anxiety and compensatory strategies have become pronounced. Socially anxious people simply want to develop the ability to walk into social gatherings without being hampered by anxiety. They want to experience the comfort of meeting people they don’t know in social contexts. They may want to introduce themselves to people, network at parties and other social contexts, or carry on simple conversations at social gatherings.

Fear of Negative Evaluation

As stated above, the root fear of those who experience social anxiety is the fear of negative evaluation. From a cognitive behavioral perspective, people hold beliefs about what they fear will occur in social contexts. Socially anxious people state their fears in several ways, which help therapists get at their thinking related to social contexts. One client may say, people will think I’m weird somehow. Another client might say, people will think I’m unattractive. Still others believe such things as people will think I look funny – sound funny – dress funny – etc. Therapists hear clients say things like I will feel like a fool trying to carry on a conversation, especially with someone I don’t know. Others might say: I don’t like meeting people; I don’t like parties; I don’t enjoy introducing myself to people I don’t know.  Again, there is nothing wrong with these statements and actions in-and-of-themselves. If people prefer not to meet others, if they don’t like parties, and if they don’t care about turning down invitations to social events, then that’s fine. Individuals, however, come to therapy because they believe their anxiety regarding social situations is over the top. Due to their fears, they can’t do the things they would prefer to engage. They may desire to make new friends, date different people, and talk more to individuals they don’t know that well at social gatherings. Hence, they want to make some changes that can help them become more comfortable in social contexts.

Researchers have developed several Fear of Negative Evaluation (FNE) scales that therapists can use with clients who experience social anxiety. Most of these scales contain statements that clients can rate on a Likert-like measurement. For example, clients can rate from 1 to 5 with one meaning not at all and 5 meaning highly true, the statement I am extremely sensitive to what people think about me. Rather than creating some major quantitative data, these scales can be used qualitatively to generate conversations between therapists and clients. Through these conversations, therapists can obtain a good grasp of how their clients function in social settings. Additionally therapists can learn how their clients utilize avoidance and compensatory strategies when it comes to social engagements.

Clients’ beliefs about social contexts and the compensatory strategies they use  to avoid such settings are the very things that must be challenged via exposure treatment. The question becomes: how is exposure treatment best done for those who experience social anxiety?

Group Therapy for Social Anxiety

Group Design for Working with Clients Who Experience Social Anxiety

There are several pathways to help clients face their anxieties about social situations. As part of their therapy counselors can ask them to attend meet-up groups, social gatherings, office parties, and any social context where there will be people clients do not know. Therapists and clients can agree on homework assignments in which clients take on the tasks of introducing themselves to people they don’t know. If clients are in classroom situations, they can agree to speak up in class a specified number of times. Such social arrangements are useful but can be difficult to control, monitor, and structure so that the client gets optimal benefit from taking on the task.

One of the major tools used in working with individuals who experience social anxiety is group therapy. The group setting itself creates a built-in form of exposure for clients. Groups can be structured along several lines. They can be non-specific encounter groups that comprise some members who experience social anxiety and other members who do not have such concerns. Such a group is representative of most social settings clients will enter.

Group settings where all members experience social anxiety is another form of group therapy. I believe that for those clients who have never experienced group work, these specified groups are a good entrance point into this kind of work. Group meetings should be weekly for a specified period of time, for example six weeks. Groups should be limited to no more than eight members. Groups comprise people that each member does not know. Hence, each week members must enter the group room where people exist with whom they have not made contact. This act alone exposes clients to one form of fear they experience about social situations. Additionally, group activities will provide each client with opportunities to act and speak in front of the other group members. Such activities expose group members to some of their worse fears: speaking in front of people, being observed by others, and then getting feedback from all the participants. Moreover, the very act of giving feedback provides exposure for group members who can learn that feedback is neither negative evaluation nor being overtly judgmental.

Role of the Group Therapist(s)

Therapists know that socially anxious individuals excessively fear such social engagements where they must talk, interact, and in some way be observed by others. Therapists must hold a space for each participant so that all group members can feel safe, respected, attended to, and not judged. Therapists should prevent personal attacks among members, which is a cardinal rule for all group therapy, but it is especially important for social anxiety groups because such personal attacks come across as judgmental, which is the very thing group members fear. Personal attacks, however, are not the same as personal disagreements. Group members can learn that disagreements among members are neither negative evaluations nor judgmental acts on the part of others. Therapists should guide and channel any disagreements that arise in constructive ways, perhaps teaching people how to voice disagreements in ways that do not sound or look like personal attacks. Group process will allow group members to give honest but non-judgmental feedback to other members in the group. Group participants will hopefully emulate the therapists’ ways of holding a safe space for clients, and begin doing the same for each other as they interact during group activities.

Therapists should take on the role of screening group members. Although not all group dynamics include screening, I think for a specified type of group, such as one designed for social anxiety, therapists should screen clients with a one-on-one interview before admitting them into the group. The primary focus of the group, and the primary concern of each group member should be social anxiety. Therapists should also administer a short FNE scale for each group member. Therapists should also create some type of qualitative feedback form for group members to complete so as to ascertain how clients believe the group therapy setting worked for them.  

Individuals in a therapeutic group eventually get to know one another and thereby become more comfortable with one another. Although for most process groups, such comfort is a good thing that can lead to group cohesion, this presents a problem for groups designed to treat social anxiety. As members become comfortable with one another, the group setting begins to lose its exposure power. Once a social anxiety group loses its exposure edge, then how does therapy proceed so that clients can continue to work on their socially anxious concerns?

Social Gatherings of Various Groups

If therapists are working with more than one group designed to treat social anxiety, then they have a built-in mechanism for creating social gatherings. Following the six-week group therapy session, clients can be asked to attend social gatherings comprising members of other groups who have sought to deal with their social anxiety. In these social gatherings, members can introduce themselves to people they don’t know, and then talk to, and interact with individuals they don’t know. The caution for designing and setting up these social gatherings entails the logistics that must be navigated so that members will feel safe in the social gatherings. Informed consents should be developed, and therapists should work with their specific groups, discussing expectations for the social gatherings. Should they be totally voluntary or required? As therapists work with numerous groups, past group members can attend the social gatherings to provide a good mix of individuals present at the gatherings. Perhaps past members can take a couple of minutes to speak in front of the attendees at the social gathering, demonstrating how they have come to manage their social anxiety. As social gatherings continue, they will grow in number, and clients can continue to follow up by attending the gatherings as long as they feel it necessary to attend. Such social gatherings can be treated as booster sessions for past group members.

Conclusion

Existential concerns exist with social anxiety just as they exist with practically any struggle through which human beings undergo. As stated above, those who experience social anxiety have as their greatest fear that other people will somehow negatively evaluate them. The simple fact is the world comprises people who do negatively evaluate others, whether or not those who are doing the evaluating know anything at all about the people on whom they are dumping. Given that negative evaluators do exist in the world, the question becomes is how much power does one want to grant such evaluators. This is an existential question. Another existential concern revolves around the question why should individuals care if people negatively evaluate them. Therapy for those who experience social anxiety does not include a promise that they will not experience negative evaluation from someone. Helping clients manage their social anxiety and become more realistic about their catastrophic beliefs and ensuing fears can have the added benefit of helping clients adjust to a world where there are some ugly things that happen out there.

At Contemplations, I hope to begin a series of group counseling experiences for those struggling with social anxiety. Be sure to check out this website for more information regarding my practice.

John V. Jones, Jr., Ph.D., LPC-S/February 14th, 2020

PROFESSIONAL COUNSELING

Counseling and Valuation

Introduction

In last month’s blog, Launching Pad, I returned to five themes I had previously discussed on this blog over the years that included mind, meaning making, thought/action, finitude/humility, and worldview. To this list of five themes I added a sixth that I call valuation. I will focus on that sixth theme in this month’s blog. Valuation in counseling involves the work that clients do when they seek to clarify their core beliefs and values. Having clarified as best they can their core values, then the work of counseling for clients focuses on what their lives will look like day-to-day as they choose to live in alignment with their chosen values.

Two Levels of Questions About Valuation

In their work, Motivational Interviewing, William R. Miller and Stephen Rollnick provide a list of one hundred values that they use with clients for value exploration. Psychotherapists use the list in a variety of ways, but for the most part, therapists and clients approach the list as a card sort whereby clients rate their top five or top ten values. These top ratings then become grist for the mill in therapy sessions regarding clients’ valuations and what their valuations mean about how they go about engaging day-to-day life. If I claim to embrace a set of core values around which I will live my life, then what will my life look like when I in fact seek to live out those core values on a daily basis?. As I look into my life, am I in fact seeking to live out the values I claim to embrace? If not, what is preventing me from living out my stated values? Do I need clarity on the means by which I will pursue certain ends pertaining to my values?

Other questions at a deeper level come to mind around values exploration work. If consistently I’m finding that I’m not acting upon the values I purport to hold, then do I in fact truly hold such values? Perhaps I need to explore what truly are my core values. Valuations should lead us to act and live in certain ways that align with our proposed core values and beliefs. Values are both beliefs we hold and ends toward which we move. Our ways of living out our core values are the means by which we move toward our desired ends. Consequently, it is important that we are clear as to what our values in fact are. If we’re not, then the work of counseling begins there, in values clarification. If we claim to have clarity as to our purported values, then the work of counseling becomes about how we live out those values. Beyond the counseling room, how we live in alignment with our core values becomes the way we live out our lives. Living in alignment with our values becomes our life work.

This month’s blog will explore value exploration work when we are clear or somewhat clear on our values, but we’re not sure as to why we are not living out those values. Or perhaps, we are not clear as to the means by which we are to live out our purported values. Usually the major obstacle that prevents our living in alignment with our values is our own self.

I will resume this discussion with the first blog of 2020 (01/14/20) and explore the deeper work of values exploration in counseling when we are not even sure as to what our values are.

