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).