Debriefing vs. wallowing

We know that often clients need to tell and re-tell their stories, but at times we come across some who seem to be wallowing -- nothing changes and they seem stuck in a world of negativity, no matter how many times they repeat their stories. The metaphor I am using here is cleaning a window, and the choice is either gradually cleaning the window for a clearer view as we look out at life, or continuing to look at life through a dirty window.

The importance of hearing the story

All clients need to feel heard and understood and respected, and this is the basis of building rapport with them. No useful work can be done without this base in place no matter what counselling tools or techniques we chose to employ.

Debriefing and processing

This is like gradually cleaning a window so that looking out becomes clearer. Assisting clients in processing their feelings and issues is one of our main aims in counselling. Debriefing may mean repeating stories, but shifts will begin to occur through the telling. Processing may include:

• understanding reasons for, and sources of, feelings
• making connections
• normalising reactions
• gaining new insights
• achieving ah-ha/ light-bulb moments
• finding new themes/ perspectives to weave through narratives (alternatives to the initial dominant story)
• meaning making
• dealing with unwanted/ constrictive baggage
• moving on from the past
• finding hope in the future/ becoming more future oriented
  

Wallowing

This is like looking inwards at wreckage instead of outwards at the future and, when glimpses are taken outwards they are through a dirty window. This window can build up more dirt over time as negative view points continue. Wallowers will repeatedly tell the same stories with the same negative themes, like a broken record,  and it seems that in telling their stories they are reinforcing their negative perspectives. Some tools to use with wallowers may include:

• asking about the things that are OK in their lives
• encouraging a re-focus on positives
• limiting the time allowed on re-telling of stories
• encouraging them to keep a gratitude journal ( at the end of each day, recording at least one thing they are grateful for) and reading back through it from time to time to see if themes are emerging

When wallowing is OK

The exception is for people who are grieving. Grief journeys need to be of the design and pace chosen by the client, not by us, and we need to respect the journey.

Freedom

Freedom is something that many people long for, but when I recently found some from work, my reactions were interesting, and I began to dissect these.

Freedom from

In my longing for freedom and in my first taste of it, my focus was on freedom from. We may desire freedom from the systemic sources of work stress and the seemingly mundane tasks that become part of everyday over-accountability. We may want freedom from being bullied or harassed, or from dealing with less than appreciative clients. There may be other things in our personal lives that we would like to be freed up from.

Feeling Directionless

When I finally had some freedom from work, I began to feel directionless, after initially savouring the sense of "freedom from". I did not know how to deal with this until I used the Magic Wand that is suggested in Stephanie Dowrick's "Changing your life: Intimacy and Solitude Self-Therapy Book". When I applied my magic wand to the word "directionless", it dissolved into "less direction", which to me is a definition of "freedom". Now I had something to use to process the feeling.

Freedom to

By re-focussing from "freedom from" to "freedom to" a whole world of possibilities and choices opens up, based on the freedom to choose how to spend each day and moment of each day.

The challenge of finding "freedom to" when still constricted by lack of "freedom from"

Now this is the real challenge! Despite all the demands of our work days, there is often the opportunity to choose:

• how and when we will undertake tasks
• when to balance work with breaks in the work day
• how to implement work/ life balance
• what other activities we become involved in apart from our core business of work with clients.

 In my work with women living with domestic violence I have often been amazed at their ability to find little pockets of freedom despite the control they are living under, and helping them to increase that freedom becomes very therapeutic for them. Using choice is a major tool here.

What ways can you exercise "freedom to" in your life?

Levels and pace of dealing with issues

I have recently been involved in really cleaning my house and, as I engaged in this task, I began to reflect that there were some parallels in working with clients.

Offloading the dust

I began by doing lots of wiping and dusting of visible surfaces. Clients too, offload their surface issues to us as they initially tell their stories, and for some, this is all they may choose to do, as this may have freed them up enough to go away and process deeper issues on their own. However we can encourage the emergence of deeper issues by using intervention strategies like:

• using questions based on our emerging hypotheses or our curiosity about missing information. 
• using written mind maps with the client to identify issues that contribute to dominant feelings like anxiety and/ or depression.

Leaving some areas unsorted

I found that, as I progressively cleaned each room, I chose to leave some drawers and cupboards unsorted, either because they had been more recently sorted or because they involved a lot of work. Clients may do the same with their issues, choosing to disclose what they feel comfortable in dealing with or the things that are currently relevant to their lives. Deeper issues may be left undisclosed until they feel strong and courageous  enough to deal with them. Our job then, is to help them build up strength, courage and trust in us.

Making connections between issues

As I moved to a new area and disturbed the dust, some of this would settle back on the areas already cleaned. So too with clients, we are only able to assist them in making connections as new issues are uncovered -- and new issues do give us the opportunity to do this. Once again, one of the best tools to assist with this is by asking questions based on our curiosity.

Refocusing when crises occur

I had a plan to move progressively from one end of the house to the other at my pace, but when mice invaded the cupboard under the kitchen sink I needed to leave the room I was in and concentrate on cleaning out this cupboard (and hopefully mouse-proofing it as I performed contortions placing tape over steel wool around the pipe holes that they had squeezed through). I'm sure we've all experienced clients presenting to a session and wanting to discuss a recent crisis, no matter what issues we were already working on, and we need to be flexible and allow for this to happen (Murphy's law decrees that if we have done extra preparation for the session, then this is more likely to occur).

Taking a break

I became so obsessed with cleaning that I was spending most of the day doing little else -- at which point my husband wisely advised that we were packing the caravan and taking a break down the South Coast of NSW (I think he was worried that he would be dusted and vacuumed if he sat for too long in his chair). Problem saturation can become a risk if clients focus too intensely on their issues, and they too may need breaks to consolidate the things they have already worked on, or to just simply re-group and focus on other things.

Letting the dust settle after trauma

There is no point in trying to clean up dust before it has settled. Although other well meaning people often encourage us to intervene with recently traumatised clients, we too need to stand back and let the "dust" settle first. The only useful things we can do is ensure that they are safe and that their material needs are being met (psychological first aid).

Beginnings

Hello and welcome!

I hope to use this blog to share practice wisdom acquired over many years as a Community Health Social Worker in a rural town in NSW.

I love using metaphors, as you will discover, and my next post will be based on one.

For now though, this is a new beginning for me. Beginnings help to keep our lives interesting and our brains active. They expand our horizons, but can also be scary and need a dose of courage. Clients coming in for their first appointments may be facing beginnings (doing something new for the first time) and we need to respect and acknowledge the courage it may have taken them to attend.

We need to be kind to ourselves too when facing beginnings.

See you next time!