Values Exploration in the Counseling Room

What Stands in the Way?

In my work as a therapist, I utilize the list that Miller and Rollnick proffer in their book, Motivational Interviewing. The subtitle of their work is Helping People Change. I have no doubt that one of the major ways that people can bring about change in their lives is to explore what they truly believe and value. Such changes occur on several levels. If I have a good hold on what my values are, then I may enter counseling to seek help as to how to follow and live those values out. As a client, I might be dissatisfied with the way my life is going for the simple reason that I have a good idea that I’m not living the way I would fully like to live. I’m not seeing in my life the fruit that should come from the ideas, beliefs, and values that I hold. Such a personal realization might lead me to seek help, input, and feedback from people I trust, which might entail entering a therapeutic relationship with someone. At this stage of how I see things, my work in counseling most likely will entail looking at more fruitful ways that I can bring about the desired ends I seek for my life. That is, I will want to search out how I can best bring about the fulfillment of my values in the way I hope to live day-to-day.

As such my counseling work will involve searching out what exactly it is that stands in the way of my living out what I claim to value. There are several discoveries that can come from such work. One of the obstacles that might be in my way is I myself. If we truly want to step into our core beliefs and values and live fully the way we desire to live, many times such decisions involve taking risks and making changes that take us out of the comfort zone of where we merely settle for what we can gain out of life with the least amount of effort. Such a dynamic is something we have to recognize as being a part of human nature. We have to become aware that many times we settle for things simply because it’s easier to do so, or because settling entails less risk. Becoming aware of our human nature can help us decide if we want to change things. Such awareness brings on choice and responsibility. We can stay where we are, or we can choose a different path. The problem is that if we stay where we are, we are already aware that while it feels safer and easier, such a choice doesn’t bring the fulfillment we desire in our lives. One of the major obstacles in living out our values is our self. I have seen this time and time again in the counseling room, as well as in my own life.

What Changes Are Necessary?

Once we become aware that we are the thing that’s in our own way, then it becomes more clear as to what changes we need to make. Perhaps it’s that job that has grown stagnate even though it pays the rent, puts food on the table, and contributes to a savings account. Although we value such responsible actions, perhaps the weightiness of the lack of fulfillment related to the job is starting to outweigh the benefits the job provides. Values exploration also entails how we value the way we have to go about making changes. Transitions in life (see here and here) are an important and weighty experience for all of us. We don’t merely willy-nilly decide to make a major change in our lives without thought and a plan. But we do need to know and decide that in fact we want to make a change. Good sense and common sense can help us decide some legitimate ways to make our desired transitions.

Perhaps it’s a stagnate relationship that is weighing us down and preventing us from following out the goals we have set for our lives. Staying in a relationship simply out of comfort is one of the more common experiences I have seen in people who enter the counseling room. Likewise, not knowing how to instill life into a relationship is another common experience I encounter in clients. Of course, making changes in relationships involves more than just one person, but such exploration can become the work of counseling. Relationship changes are difficult. Such explorations and discoveries are some of the most difficult we encounter and try to make happen. Like anything else, such changes take courage, the willingness not to settle.

Countless other things can stand in the way of living out our values in a fulfilling way that require changes. Finances, where we live, how we balance work and leisure, spiritual beliefs, the pursuit of meaning and purpose are just a few of the areas we can explore in the counseling room or with trusted mentors. We first, however, must become aware of what stands in the way, particularly if we are the ones standing in our own way. And then, we must become clear on the desired changes that must take place if we seek to live in alignment with our stated values. What are the ends, and what are the means to reach those ends?

Conclusion

Before closing, I want to state emphatically that there is much more to this discussion. Yes, I can be in my own way, particularly not wanting to take risks or put forth the required effort to make changes in my life that align with my values and goals. And yes, I need to become clear on what the specific changes entail that I need to make in order to align with my values and goals. I need to be clear on the ends and the means to reach those ends.

But there is another caveat to this work of values exploration that emerges in counseling. What if I simply don’t know what in fact are my core values? What if I lack clarity as to what are my core values, and I don’t know how to go about discovering what they are? Perhaps I’m the obstacle in my way, not because I don’t want to risk, but because I simply don’t know what I believe in my core. Perhaps, like many of us, I have inculcated values I claim to hold, but they are truly not my core values. Perhaps I haven’t taken the time to question values I say I hold, and decide if they are in fact my values. What prevents me from living a fulfilled life is not the unwillingness to take a risk on certain values, but comes with the fact that I simply don’t know what I value. Such questions and realizations are another aspect of values exploration. It is the type of work that I thoroughly enjoy undertaking with clients. This second, and what I call a deeper type of work in values exploration, is what I will write about with the first blog of the New Year 2020.

Suffice it to say for now, individuals can have a clear picture of the values they hold, and the kind of life they want for themselves, but they are not sure what prevents them from getting to their desired ends. They need to be clear on the obstacles in the way and the means they must take to reach their desired ends. Such work is worthwhile and important work. And it can be fulfilling work, both for clients and for counselors.

John V. Jones, Jr., Ph.D., LPC-S/October 14th, 2019

PROFESSIONAL COUNSELING

Philosophical Counseling

Introduction

This month’s blog article kicks off the beginning of my seventh year of blogging for Contemplations. Interestingly enough, I believe it has taken me seven years to fully formulate how I conceptualize my practice. Over the last several months I have written several blog articles that deal with the theme of means and ends. (They can be found here and here.) Additionally, I also have written some blogs on meaning making and the good life. My practice, Contemplations, began as one offering an existential approach to counseling. As such, rather than operating off the medical model, my practice sought to engage clients along the lines of philosophical thought. The aim of my practice is to utilize philosophical ideas brought to the nitty-gritty of living life day-to-day, rather than some academic conversations around philosophical topics. Philosophical counseling became for me an idea that I wanted to explore.

Philosophical Counseling

The Search for Meaning and Purpose

The philosophical counseling movement began and took root nearly three decades ago. Although I was drawn to such a form of counseling, I had some concerns about how a private practice around the notion of philosophical counseling might operate. As an approach to counseling, it sounds more like what many people designate as coaching. The idea of being a professional coach did not appeal to me. Philosophical counseling as an inchoate idea began for me several decades ago when I read Viktor Frankl’s Man’s Search for Meaning. I knew I wanted to shape my practice around people’s search for meaning, but I didn’t know to call it philosophical counseling. As such, I envisioned my practice as involving a place where people can come to explore what their lives are all about. Rather than a technical practice, utilizing specific interventions for diagnostic matters, I established Contemplations as a place for people to take a step back, slow down their pace, and embrace some time to reflect on matters that were important to them. My practice, then, would entail the primary work of exploration. Since I opened Contemplations, I have spoken with numerous clients who wanted to explore the idea of a meaningful and purposeful life. Whether their exploration focused on career, finances, relationships, or family, they wanted a time and place to formulate their thoughts. Carving out a meaningful existence is important to people. A counseling practice can focus on such a search.

Encountering Life Difficulties and Obstacles

There is the reality that people enter counseling because they face difficulties in life that they are not sure how to navigate. Such difficulties come in all variations. Individuals may experience obstacles to the goals they set for themselves. Some difficulties entail simply the normal stuff that life throws at us. Other difficulties may entail huge barriers we bump against that we weren’t expecting. They become formal foes about which we don’t know what to do. Although philosophical counseling can most definitely help people problem-solve so as to navigate barriers that life places along our paths, another angle to this approach helps clients reflect on what such problems in life mean, how they deal with these problems, and what they learn about themselves as they seek to navigate the difficulties they encounter. Philosophical counseling then focuses on process as much or more than it does on content. In so doing, it doesn’t obviate problem solving, but it does help prioritize clients’ understanding of matters before too quickly delving into problem solving. This approach to counseling can help clients reflect on how they deal with setbacks, illnesses, losses, and failures that occur as they pursue their life goals.

Life Transitions

Life transitions (see here, here, and here) have been a focus of the work I engage in my practice. Transitions cover the gamut of human experience. Such changes in life as graduating from college and entering the job market, changing jobs, moving to a new city, marriage and starting a family, divorce and ending relationships, and retirement can produce upheaval and anxieties in people’s lives. Counseling can help individuals navigate these transitions as life brings them on. In such transitions, the search for meaning never fades away. The manner in which we take on these transitions will say a lot about the way we view life and the principles by which we live. Philosophical counseling can help individuals shape their thoughts around such concerns.

Life Goals: Means, Ends, and Valuation

Individuals set goals for themselves. They enter counseling for various reasons regarding the goals they hope to achieve. They may not be certain as to what their goals actually are. They may have originally thought that they had certain ends they set for themselves, but have come to question whether or not their desired ends are truly ones they desire. If they are clear as to the ends they set for themselves, then they may want to enter counseling to discuss the best pathways to their ends. Such pathways I call means. Means and ends entail a process that people can embrace to obtain ideas as to the best ways to accomplish their ends. Discussing means to ends also helps individuals clarify their ends. Anytime we discuss ends in counseling, we are also discussing evaluation. Values exploration has become an important part of the work I want to do in counseling. Although people may have an idea as to what their core values are, as they explore those they may come to realize that many of their values they have inculcated without personally reflecting upon the question as to whether such designated values are truly ones they embrace. Again, a philosophical approach to counseling can aid people in these explorations.

Spirituality

If counseling entails clients clarifying their values and searching out their goals, then it may very well entail some exploration into a client’s spirituality or spiritual beliefs. Contemplations is a practice where clients’ spiritual beliefs are welcome. Many individuals embrace some form of spirituality to navigate their lives. Their spirituality informs them as to their values and the principles by which they live. Likewise, individuals can enter therapy when they encounter difficulties with and doubts about their spiritual beliefs. The counseling room is a place where such explorations can take place. Moreover, spirituality can, and most likely will, inform all the areas of focus that have been delineated in this blog article. People draw on their core spiritual beliefs to work through life difficulties, transitions, and goals, and especially in their search for meaning and purpose. As such, exploration of one’s spirituality involves discussions that are personal, meaningful, and philosophical.

