To lead or not to lead

Ten reasons why therapists find it tricky to make suggestions

‘I suggest that you.. ’ is something I rarely say to clients. This is an example of therapist directivity that sits toward one end of the continuum. If you are deciding how much you want to be led by your therapist – how directive an approach you want – the following may help. For the purposes of this piece, I’m defining directivity as the ‘I suggest’ kind of comment.

Here are 10 reasons why I don’t tend to direct clients – and some exceptions.

1. I’m cautious about being reductive. When I have offered suggestions I’ve sometimes felt that I’ve missed the intricacy and complexity of the human before me.

2. My value is in helping someone to be, rather than do. Twee though it may sound, ‘being’ is where real empowerment resides in my view. Further, there’s already plenty of ‘this is what you could do’ around – from friends, family, on the web etc. I’m paid for something different.

3. If I’m directing, I’m probably not empathising – and empathy is a hundred times more powerful, sister. That’s what I’ve experienced and witnessed over the past decade.

4. It’s impractical – I don’t have access to the necessary information. But empathy often nudges clients to ways and means for navigating their odyssey. The process of empathy helps to ‘mine’ for knowledge: my genuine, inquisitive tip-toeing in a client’s world has, time and again, led to new and pertinent information being unearthed. Such information has invariably led to different – empowering – choices.

Below is an example from my own therapy:

Me: I don’t like to admit it but I feel envious
Therapist: Yes, you’re envious! You’re coveting something, missing something in your own ‘house’ – but what?

I subsequently made several changes to ‘my own house’ that in fact fed my self-esteem, leaving me less inclined to compare. My therapist’s empathy helped me to crystallise what was missing in my life. I needed to register my envy as information in order to take action. When I did, it dissolved.

My therapist could not possibly have come up with the specific changes I needed to make. Only I knew, for example, what interested and motivated me, what bored me, what frustrated me and so on; and hence what needed shifting. Similarly, as a therapist, I see that the changes my clients conjure I could not possibly have put on the table.

5. I don’t have a clue. When I’m asked, ‘what would you do?’, often the answer is that I don’t have a scooby. I’m back to information: my entire experience of a situation, including my feelings and bodily sensations, are data points that direct my subsequent responses. With a hypothetical question, I’m missing all this data. I can help others access their self-knowledge though – that’s definitely my jam.

6. I don’t want to risk my respect for you seeming conditional. By directing, I’m likely to confer that ‘I prefer you to take one course over another’. The subtext may well be understood as: ‘my respect – or acceptance – is conditional on you following this’. This has implications for what you might choose to share or show of yourself, yet my priority is to make it as easy as possible for you to bring as much as possible.

7. It’s an illusion – and potentially a disempowering one. If I’m dishing out advice we’re probably a world away from what I call empowerment. I.e. You finding your own creative solutions and accessing your self-expertise. ‘It is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried’ said the eminent therapist and academic, Carl Rogers. If I start to lead, then I’m also saying that ‘I know best about you’. How does that help your relationship with yourself?

8. I don’t know you well enough. If I do give my opinion, I want to be confident that you will discard it if it doesn’t resonate. However, often the very reason that people end up seeing me is because they have lost themselves – they don’t trust their own judgement and don’t know what resonates. If I don’t know you well enough, I can’t gauge my confidence that a. you know enough of your own position to discard mine if unhelpful and b. you’d be able to tell me.

9. I do know you well enough and know the risk of disempowering is high. For those struggling with shaky self-esteem or identity, for example, it’s probably hard to know how my opinion/suggestion sits or interplays with their own. It’s common in these scenarios for my opinion to be taken on automatically because of my role or title. I then need to tread carefully; I’m being given a heck of a lot of power. And this is the opposite of what I want: to empower, to help people self-direct.

10. There’s too much tension with autonomy. I’m mad keen on the ethical principle of ‘autonomy’ (as in the BACP Ethical Framework for the Counselling Professions 2018). If I’m telling someone what they could/should do, I’m probably not fully respecting their agency.

Exceptions

Where safety is concerned, abuse or self-harm for example, I’m down with being directive (‘have you thought about seeing your GP’, for instance). I’m not lofty in my ideals or poetic about therapy to the extent that I miss the practical imperative of client safety. Non-directivity is not a fixed entity.

Where it’s explicitly solicited i.e. when a client directs me to direct them: ‘I want your opinion on this’ or ‘what do you think I should do?’. My newly-qualified self may have floundered in attempting to pass the question back. Now, I’d try to honour the request more fully. That is, honour the client’s knowing of what they need (even if this is an opinion); as well as attending to the process (exploring the request itself including what the question means to them). Often when I’ve responded with something like the latter, I’ve not got the chance to give my opinion. It usually turns out that the client wasn’t that invested in it; or that the question was a symptom of something more meaningful that then occupies their attention instead. And sometimes my opinion is exactly what they want; and I do not necessarily need to withhold it – far from it.

Further, if I were to withhold when asked for an opinion, I may inadvertently be reinforcing the idea that I know best. Something like, ‘you think you need an opinion but I know that’s not what you really need’..! For this reason, as I’ve become more experienced and adept at computing all of the above, I’m more inclined to meet a request at face value; as well as to attend to the process around it.

And one more thing

Lest non-directivity be confused with neutrality: I’m far from neutral in sessions. I’m frequently exacting and open about how what I hear and see lands with me. And that itself could be experienced as directive.. However, I believe it leaves clients space to take hold of my offering, or not. And it avoids risks around respect and power. In taking a nuanced, non-directive stance my overwhelming experience is that feasts and fire evolve.

This article was originally published on Welldoing.org: https://bit.ly/2Trn0dJ

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