Conclusion

I’ve been asked by several people over the years about why I chose this path for my practice rather than working with populations where people experience severe depression, debilitating anxiety, or life-altering psychotic disorders. First, I am glad that there are people who want to work in mental health clinics and mental health hospital settings. The work done in those settings is highly needed and rewarding, I’ve done a little of that work along the way, but I decided it was not the type of work on which I wanted to fully focus. Second, sometimes the search for meaning and purpose can leave people feeling highly anxious and deeply depressed. I’ve worked with such clients on more than several occasions. It is not as though these concerns do not emerge in the kind of work I do. Third, and I think this addresses the premise behind some of the questions relating to setting, the work I do is just as important as the work done in mental health clinics and hospitals. The people searching out this work encounter struggles in life that counseling can help them navigate just like anyone else. I also believe that those who experience severe depression and debilitating anxiety also experience crises in meaning. Although the work involved may include more clinical interventions before such clients can face existential issues, their existential crises are real. Philosophical counseling is an approach that counselors can embrace to pursue and obtain a fulfilling practice. The human condition places all of us before the vagaries of life whereby we deal with time, meaning, and fulfillment. Human beings are meaning makers. Why wouldn’t therapists seek to work with clients who search for a life that is fulfilling?

John V. Jones, Jr., Ph.D., LPC-S/August 14th, 2019

PROFESSIONAL COUNSELING

Counseling as a Science of Human Action

Introduction

Two years ago to this date, I authored a blog about human action and personal journeys (here). Since that time, my thoughts have taken on more shape as to how I think human action, an idea from the great economist Ludwig von Mises, readily applies to the field of counseling. Although a concept used by Mises in the field of economics, it equally applies to the field of counseling because Mises saw human action as an approach not only to economics but to life as a whole. Human action is not a conceptual tool merely for economists. It’s an idea that addresses how human beings approach life. In some ways Mises’ idea is similar to some of Alfred Adler’s work, and more contemporarily, to some of the ideas found in Acceptance and Commitment Therapy (ACT). Likewise, although Mises spoke about the science of human action, he held strongly to the notion that economics was not and should not be conceptualized as a science in the framework of the natural or physical sciences. Both Mises and F.A. Hayek, another great Austrian economist, addressed the notion of scientism, whereby fields that deal with human action seek to emulate the natural sciences rather than carving out their own domain utilizing the proper tools for the study of that domain. As such Mises was leery of the emphasis on strict empiricism, materialism, determinism, and reductionism in conceptualizing human beings and human action. Evaluation, meaning, and purpose ensconced in time set the human being apart from other animals. I concur with Mises, and I believe just as he viewed economics, that the field of counseling is not a hard science, as designated by the fields of physics, chemistry, and biology. Although these fields make their important contributions to understanding human nature, the human being is more than the sum of his physical and biochemical parts, and his existence should not be reduced to any material part of his being. The use of his mind sets him apart from all other animals. In agreement with Adler, Mises posits the human being’s teleological actions. Why I would employ notions garnered from Mises rather than being a straightforward Adlerian is because I think Mises captured what he calls the science of human action in a way that, at least for me, is more applicable than several Adlerian concepts from which I wouldn’t draw. Likewise, I believe ACT has similar concepts that contribute to my conceptualization of human action. Unlike ACT, however, I’m not a behaviorist.  This blog article builds on the earlier blog I wrote and delineates how I would use Mises’ concepts as a science of human action to guide me in my work with clients.

Human Action

Mises posited a simple axiom: human act. In his approach to the science of human action, he sought to explain what human action is all about and how human beings use action to obtain what they seek and hope for in life. From an economic perspective, Mises postulated that human beings seek to exchange one set of circumstances for another set of circumstances that they view as more valuable, providing them the kind of life they desire. Hence, human beings evaluate. They exchange something for something else that they value more. Although Mises was an economist, he was also a social scientist, so he didn’t view human action in merely economic terms as we think of that field today. He sought in the science of human action how we could better come to understand the truths of human nature. The human being is an idea generator. His ideas guide him through life.

Ideas, Beliefs, Values, and Actions

Individuals act toward certain goals based on ideas and beliefs they hold and evaluations they make. Hence the goals they set are generated by beliefs and values they hold, beliefs and values that will lead them to the kind of lives they hope for themselves. In seeking to carve out their lives based on what they believe and how they evaluate things in the world, human beings act on what they hold to be true and valuable to themselves. In other words, they seek certain valued ends. Ends or goals that human beings seek require means to get to those ends. The actions that human beings take are the means to bring about the ends for which they hope, aim, and value. Beliefs and evaluations mean we use our mind to carve out our existences, setting us apart from the rest of the animal kingdom.

Time

As human beings we are ensconced in time. We possess only a limited amount of it to accomplish what we hope to achieve. In making plans or setting goals, we must take into account that to reach the ends we hope for, a certain amount of time must be expended. We cannot escape that human truth. Questions revolving around time cause other values to come into play. How much time am I willing to expend to reach a certain goal? Is the amount of time required worth the trade off for seeking that end? Are there means I can use to reduce the amount of time it takes to reach a specific goal? If not, then am I willing to embrace the value of delayed gratification. Time is an important consideration on several levels. Time is a resource with which we are limited. Time is the pressure cooker that heats up our willingness to expend energy that we put into seeking certain ends. It is human nature to want the things we desire as quickly as we can get them with the least amount of effort expended. Becoming aware of this characteristic in our nature, we can choose to do something about it. The something we can choose is delayed gratification. We exchange the discomfort of longer amounts of time and greater amounts of effort required for goals that we believe will be worthwhile in the long run. Long- run living as opposed to short-run living is an exchange we make in life based on values we’re willing to embrace. Obviously, the older we get, the more the factor time plays in our decisions. Time is always the pressure point in the decisions we make for how we want to live our lives.

Choice

One of the major characteristics that set the human being apart from other animals is the use of our mind in making choices. The choices we make are signposts regarding the beliefs we hold and the evaluations we make about things in the world. We choose our ends, and then we choose the means to accomplish those ends in the most efficient manner we can. If we come to realize that our chosen ends are not necessarily the ones we truly desire, then we change our mind, and thereby, change our course in life. These changes cost effort and time. If we come to realize that the evaluations we make are not necessarily the values we thought we held, then a change in valuation leads to life changes as well. As we navigate the sinuous path called life, we are constantly faced with choices we have to make. Do I truly value A instead of B? If I thought I valued A but came to realize I value B, then what does that mean in terms of means and ends? What if I set my mind on an end, and then realize it’s not an end that I truly desire? Such changes in beliefs, values, and goals can lead to particular tweaks applied to our navigations, or they may lead to revolutions as to how we determine to pursue life. Along the way, there are always the choices we make and the questions revolving around the payoffs and trade offs that go with those choices.

Individual Meaning and Purpose

Another major characteristic that sets human beings off from other animals is our desire to pursue a meaningful and purposeful life. We set ends for ourselves because we value those ends. Where we want to get to, what we want to achieve, and all we hope to accomplish means something to us on a deep level. A common experience we encounter is that as we set ends and accomplish them, those ends themselves can become means that keep us moving on toward what we consider greater and deeper goals. All in all, ends and the means we use to accomplish them hopefully will lead us to a place in life that is meaningful for us. Values, meaning, and purpose go hand-in-hand and drive each individual toward a set of goals. As such, they are highly individualistic as opposed to collectivistic. Each individual must decide what he or she wants from life. Although we are interconnected, no other individual can ultimately decide the course of our lives for us. If we give that decision over to someone else, then we have given over our life to someone else. In doing so, we become less than human. Mises was highly individualistic in his formulations, and so am I.

Conclusion

What does a science of human action mean for my work as a counselor? I too have chosen ends. I do not work in a hospital setting or in what may be considered severe mental illness settings. Although that kind of work is valuable, I leave it to those who choose to do it. I work in a private practice geared toward individuals who are experiencing certain transitions in their lives. Such transitions lead them to question what’s next in their lives. They may need to explore what means they can use to accomplish the ends they hope to achieve. Then again, they may not be that clear as to the ends they want to pursue. Or they may need to start with clarifying exactly what their values are before they begin moving forward in their lives. In their work with me they can take the time to reflect – to contemplate – how their beliefs and values interact with the goals they want to set for themselves. They may need to stare the pressure cooker of time in the face and deal with how much or how little of that resource they possess. Perhaps time is teaching them the lesson to exchange short-run living for long-run living in the form of delayed gratification. They may be faced with the struggle of radically changing what they thought they believed and valued. Perhaps it’s time for them to search for and reflect on what is ultimately meaningful and purposeful for them. This is the kind of work I do.

Science is a systematized body of knowledge. What Mises designated as a science of human action does not draw on the methods and tools utilized in the natural sciences. Counseling is its own domain and field of endeavor. It is not physics, nor is it chemistry. To seek to emulate those fields would entail scientism rather than being scientific. The field of counseling possesses its own value in what it offers individuals. The counseling setting is a space where people can reflect on what they want to do and how they can move toward what they desire for their lives. Humans act. One action is to enter therapy to reflect, clarify, contemplate, and then evaluate so as to move toward certain goals. This is all part of human action. The conclusions that people reach in counseling are not left at the door as they exit the counseling process. Like anything else that human beings engage, clients will decide what value counseling played in their lives. They will act on it accordingly as they see fit.

John V. Jones, Jr., Ph.D., LPC-S/July 14th 2019

PROFESSIONAL COUNSELING

Postgrads: Considerations Upon Entering the Field of Professional Counseling

Introduction

As a Licensed Professional Counselor with Supervisory Status, one of the most fulfilling components of my work entails both supervising and mentoring Licensed Professional Counselor Interns (LPC-I).

For those not familiar with the field of counseling, the supervision process requires graduates of counseling programs to undergo a postmaster’s internship, during which time they are designated as Licensed Professional Counseling Interns. Typically licensing boards within each state set particular standards by which interns undergo weekly supervision with their chosen supervisor. As part of those standards, interns must undergo supervision while logging so many administrative and direct counseling hours. Direct counseling hours involve any face-to-face time that interns meet with clients. Administrative hours entail hours associated with the work of counseling, involving anything from writing case notes and researching information about clients to hours spent in supervision. For most states the requirements for interns is that they log 3000 postmaster’s hours, with a minimum of direct contact set at 1500 hours. Although, these standards vary from state to state, many states are now moving to more uniform requirements due the accreditation process that university counseling programs must undergo. Additionally, interns are not allowed to complete this process in less than eighteen months. What that means for prospective graduates of counseling programs is that they are looking toward at least an additional eighteen months before they are fully licensed. They are also looking at limited income during this year-and-a-half due to their status as an intern.

Obviously, interns enter the supervisory process with a shipload of questions, not only about how to work with clients, but also how to think about their professional futures. In this blog article I want to proffer some possible guidelines that LPC-I’s can reflect upon if they find them helpful to do so. I will break down the discussion as follows: a) entering the process of supervision; b) undergoing the process of supervision; and c) exiting supervision – the transition from Intern to fully Licensed Professional Counselor (LPC).

The postmaster’s Internship is an onerous process, so I do hope both present and future interns will find some of these thoughts helpful.

Beginnings: The Transition from Graduate School to LPC-I

I can only highlight some general steps involving your transition from graduate school to the professional world of counseling. Each state has its own State Board for counselors, and several of the states have different names for their licensees. Some states, as the one in which I live, designate counseling professionals as LPC’s. Other states use the title Mental Health Licensed Counselor (MHLC), while other states designate similar titles. Due to the move toward common accreditation for university counseling programs, though the name for practitioners varies from state to state, the training is similar, as are many of the regulations for counseling professionals. I will use the nomenclature utilized by the Texas State Board of Examiners of Licensed Professional Counselors. Much of what I outline here will apply generally to all state designated licensed counselors.

When you graduate from a counseling program, now typically a 60-hour program with the curriculum delineated by the State Board, you will not step into the professional role of a fully licensed professional counselor right away. Instead, you will step into the role of the LPC-I. Note that the LPC-I is a license, so once you navigate the beginning requirements set by the the State Board, you will possess a license to work as an Intern. First you will have to pass a State Board Exam, typically containing 250 multiple-choice questions. There are several study guides and preparation workshops available for your study and prep for the exam. The postgraduate is allowed three shots as the exam before remediation is required, which typically involves repeating some graduate coursework. There is also a Jurisprudence Exam that you must complete, but it is not a pass/fail exam. You read through the regulations and answer the questions until you know the correct answers. Once you have completed the LPC and Jurisprudence exams, you begin your search for a supervisor. In Texas, LPC counselors with Supervisory Status are designated as LPC-S. The website for the State Board has rosters of all three levels of counselors – LPC-I, LPC, and LPC-S. The Board indicates where each counselor is located in the State, so interns looking for a supervisor can note those who live in their area. Interns cannot begin accruing their supervised hours until they pass the required exams mentioned above, have obtained a setting where they will work as an intern, and have a supervisor in place. Once the intern lines all that out, he or she can begin chipping away at the 3000 required postgraduate hours.

Choosing a Supervisor

Typically some graduates already know the LPC-S with whom they would like to work as a postgrad intern. Many new graduates, however do not, or the individual with whom they would like to work has no available space. Choosing a supervisor is an important decision for the postgrad. Here are some pointers I would offer. First, do not simply choose someone because you feel desperate to obtain a supervisor. Good reflection upon choosing a supervisor is an important process, and it’s an interview in which you interview the supervisor as much as he or she interviews you. The relationship between you and your supervisor will last for at least eighteen months, so you want a good working relationship with the LPC-S you choose.

Supervisor – Intern Fit

Second, you are looking for a good fit between you and your supervisor. The field of counseling is conceptualized and approached in terms of practice in a myriad of ways. One’s counseling theory is just one component that you look for in terms of fit. There is no reason, however, that you can’t work with a supervisor who holds a different theoretical model than you. Most practitioners these days integrate several theories as it is. I’m not saying that theory is unimportant, but I don’t believe it’s the single most important determinant for choosing a supervisor. But it is a start. For example, if you want to work from a behavioral or cognitive-behavioral model, a supervisor who practices from a psychodynamic perspective will view the work much different than you do. But that’s not a reason that you shouldn’t or couldn’t choose such a supervisor.

Supervision Atmosphere

Third, in terms of looking for a good fit, you want to try as best as you can to discern in your interview if the supervisor is someone with whom you would feel comfortable working. Though they may have some different conceptualizations, they may also have a style and a personality with which you feel at ease. Some supervisors simply don’t care to match on the basis of theory. Other components such as style, willingness to take and give feedback, and openness to continued learning as a practitioner are deemed more important than theoretical orientation, both by interns and supervisors. The type of clientele with whom the supervisor works may be the kind of population with whom you would like to work as well. So the context in which counseling work takes place can be an important and deciding factor for choosing both your worksite and supervisor. I meet with prospective interns for a free consultation so that both the intern and I can decide if the fit is a good one.

Know that there are a variety of components by which you can decide which supervisor will be a good fit for you. A few of these components are: theoretical model, counseling style, supervision style, personality, type of clientele and practice, setting of practice, and many more. You might want to make a list of what you’re looking for in terms of a supervisor before you begin the interviewing process. Obviously, supervision fee is an important consideration from your own personal financial standpoint. Some agencies or institutions may have supervisors on staff from whom you can receive free supervision if your place of employment offers that perk.

Engaging the Process of Supervision

Just as they have with their clients, supervisors have a supervisory style by which they work with interns. Although you can clarify that as much as possible during the interviewing process, there’s a lot regarding the day-to-day supervisory work that you will not know and see until you are in the middle of the process. Know that you can change supervisors at any time. At the same time, you want to be clear as to why you want to make a change in supervision. The ability to work with supervisors who conceptualize and see some things different from you can be good training if both you and the supervisor know how to navigate such differences.

Regardless of the specific supervisor’s approach and style, there are some things that you can decide that you want from supervision. First, do not approach the supervisory experience as a place where a supervisor merely tells you what to do with your clients. You want a supervisor who will work with you so that you can truly build your own approach and style as a professional. Thereby, second, you want a supervisor who will engage supervision as an exploratory process to help you come to your own conclusions about the way you want to approach the work of counseling and the manner in which you hope to engage your clients. Although you want challenges, questions, and an open exploratory process, you do not want a supervisor who merely tells you what steps and interventions to use with your clients. Although interventions can be a major discussion in supervision, you want that discussion to revolve around your training, skill development, and how interventions fit with your personal approach and style. In other words, the over-arching goal of the supervision process is to provide a pathway for you to develop your own professional approach and style. Supervisors should help you with not only some possible interventions to utilize, but also they should help you develop your own conceptualization as to why you work the way you do. Note that such conceptual knowledge and skill building will not end in supervision, but will be a continuing developmental process as you work in the field of counseling.

There are several questions you can reflect on during the supervision process that can help you decide how the fit and supervisory work is going for you. First, is the supervisor allowing you to develop your own way of working with clients, or is he or she trying to strongly influence everything you do, including adapting the theoretical model the supervisor holds? Second, does the supervisor challenge you in ways that will help you develop and grow as a professional? Third, do you get the type of feedback you’re looking for that is conducive to professional growth? Do you feel like you have room to grow and develop professionally in the way that you hope to do so? Does the supervisor meet his or her responsibilities as a professional LPC- S should? Do you sense that the supervisor has your professional interest and development at heart, or is the supervisor trying to simply reproduce the way he or she works?

There are some other emphases that I believe supervisors should engage in additionally to staffing the intern’s caseload. First, I think it’s important for supervisors to have an ongoing discussion with interns regarding their professional goals for the future. What kind of work does the intern hope to pursue? Is there a particular population with whom interns hope to work fully, or at least emphasize in their caseload? You want to find ways to broach these subjects as much as possible with your supervisor as you work through your required supervised hours. Likewise, you want to engage in research in areas of personal interests to discover what the type of work you hope to do actually entails. Hopefully, you have been able to engage this work at least to some extent during your postgrad Internship, although that may not be possible for all Internship settings.

Second, I believe it’s important to have thorough discussions with your supervisor regarding the Code of Ethics for professional counselors. You want to bring any ethical concerns you might have to supervision and to determine as clear an answer to them as possible. It is important that you constantly update your knowledge on ethical issues in counseling. It is also important that your supervisor recognize any situation that may bring up certain ethical questions.

Finally you want to trust your supervisor when your working with clients that really challenge you, and perhaps make you feel less competent than you would like. These are important discussions to have during the supervision hour. Supervision should be an open forum where you can voice your questions, doubts, and any feelings regarding the confidence you have as a developing professional. Work in this field has a way of challenging your sense of competency. You should not let that undermine your work and future goals. Although your supervisor is not your counselor, those areas where you professionally vulnerable are welcomed opportunities for professional development when working with a good supervisor.

Exiting Supervision: The Transition to a Fully Licensed Professional Counselor (LPC)

So now, you have made the transition from Intern to a full LPC. What’s next? This is the exciting part of your career obviously. As stated above, hopefully in supervision, you have been contemplating and reflecting upon the kind of professional you want to become. Your work can involve private practice, a practice that serves particular populations, or work that involves such settings as mental health institutions, professional clinics, or clinical mental health hospital settings. Likewise, hopefully you had the opportunity at least part of the time during your Internship to work in the areas you hope to develop. Moreover, as you begin nearing the end of your supervisory requirements, you began checking out settings and counseling professionals involved in the kind of work you hope to do. The best scenario is that you chose a setting where you will continue the kind of work you were doing under supervision. Note, however, that all the experience you receive as an intern will serve you in many capacities as you move on toward your LPC practice. Working with clients is the experience that will help build your skills and determine which direction you want to go post Internship. No experience with clients is wasted, even if it keys you to the kind of work you most decidedly do not want to engage.

Let me offer some advice as you move forward into your professional journey. There will be many other professionals who have a take on what they believe you should do as an LPC. That’s okay. There’s nothing wrong with input and some guidance. What you must be aware of, however, and where you must draw the line is that the decision regarding your professional direction is yours and yours alone. It is important that you are honest with yourself as to the type of work you hope to do, and about the type of setting in which you hope to work. By all means, take in and listen to input, feedback, and advice; however, ultimately the decision falls in your court. The last thing you want to do is seek to live another person’s goal for your professional life. Working in a setting or with a population that is not a good fit for you is a short road to burnout. The work you want to do that truly comes from your mind and heart is as worthy as any work other people are doing.

Those who want to go into private practice particularly face pressure from others in the field about pursuing their own goals, way of living, and professional satisfaction. There are plenty of people who want to work in agencies, clinics, and hospitals. That type of work is admiral work, but it’s not for everybody. And the same can be said for private practice. It isn’t for everybody. Indeed to pursue private practice requires that you have somewhat of an entrepreneurial spirit about you. Those with such a spirit experience other pressures from the field regarding setting fees and the amount of money they hope to make. I hope individuals realize that becoming a professional counselor will most likely not make you a millionaire anytime soon. But what you should not feel is any pressure and guilt regarding your desire to make a decent living for yourself. If you are not income aware, or if you find it difficult to charge clients respectfully for your time in order to meet your personal needs, then you are on another short road to burnout. You are a professional, trained, and skilled, so you have a right to give it a shot to build a good practice and make a decent living for yourself.

There are a multitude of settings in which people can find satisfying counseling work in addition to private practice and agency work. Some counselors I know personally love their work in corporate settings. Again, it’s not for everybody, but it’s satisfying work for many. Others enjoy their work in Community College and University Counseling Centers. There are a variety of roads you can take as a professional counselor. Don’t cut off the paths and possible opportunities by looking only at what counselors typically do. You can be as creative and imaginative as you want in carving out a professional life for yourself.

The populations that experience severe mental health problems, and have little financial means to obtain the help they need indeed need people to serve them. And there are many agencies and clinical settings where one can find fulfilling work in meeting those needs. Like any setting, it’s not for everyone, but it is satisfying work for many. Moreover, you can seek out opportunities to volunteer your time at such agencies or clinics if your other work gives you time to do so.

Like anything else in life, you have to determine for yourself the path that you want to follow and responsibly do what it takes to set yourself on and travel that path. And like many roads in life, rather than a straight highway, you will encounter many sinuous pathways that will lead you to question, doubt, and possibly change the road you’re on. After all, these are the experiences that your clients engage as well. And the many questions and doubts they have about their journeys might well lead them into your counseling setting.

Conclusion

What is it to be a professional in any field of endeavor? Some of the things I think of include a body of knowledge, skill level, and the opportunities to pursue self-development, both professionally and in the way that one takes on life in general. Knowledge and its continued pursuit and growth allows us to reflect upon and think about how and why we work the way we do. Accruing professional knowledge should not end, and it should not only grow in some linear fashion, but also it should expand in ways we could have never realized when starting out on our professional journeys. Our own personal horizons should expand with our work. Skill development entails that 10k-hour rule that allows us to develop an expertise that is carved out over time. Skill development also has a way of taking us in directions we couldn’t realize before we developed the skills needed in our work.

Finally, work is one component of so many others that contributes to the kind of life we hope to carve out for ourselves. Although it is only one component, that is why it is important that we own the professional path we choose to follow. Over time, our thoughts, beliefs, and ideas will alter and might even dramatically change. The way in which we approach life with integrity in all areas of living should also inform the way in which we with integrity face, pursue, build and stand upon our professional endeavors.

John V. Jones, Jr., Ph.D., LPC-S/October 14th, 2018

PROFESSIONAL COUNSELING

Reflections on Group Counseling

Introduction

I’m not sure what the power of group work is all about, but I do know that group counseling offers intense experiences for those who engage the dynamic of group psychotherapy. Because of the intensity that crescendos at times in group therapy, this approach is not for everyone. I do believe that group therapists should interview possible candidates for group work, assessing whether or not each individual is a good fit for group dynamics. There is not a hard cut method to eliminate all possible problematic clients, but at least a meeting one-on-one with potential members before the group is established gives therapists a possible look at any interpersonal concerns that could disrupt good group interaction.

Group counseling can be designed to help various individuals who experience a wide array of concerns. I have in mind three types of group work I would like to offer clients. I will label each type as follows: 1) interpersonal dynamics and personal growth; 2) group dynamics for social anxiety; and 3) group dynamics for values exploration. I will provide a short discussion of each of these group topics respectively. First, I will offer some thoughts on face-to-face meetings with clients previous to their beginning group therapy along with some ideas about assessing prospective group members as to whether or not group counseling would be a good path for them.

Assessing Clients for Group Counseling Fit

Although the diagnostics that revolve around personality disorders are controversial at times, I do think descriptions of potential interpersonal dynamics that the DSM-V offers associated with personality disorders can be helpful in determining the potential fit for prospective members for group counseling. The emotional dysregulation that accompanies those who are diagnosed as Borderline does not bode well for process oriented group therapies. The group skills work that DBT offers these clients is the best pathway for them until they can better regulate their emotions and then pursue process work in therapy if they so choose. Obviously therapists would want to rule out potential members who evidence antisocial or narcissistic tendencies. Dependent personality disorders can also prove problematic where interpersonal relating is key to group work. Those people who might be considered by some as fragile, not open to others’ feedback, and lack the ability to be self-critical would be better served by individual therapy until they are ready for group dynamics.

Those individuals who experience psychoses, intense anxiety disorders, severe depression, and struggles with eating disorders may not be ready for group work as well. On the other hand, group work can be helpful for these individuals if they engage group therapies that specifically deal with these particular diagnostics. I don’t believe a diagnosis of these disorders should automatically rule out one’s ability to engage group work.

The face-to-face interview for potential group members should focus on several interpersonal dynamics. How well does an individual articulate his desire for wanting to engage group counseling? Does the interviewee appear open and honest about her needs? Is the individual self-critical about areas where he wants to pursue personal growth? If someone merely wants to meet people, then he or she should pursue social networks rather than group counseling. Group settings are not the place to find someone to date. Even those who have experienced therapy in the past, and group therapy in particular, may be too therapy savvy, looking for a place to show off their therapy know-how rather than legitimately seeking group counseling because they believe it might help them.

There are many other things to think about regarding the pre-group therapy interview. At the same time, as a therapist, one doesn’t want to overthink the assessment. After all, individuals are unique in their interpersonal strengths and those areas where they think they need improvement. I simply want to see how a person engages conversation with me in a way that I would feel he or she would be interesting to work with in a group dynamic. Group counseling involves a context where people can be glaringly honest with one another. So individuals need to possess somewhat of a strong ego at the outset while simultaneously possessing the willingness to open themselves to possible areas of growth and improvement.

Types of Group Counseling

There are countless foci out there around which group therapists shape their work. Therapists might shape the group work they do according to a particular diagnostic, such as Major Depression or Social Anxiety. Therapists also can work with particular populations of individuals. Group work can be designed for those who have reached retirement age, those who have recently gone through a divorce, and those who are facing some type of bereavement and grief. Therapists usually design group counseling around those areas in which they are interested and experienced. I have in mind three types of group counseling that I would like to offer clients: 1) Interpersonal dynamics and personal growth groups; 2) group dynamics for those who experience social anxiety; and 3) group dynamics for values exploration. I would structure each of these types of groups so that they contain no more than eight members, and the time limit of each group would entail eight weeks. Hence, these are not long-term groups in my mind, but they are long enough for people to accomplish some specific goals.

Interpersonal Dynamic and Personal Growth Groups

What immediately comes to mind when one thinks about this type of group work is the old encounter groups associated with Carl Rogers. Others might be more familiar with Irvin Yalom and the type of group work he designs. Although influenced both by Rogers and Yalom in my reading and study of their work, I would add some structure and get some idea of specific goals that people have for wanting to engage this type of group. Interpersonal growth groups allow people to interact in ways that they discover things about themselves and others, mostly derived from how they relate to members in the group. Historically these types of groups can be ongoing for quite some time, and they can either be closed or open-ended groups, the latter allowing for the introduction of new members from time to time. These types of groups allow people to work out some of their concerns revolving around interpersonal relationships, be they intimate, family, or close friendships. It is the type of group counseling that calls on people to learn more about themselves as they engage others. Thereby they also may learn how to better relate to others. Interpersonal interaction, giving and receiving feedback from others, and honing a self-critical eye about how and what one wants to change in his or her life form the core work of this type of group. The eight-week time limit that I would place on these groups make them quite different from the old encounter groups developed by Rogers and the interpersonal psychotherapy groups that Yalom led. The tasks of the therapists is simply to facilitate interpersonal interaction among group members.

Group Dynamics for Social Anxiety

Over the years that I have worked as a private practitioner therapist, I have worked with numerous individuals who experience social anxiety. It appears more prevalent in society than people would anticipate. Cognitive Behavioral therapists have worked with all anxiety disorders in terms of what they call exposure therapy. Clients confront the very objects or situations that cause anxiety to overtake them. If an individual experiences intense anxiety when driving over bridges, and thereby becomes unable to do so, then therapy proceeds in working with the person to do just that, drive over bridges. Such exposure work may entail flooding, whereby the person jumps headlong into the pool of anxiety that threatens him. If clients are not willing to engage flooding, therapists and clients strategize some step-by-step process through which clients can at their own pace approach angst producing situation. The first approach is called flooding, and the latter approach is called systematic desensitization. For those individuals who experience social anxiety, the group itself is the exposure treatment because those who are socially anxious seek to avoid social situations, especially those social contexts where they do not know people. Group work is ready made for the type of exposure that might help clients face and deal with their social fears. Those who are socially anxious excessively fear negative evaluation from others, so the interpersonal dynamics in this type of group will become important in helping individual members receive feedback about how others perceive them. Obviously such interpersonal dynamics can be risky, and one of the major tasks for the therapists is to squelch any dialogue that approaches verbal attacks and abusive words hurled from one member to others.

Group Dynamics for Values Exploration

Values exploration has become an important component in various types of therapy from a variety of modalities ranging from existential work to Acceptance and Commitment Therapy (ACT). The work entails the search that individuals carry out regarding what they believe to be their core values that guide how they want to live out their lives. In most ways, we are doing just that all the time, but we may not be aware of the core value off which we are operating. As well, we may claim to hold a particular core value, but we have never thought it through as to why it is a core value. Moreover, we may sense that there are too many times that we act in ways that are not in alignment with what we claim to value. Work around such experiences may involve trying to uncover why we are failing to live in alignment with our core values, or as important, therapeutic work may lead us to question do we in fact believe what we claim to believe. Alignment between what we claim to value and how we act in our lives is one of the major goals of values exploration. Values exploration is premised on the notion that a life of fulfillment is based on such alignment. Although we are never perfect in this alignment, for many people it is a worthy goal to pursue. The notion that the good life entails the fact that we say what we mean, and mean what we say is a strong value that pulls at many people. Moreover, we hope to claim that we act in ways that we claim to believe. As described here, this type of group work entails an overall specific regimen that then allows individuals to establish goals for their lives based on what they conclude in terms of their search for core values. The tasks of the therapist may be more structured than the other two types of groups, specifically in the beginning when group members are seeking to decide what they believe their core values to be. Many therapists utilize Q-sorts to engage clients in the work of values exploration.

Conclusion

The above descriptions of the three types of group work that interest me are necessarily short, and their discussions in no way tap all the concerns that therapists face in designing group work. The general concerns for therapists who lead groups are always present. I purposely didn’t discuss those because this particular blog is not an introduction to group therapy. Rules for group dynamics, methods and techniques, and group leadership or facilitator style always remain important reflections for therapists who want to engage group work. Single leader/facilitator versus co-leaders/facilitators is also an important position that group therapists want to consider.

As I stated above, I determined these three types of groups based on my interests. I also think that, for whatever reasons in the evolving process of therapy, these topical themes appear to be ones that are popular in today’s therapeutic world. People still want to learn how to develop interpersonal relationship skills. Devastation and avoidance of life fulfillment due to social anxiety is a constant reminder of how prevalent this concern is in today’s social climate. And values exploration has become a hot topic along with the practice of mindfulness. For these reasons, it is important that as therapists we shape well-articulated reasons for how we work with these concerns. Likewise, it is important that we find ways that generate good outcome when it comes to this type of work. Popularity can indeed breed onslaughts of mountebankery. I believe group therapy designed around these concerns can and will generate good therapeutic outcome. Like any other type of work in the therapeutic world, we should attend to the research and work of other therapists. Also, we must possess the attitude that we want to assess as best we can the outcome of our work. That’s easier said than done many times.

 

John V. Jones, Jr., Ph.D., LPC-S/September 14th, 2018

PROFESSIONAL COUNSELING

Acceptance & Commitment Therapy (ACT) Part II: Psychological Flexibility

Introduction

In this month’s blog article, I continue my discussion of Acceptance and Commitment Therapy (ACT) which began with last month’s discussion of ACT and the notion of psychological inflexibility.  Countering the notion of inflexibility, ACT therapists conceptualize their work with clients as building psychological flexibility. ACT theorists have developed what they call the Hexaflex to conceptualize both psychological inflexibility and psychological flexibility. Last month’s article delineated the six core pathological processes that lead toward inflexibility. In this month’s article, I will delineate what ACT practitioners call the Six Core Therapeutic Processes that help clients strengthen psychological flexibility. The six core therapeutic processes are: 1) Contacting the Present Moment; 2) Defusion; 3) Acceptance; 4) Self-as-Context; 5) Values; 6) Committed Action. Each of these therapeutic processes counter the six core pathological processes discussed in Part I of my discussion of ACT.

A Couple of Reiterations

I want to recall some things from Part I of this discussion. First, one should keep in mind that the six core processes of ACT are not separate processes. All six processes work in a holistic manner to help clients develop psychological flexibility. Another clarification I want to reiterate is that as a counseling practitioner, I do not believe that one theoretical approach answers all concerns that clients bring to therapy. Even if such an approach could be developed, it would not eliminate the usefulness of other approaches that have been developed from which practitioners could draw. A final point I want to reemphasize is that I do believe ACT to be a theoretical model and way of practicing that easily integrates with a variety of other approaches to counseling. As one who practices from an existential framework, I find ACT a highly flexible (no pun intended) model for those practitioners who consider themselves integrationists or eclectic. The model itself pulls on several eclectic and philosophical ways of thinking. No doubt ACT purists consider themselves behaviorists. I think of ACT from a different perspective. I find this model intriguing, powerfully holistic, and one that clients can easily grasp, though much of the work, as any work in therapy, can be difficult.

The Six Core Processes of ACT

Contacting the Present Moment (Be Here Now)

Have you ever taken a morning stroll, whether it be through a wooded path, along a lake shore, or around the block, and when you return home you realize that you do not remember a thing you encountered because you were caught up in your ruminating thoughts, worries, and concerns the whole time you were walking? You don’t remember what you encountered, what you saw, the breeze or lack of breeze you felt, the sounds you heard, or the smells in the morning air. Quite frankly, such experiences are common among human beings. When we are caught up in our thoughts, we tend to lose contact with our experiential encounters with the world around us. Not that thinking is a bad thing, or that reflection on problems we want to solve is something we should never do. But when our thoughts capture us to the point that we lose all sense of what is going on around us, we have lost the ability to be present in the moment. Such present awareness is a grounding experience. Being present in the moment not only pertains to the physical environment around us, but also it pertains to our psychological world. Most importantly, it speaks to both simultaneously. Being here now is a personal awareness experience that helps us stay in the moment as opposed to drifting onto automatic pilot where we simply go through the motions during the day without being aware of anything around us. Why is contacting the present moment, being here now, an important component of psychological flexibility?

Defusion (Watch Your Thinking)

ACT practitioners talk about cognitive defusion, which is the opposite of getting caught up in the cognitive rumination whereby we are guided by our thoughts in a way that keeps us from being presently aware. The practice of defusion calls for people to step back from their thoughts, let them come and go, and disentangle themselves from ruminative thinking. From the conceptualization of ACT, thoughts are nothing more than words that we say to ourselves or pictures that fill our head. Rather than being grasp as realities, they can be held lightly so as to be understood as useful or not. The major work is to help clients in ways that they do not get tangled up in their thoughts. When it comes to experiences such as depression and anxiety, rumination and the inability to break out of certain patterns of thinking maintains those experiences. The practice of mindfulness can be used here to help clients defuse from their thinking. Mindfulness helps clients be here and now. When clients develop the practice of defusion, they are more psychologically flexible because their thoughts as patterns no longer have a hold on them.

Acceptance (Open Up)

When we experience painful feelings and unwanted emotions, naturally we want them to stop. We develop methods of avoiding them. Though such avoidance can be helpful at times, most of the time it prevents us from dealing with uncomfortable and painful experiences that face us. In a mindfulness way, acceptance means that we let go of the struggle we face with painful feelings, sensations, urges, and emotions. Mindfulness activities can be utilized with helping clients develop acceptance. In a sense, acceptance helps people give breathing space to those experiences they would rather avoid so as to cease the fight and resistance, and face them so as to deal with them. No doubt, acceptance is a loaded term. Acceptance does not mean that we learn to like such negative experiences, or that we welcome them. It simply means we accept the fact that they are with us, we give them breathing space, and we place them in some psychological light so that we can face them and understand what they mean for us.

Self-as-Context (Pure Awareness)

When we think of being human, different people conceptualize human beings in a variety of ways. The common language regarding being human revolves around words like mind, body, spirt, and soul. Some people believe we are pure mind, while others hold a more materialistic view of human beings. The behavioral formulation from ACT comes through in dealing with the concept of self. As I spoke in Part I of this ongoing discussion of ACT, I’m not a fully Eastern in my thought as some ACT therapists are. I do believe there are some things we can learn from Eastern thought, but I do believe in a core self and identity. ACT theorists conceptualize the mind in terms of what they call the thinking self and the observing self. When we are caught up in our thinking, which entail generating thoughts, beliefs, memories, and judgments, according to ACT we are experiencing the thinking self. The thinking self makes plans, daydreams, and fantasizes about things. The observing self, on the other hand, is an in-the-moment experience. We are experiencing the observing self when we are aware that we are thinking, feeling, sensing, or whatever it is we are doing in the moment. Some people call this pure awareness. ACT practitioners call it self-as-context. We all go through life changing, growing, developing, letting go of and picking up new values and beliefs. Yet the you that notices these changes across time does not change. This you is what ACT therapists consider the observing self or self-as-context. Again it is an understanding of human experience that contributes to our ability to become aware.

Values (Know What Matters)

Much of my work with clients revolves around their becoming aware of what they value and then seeking to live in alignment with their values. Sometimes such work leads to clients’ exploring what they claim to value, only to find out that they, in fact, do not value what they claim. Such values exploration is important work because if I become aware that I really don’t value things as I say, or perhaps I’ve merely inculcated them from my surrounding family, society, or culture, then I must pursue and discover for myself what I truly value. Exploring and questioning values is important awareness work as well. Clients enter therapy at times saying they value things, but find they are acting in ways not in alignment with what they claim to value. Why is this the case? A value is that which deep in our heart says, this is what I want my life to be about. So questions such as, what do I stand for, or what do I want to do with this one life I have in this brief moment that I have it, get at what we value. We can watch the ships sail by and never choose to set sail with any of them. We can listen to the second hand of the clock tick by while never getting off our ass to do anything. This is a possible sad scenario for many people, whether we want to admit it or not. Values apart from action are meaningless. In fact, what we value imbues our actions with desired qualities that align with the value. Values define how we want to behave on a day-to-day basis. I remember standing outside of an academic building one winter in a cold, sprinkling rain, questioning whether or not I wanted to continue with my Ph.D. work in counseling. The work was going to be long, I was looking at being tight with money, and I was at an age that either I was going to do it or not. My values pushed me on at that moment. But the experience speaks to how difficult at times it is to live in alignment with core values. I truly believe it is easy to give up on living according to our values. I think people enter counseling at times because they are trying to clarify their values, are experiencing the difficulty in aligning with their values, and are trying to find the courage to live according to their values. Exploring and recognizing values can be some of the most difficult work people can do. Then doing what it takes to live those values out is another difficulty that life offers us.

Commitment (Do What It Takes)

Commitment is action. Effective actions are those that are guided by our values. Obviously, not living out what we value gives rise to a plethora of uncomfortable and unwanted thoughts and emotions. This is no less true when we seek to live in alignment with our values. Doing so gives rise to an array of both pleasant and unpleasant thoughts and emotions. It takes courage to live out what one values. Effective and committed action is the opposite of experiential avoidance, which can come about due to a lack of courage to do what it takes to live out our values, even when it’s difficult. The last year of my doctoral work was some of the most stretching times I experienced up to that point in my life. I was strapped for money, living in a dump of a house and apartment, and wondering whether or not when all was said and done, would it take me anywhere. Effective action then is value-congruent action. Many behavioral techniques can come into play here, including goal setting, planning, skills training, and other behavioral activation techniques. But these techniques are mere formalities if the work around a client’s actions are not value-congruent actions.

Conclusion

The six core processes of psychological flexibility counter those six points of the ACT Model of Psychopathology discussed in Part I in last month’s blog. Contacting the present moment counters problems that ensue through the dominance of the conceptualized past and future. Defusion counters what happens when people become cognitive fused with their thoughts and rumination. Acceptance helps us open up so as not to deny painful thoughts and emotions, thereby experientially avoiding ways of recognizing and dealing with them. The notion of the self as context helps us detach from the wooden and rigid conceptualized self. Knowing what matters, that is becoming aware of our values, provides clarity and contact that are lacking with we are unclear and unaware of our present values. Effective action, which is action in alignment with our values, enables us to escape unworkable action. These core processes are merely a conceptual framework for ACT. There is much more to this approach as therapists and clients delve into any one of these processes. The work is also holistic. By exploring any point of the six-point Hexaflex or diamond, all six points will be effected in some manner.

It is important to recognize that ACT is simply not a set of techniques tied to the Hexaflex. The aim of ACT entails a philosophical take on life. ACT therapists state that their aim is to help clients create a rich, full, and meaningful life while accepting the pain that inevitably goes with it. This philosophical perspective is why I believe that ACT meshes well with my spiritual and existential framework for my work. Likewise, the emphasis on mindfulness is an important piece that integrates well with how I work. As an ancient concept, mindfulness is found in a wide and historical range of spiritual traditions, including Buddhism, Taoism, Hinduism, Judaism, Islam, and Christianity. Western psychology via research and practice had begun to recognize its usefulness in the practice of counseling. Mindfulness can be used to increase awareness, openness, and psychological flexibility. Above all, however, ACT is about valued-living. In that sense, it overlaps and can be easily integrated with many counseling approaches.

I’m not a one-theory man. I’ll use whatever I can get my hands on in order to help my clients reach their desired goals. In saying that, I’m not a pure pragmatist either. We all have values on which we base our living, whether we are aware of it or not. I too have mine. And like many people, I’m striving day-to-day to become, not only more aware of what they are on deeper levels, but also I’m looking to become more aware of how to act on them in a consistent manner. A rich, full, meaningful life is most definitely worth living. Is it not?

References: Harris, R. (2009). ACT made simple. Oakland, CA: New Harbinger Publications.

 

John V. Jones, Jr, Ph.D., LPC-S/May 14, 2017

PROFESSIONAL COUNSELING

 

Acceptance & Commitment Therapy (ACT) Part I: Psychological Inflexibility

Introduction

Given the way psychotherapy has evolved over the past century, I am not one who places all my eggs in one basket regarding one theory about how to work as a therapist. I think the integration and eclectic movements that took hold in the 1980s & 1990s allowed therapists to move away from the idea that there is one right way of doing therapy, and that everyone must align with that proven way of working. Likewise the integrationist movement allowed therapists to free themselves from the notion that individually each therapist must choose one way of working among the many theories and approaches that have been developed over a century that began with Freud. As a therapist whose framework is existentialism, I integrate many approaches for my work with clients.

I offer the little preface above because over the next couple of months, I am going to discuss an approach that I find useful, and one that I will integrate within my framework for working with clients. It is Acceptance & Commitment Therapy, or simply ACT. The approach integrates well with several other conceptualizations, such as cognitive therapy, Motivational Interviewing, and existential work. I find its conceptualization squares and meshes well with existential thought along several avenues, including its take on experiential avoidance, values clarification, self-knowledge, and the conceptualized self. Though those avenues are more easily addressed as integrating well with existential thought, all the points of ACT on its Hexaflex I find mesh well with existential thought.

It is the ACT conceptualization as presented in its Hexaflex that forms the structure of my discussion. For this month’s article, I will focus on the Hexaflex as ACT therapists use it to discuss what they call the Six Core Pathological Processes. Though I do not necessarily like the nomenclature pathological, I find I do like much of the conceptualization that ACT presents through this model. ACT therapists designate these processes as Psychological Inflexibility. In next month’s article, I will discuss the ACT conceptualization that counters the pathological processes delineated by ACT therapists with their six core processes of Psychological Flexibility. From the ACT perspective, Psychological Flexibility is a holistic understanding of human functioning that involves living in the present moment, opening up to life’s possibilities and vicissitudes, and doing what matters. ACT theorists and therapists delineate Psychological Flexibility along six core processes they conceptualize in their Hexaflex. These six core processes are: 1) Contact with the Present Moment (Be Here Now); 2) Acceptance (Open Up); 3) Defusion (Watch Your Thinking); 4) Values (Know What Matters); 5) Committed Action (Do What It Takes); and 6) Self-As-Context (Pure Awareness). These six processes are explored in therapy to counter any points that emerge when clients become trapped in psychological inflexibility via the Six Core Pathological Processes. In this blog article I will delineate these pathological processes as conceptualized by ACT therapists. I will discuss the remedy or counter to these pathological processes in next month’s blog article.

ACT: The Six Core Pathological Processes

Just as the Hexaflex is used to delineate the core processes for Psychological Flexibility, likewise it is used to conceptualize the core processes of Psychological Inflexibility. The ACT Model conceptualizes Psychological Inflexibility in terms of the following six core processes: 1) Dominance of the Conceptualized Past and Future; Limited Self-Knowledge: 2) Experiential Avoidance; 3) Cognitive Fusion; 4) Lack of Values Clarity/Contact; 5) Unworkable Action; and 6) Attachment to the Conceptualized Self. From the perspective of ACT therapists, the two processes of cognitive fusion and experiential avoidance give rise to and maintain all the pathological processes. I may be playing with words here, but I really like the notion of inflexibility as opposed to pathology. From my perspective too much of therapy pathologizes experiences that people go through that can be understood in proper contexts. In other words, I don’t view experiences as depression and anxiety as medicalized illnesses that need to be cured. Indeed I understand that these experiences can impact human beings at a physiological level that may need to be addressed via medications. But depression and anxiety are experiences that come with life. I believe other phenomena such as schizophrenia, bipolarity, and forms of dissociation and emotional dysregulation will be eventually explained along neurological avenues. However, personal concerns that come with those experiences can be addressed by therapy utilizing ACT and other approaches. For example, how might an individual relate to the notion that for most of his life he will have to be medicated for some form of schizophrenia? How might she view herself for being labeled with such a diagnosis? These and others like them are personal concerns that can be worked through in therapy.

Cognitive Fusion

Cognitive fusion is the experience whereby a person becomes entangled in his thoughts to the point that they dominate his awareness and have a huge impact on his behavior. What is not being said here is that it is wrong to think. The focus of the work is more on the thoughts to which one is fused, and how that fusion impacts day-to-day action. For example, a depressed person might ruminate significantly on the thought I can’t change anything in my life. Or they might feel, It’s too much effort to try to change anything; nothing works. These thoughts are often connected to past memories that might have been extremely painful. Experiences such as failed relationships, business failures, or other disappointing ventures become the focus of fused beliefs. Clinical depression involves fusion to the point that individuals can experience excessive worry, continual rumination, and endlessly trying to understand why am I like this. Much of what ACT calls cognitive fusion meshes well with the cognitive therapy conceptualization of negative thinking about the self, others, and future. But as will be explained in this and next month’s blog articles, ACT takes a different approach from cognitive therapy in working with cognitive fusion.

Experiential Avoidance

It is natural for anyone to want to avoid unpleasant experiences, and that is true of private experiences as well as contextual ones. We find ourselves trying to find ways to quit thinking about things, to cease holding onto recurring painful memories, and seeking to avoid uncomfortable feelings. Fusion and avoidance are like two sides of a coin. They are hard to fissure, so they form the coin that drives the entire machine. The name of the therapy, Acceptance & Commitment Therapy, provides a clue to the therapeutic work that is used to counter experiential avoidance – acceptance, which utilizes a mindful approach to therapeutic work.

Dominance of the Conceptualized Past and Future/Limited Self Knowledge

Fusion and avoidance typically lead individuals to become stuck in certain contexts; consequently, they lose contact with the present, or living in the here-and-now. We probably all know people, and even can recall our own personal experiences, where we so tightly hang onto a past experience, or put off living due to an extreme focus on and concern about the future. Being stuck in either the past or the future robs us of here-and-now experiences. Though not unanimous by any stretch of the imagination, many depressed individuals tend to hang onto past failures while anxious clients fear the future on some level. Both the past and the future, while not unimportant, can rob us of living in the here-and-now.

Lack of Values Clarity/Contact

This process as described by ACT therapists meshes well with existential thought. Individuals can become immersed in situations, lost in certain contexts, and sense that their lives lack direction because they are not clear on what they truly value. Individuals can experience a disconnect between the way they are living on the one hand, and, on the other hand, the fulfillment in life they hope to find because they might be acting on values about which they are not clear or do not truly believe. Individuals can inculcate values from their social contexts without truly assessing whether or not they value what they claim to value. Values clarification can help these clients determine what they hold as important so as to act on what they truly believe.

Unworkable Action

If people lose contact with the here-and-now and are unclear as to what they truly believe, they find themselves in patterns of behavior that simply are not getting them what they want. In other words, what they are doing is not working. What they are doing is not working because what they are doing is not aligned with anything they really believe or value. Hence, rather than mindful actions based on personal values, people can become caught up in mindless activities, reactionary behaviors, and turn into automatons, all of which can lead to purposeless action, directionless living, and constant experiential avoidance because of the lack of fulfillment and pleasure in life. Aligning action with values can help individuals begin to move purposefully through life.

Attachment to the Conceptualized Self

We all can present, tell, or write some form of narrative that speaks to who and what we believed ourselves to be. These narratives form the way we describe ourselves. We can fuse with our self-narratives to the point that we are our self descriptions. I understand the problem of identifying with negative self-narratives, such as I’m a failure. But I depart in some sense from ACT on this point in that I do believe in a core self. While mindfulness can help us better understand ourselves as self-in-context, I’m not in alignment with the total Eastern view of the human being as not have a self, or viewing one’s understanding of the self as an illusion. I also agree that overly identifying with even positive self-narratives can be problematic if we continually deflect input from personal experiences and try to solidify a particular notion about ourselves as a total narrative about who we are. I find myself somewhat more Western here with the notion that an individual is a self-in-process, continually undergoing change, and hopefully growth, throughout his or her life. To be in process requires openness to life. I don’t believe it requires not having a core self as much Eastern thought tends to hold. Nonetheless, having stated my differences here, I think the work that ACT pursues with clients to help them defuse from problematic self-narratives is a valuable part of the work in this approach.

Conclusion

Obviously, these six core processes do not stand alone. They overlap and interact with one another, and one process can trigger another. If I believe that I’m a failure, then I will experientially avoid trying new and risky ventures. These six core processes of psychological inflexibility are countered by the flip side of the six core processes of psychological flexibility. These processes I’ll tackle in next month’s blog article. The notion of flexibility is one with which I resonate. After all, what is flexibility other than adaptation. We all move through our lives, evaluate our experiences, determine whether to hold or discard certain values, and seek to live in alignment with what we know and believe. We are in process and constantly engaging change and growth.  We are in constant movement toward carving out an adaptive and flexible understanding of our identity or self.

References: Harris, R. (2009). ACT made simple. Oakland, CA: New Harbinger Publications.

 

John V. Jones, Jr, Ph.D., LPC-S/April 14th, 2017

PROFESSIONAL COUNSELING

The Quest for Meaning: Part II

[This discussion is the second of a three-part exploration of the human capacity for meaning-making. This article also continues a series I began in October, 2015. The series of articles as projected into the future will cover various themes that I explore with clients within the counseling framework I practice.]

It is not what we require of life that matters, but what life requires of us. – – Viktor Frankl

Introduction

If you had to reflect for a while, and then try to put into words what it is that enables you to think of life as meaningful, what words would you find that would satisfactorily express your response? Last month I stated that I believe we are meaning-making creatures. Our minds are created in such a way that we seek to make meaning of our various experiences. Moreover, we prioritize and hold dear what we garner from life that is most meaningful for us. In this month’s blog, I want to add that I believe that much of our meaning on a deep level comes through the struggles we face, the difficulties we work thorough, and suffering that we might encounter. That is not to say that meaning cannot come through other measures; it can and does. In fact, I think meaning can come through the simple pleasures we experience day-to-day. Most importantly, that is not to say that we should hope for difficulties and struggles in our lives. That would be masochistic. For each of us, however, struggles of various kinds tend to be part of our lives. When they occur, the question becomes: What do we do with them?

The Hard Work of Meaning-Making

Using our mind, if we’re to do it properly, is hard work. I’ve seen it time and time again as a professor and a professional counselor, how difficult it is for people to explicate their core values and beliefs about life. In Christian settings as well, it is difficult for many to state how being a Christian informs all aspects of their lives. We tend to separate our spiritual beliefs from the rest of living, our education from any life goals we pursue, and our core values tend to be segmented into such categories as work, family, entertainment, and church.

We encounter the world in a multitude of ways and through a variety of experiences. By our very nature, we use our mind to evaluate our experiences, interpret them, and attribute meaning to them. Our understanding of life’s experiences happens on many levels. When asked about meaningful experiences, most people reflect on those that hold what they would consider deep meaning for them, those that lead to experiences of passion, fulfillment, and joy. Likewise individuals who work through experiences of struggles and pain point to such experiences as carrying profound lessons and meaning for them. Indeed, some would say that those events in life that entail facing and working through struggles and suffering of some kind can provide the most profound understanding of what life requires of us. Such experiences are ones that raise questions and doubts, and they strongly engage our beliefs and values by which we claim to live.

As I will address in next month’s blog, I don’t consider meaning-making to be simply about finding the one Big M, in terms of some abstraction. Because I strongly believe that life involves constant learning, I likewise believe that our meaning-making is a continuous life-long journey. And although some experiences are more profound for us than others, our making sense of life involves how we take in all the day-to-day experiences of living. Usually, making meaning of various experiences of our lives comes through some type of reflection. Reflecting back on experiences, both painful and joyful, can bring a sense of deeper understanding, as well as the reality that we may have to remain open for quite some time before understanding of some events in our lives comes. There may be experiences in our lives of which we will never make total sense.

Meaning-making comes through those times we put aside for prayer, contemplation, and reflection. It’s not, nor should not be, something we can do every minute of everyday. Such ruminating would lead to our being stuck in a mental quicksand. Some people, however, do not take the time to reflect on life in such a way. Meaning-making is hard. It can lead us to think about things we would rather not. Sizing up those areas in our lives that we feel good about, and those where we think we’re lacking can bring discomfort, a feeling of uneasiness. It’s difficult work at times to become clear, authentic, and truthful about our basic premises, core values, and whether or not we’re living in alignment with all we claim to believe.

Challenges in the Search for Meaning

As I’ve stated before in other articles from this blog, one person in the 20th Century who has contributed to my thoughts on meaning-making is Viktor Frankl. Frankl developed his thought on the importance of meaning-making via his experiences of interment in Nazi concentration camps. His ground-breaking work that explored his personal experiences, Man’s Search for Meaning, emphasizes that in their life journey, people can find meaning in even the most seemingly meaningless and absurd situations. Clients enter counseling many times facing what they feel as a meaningless and absurd existence. As a professional counselor who is a Christian, I do not hold that existence is meaningless and absurd. Yet I recognize that one’s experience of life as such is real to them. There are no platitudes or simplistic answers or formulas to easily and quickly resolve such struggles for clients. The complexities we face in life will assault our beliefs and core values. Life has a way of challenging us, raising doubts, leading us to re-evaluate things, and making us question what we claim to believe and know, if indeed we’re open for such challenges. I believe all people can deepen their understanding of their lives. I also think that such deepening most likely entails the necessity for courage and strength, that I personally believe is garnered through grace. But that’s a far cry from simplistic answers that negate the profound complexities we face in life.

Conclusion

What am I not saying? As touched on in the introduction, we need not go looking for problems, difficulties, and suffering so as to deepen our understanding of life. On various levels for all of us, those encounters tend to come on their own. No masochism here, please. Likewise, I’m not saying that profound meaning cannot occur in the most simplistic of experiences. Those pleasurable things that may occur for us in our day-to-day existence can bring some form of personal meaning. I remember the first time I drove alone from Texas to Durango, Colorado. Coming upon and driving through the Rockies was indeed a memorable and profound experience. Personally, I’m very aware that my life has, for the most part, been free of suffering. I’m blessed indeed. I would prefer to keep it that way, but I do not have that much control of life. And it’s a rather hubris-filled notion to believe that I should. Every time I read Frankl’s, Man’s Search for Meaning, I always cannot help but question: Could I make it through such horrific events? Countless people throughout history, and individuals I know presently, have born witness as to how suffering deepens their understanding of life, and what is truly valuable and meaningful. All I can do is state the principle that I’ve heard time and again. I want to say I believe it, but for me, personally, I’m not sure what I would be made of in such contexts. And quite frankly, I don’t want to find out. Perhaps, and I think rightly, that is what grace is all about.

How we make meaning of our lives gets at our worldview, our take on existence, and our way of using our mind to make sense of and comprehend those experiences life brings our way. I will explore this avenue of thought more in-depth on next month’s blog.

John V. Jones, Jr., Ph.D., LPC-S/March 14, 2016

GENERAL ESSAY/PROFESSIONAL COUNSELING