American Counseling Association Weblog » Susan Jennifer Polese

Encouragement by Another Name

rdanielburke — Tue, 03 Apr 2012 13:16:57 +0000

Susan Jennifer Polese

I am currently involved in an interesting conversation thread as part of an American Counseling Association group on LinkedIn. First off, I highly recommend that counselors get on LinkedIn and create a profile. It is a great way to network and be part of a counseling community. Once on there, take a moment to join the ACA discussion group – it is there that you can communicate with other professionals and expand your knowledge. Discussion thread messages may be directly emailed to you – in case your want to be in the know. And in the know, I am!

Currently, among other topics, counselors and counselors-in-training are discussing the difference between coaching and counseling. The general consensus is that the difference lies in the level of functioning of the client. Coaching is suited for people who are basically mentally healthy and want to improve and counseling is best for those who are emotionally fragile and/or mentally ill. Although I agree with this as a general statement, I don’t believe that all counseling clients are required to have emotional problems or to be mentally ill. Counseling is vehicle for change for any client who chooses to use it as such. That being said, there is so much more to consider – such as similarities between the two.

Coaching and counseling have much in common. I’ve mentioned before that I became a certified life coach before entering graduate school for clinical mental health counseling. When I began my grad-schooling I was amazed to learn of counseling theories that are virtually identical to coaching. An example is solution focused therapy which is a strength-based approach that focuses on action, goals and solutions to problems. It is a non-medical model approach that is present and future oriented and sees the client and therapist as partners. When I learned of this in my theories class: I thought , That is coaching! Other theories that are right at home in the coaching realm are existential and reality therapy. In fact, in reality therapy the client is encouraged to envision their “quality world” – an idea that can be paramount in coaching. Can it be that coaching was born from counseling? If so, the relationship continues. I received information from my coaching school regarding new approaches to coaching and one was Cognitive Behavioral Coaching, another was coaching based on Choice Theory; the precursor to reality therapy. I was quite surprised by this, but in retrospect it makes sense. Although coaching and counseling run parallel the two paths seem to intersect often.

The thorough history of the two disciplines is a blog for another day – right now counselors are concerned about what coaching is, should they part-take and where do ethics fit into it all. My perspective is that someone with a mental health degree can add on coaching to their tool box. Unadulterated coaching is very powerful and part of the power is the complete absence of psychopathology. I wouldn’t, however, encourage a counselor to call themselves a coach if they haven’t gotten certified as such – therein lies the true difference between coaching and counseling: counselors are licensed professionals who are required to be supervised and tested before receiving credentials. As an unregulated, budding field life coaching is not licensed, and exists in a grey area in which ethics can be murky. And so the debate rages on.

Susan Jennifer Polese is a counselor in training, a personal coach and a freelance writer. Her areas of interest are mindfulness, divergent thinking, and creativity in counseling.
www.evolutionlifecoachingstudio.com

To Be or Not to Be – An Anxious Look at Existential Counseling

rdanielburke — Tue, 21 Feb 2012 20:46:55 +0000

Susan Jennifer Polese

Having just finished a very long, grueling text book chapter exploring anxiety disorders my interest in existential counseling has once again been piqued. I’ve been interested in existentialism for years having studied the philosophy of Kierkegaard and the prose of Camus.

As an art major attending college in Manhattan I spent many an afternoon in the halls of the Museum of Modern Art discovering the paintings of DeKooning and Jackson Pollock. And of course, being a thoroughly modern woman I devoured the feminist manifesto “The Second Sex” by Simone de Beauvoir. What do all of these incredible icons have in common? They were each existentialists. Although one or more of them may’ve thrown a glass of wine in your face if you met them at a cocktail party and called them one. Personally, my favorite existentialist (if not self-identified as such) is Samuel Beckett who created characters steeped in angst and faced with adversity at every turn – kind of the way real life is when you look at it very, very closely.

I hadn’t known there was a psychology theory born from existentialism until my first year of graduate school. Immediately enthralled I read the works of Viktor Frankel and poured over “The Art of Existential Counseling” by Van Kaam. Frankel survived the death camps of Germany and maintained that we each have the choice of how we react to circumstances. My classmates and I learned about this theory in a freshman class and in many ways it seemed to be one of the more difficult theories to implement. The strength of the approach, however, is it completely eradicates any inkling of a victim mentality and puts power into the hands of the client.

After reading about anxiety disorders extensively I began to reconsider existentialism and its potential role in therapeutic sessions. Anxiety is an important element in existential therapy and it is supported by the viewpoint that anxiety is manifested by an individual’s complete freedom to decide and complete responsibility for the outcome of such decisions. Just writing that gives me angst! Yet, I find this view of anxiety as very empowering, if a little intimidating. This way of thinking considers anxiety an energy that can be channeled, used and not simply eliminated.

A being free in the world – this is the existential view of the client. However, it’s important to remember that the world in the case means the client’s subjective world of meaning – her attitude toward the world in she was born, raised, and educates and participates in daily. It is a subjective experience – once again challenging the counselor to see the world through the client’s eyes.

A Catalyst to Change – Rethinking Depression

rdanielburke — Wed, 01 Feb 2012 17:14:27 +0000

Susan Jennifer Polese

I have a personal relationship with depression. The depressive periods in my life are highly situational in so much as in the past they occurred after my divorce and most recently since the death of my mother. However, I am no stranger to the effects that chronic depression can have on a person and the people in their lives. I am certain that along with having difficulties with anxiety, my mother suffered from depression – never really addressed clinically or in any other way. The man I married when I was in my twenties was most certainly depressed – like so many others I recreated in my adult life what was familiar to me as a child. He, also, do this day has never addressed his depression – or chronic basic unhappiness. I have been affected by depression and so I am interested in what this condition is and ways to combat it – and in another sense, ways to accept it and actively deal with it.

Depression is clearly defined by a list of symptoms in the DSM-1V and will certainly be defined, again if differently, as a list of symptoms in the upcoming DSM-V. Certainly, these criteria will aid counselors and other mental health professionals in the pursuit of helping their clients. Diagnosis is made with the use of the DSM – but there are many differing views of what depression is, how to treat it and if it really exists at all.

That being said perhaps we can, for the moment, rethink depression much the way William Glasser, the founder of Reality Therapy does. Glasser maintains that we need to take responsibility for what we are and what we are experiencing. He states that being depressed, being anxious, even having a headache are expressions which avoid our responsibility in behaving in these ways. We choose to be depressed and hence, when depressed, we are depressing. We choose to have a headache, and hence, when we have a headache, we are headaching. He uses verbs to describe these conditions because we are choosing to experience this. This viewpoint does not support treatment with a medication.

Depression through the lens of Dr. Martin Seligman, the developer of positive psychology, changes the focus from what’s wrong to what’s strong. This ideology views the fight against depression as a journey through which the client accesses creativity and strength to endure and overcome deep unhappiness. Through these actions meaning can be found.

Eric Maisel is a creativity coach has who has written a book “Rethinking Depression” and previously wrote an article for Psychology Today exploring depression. Like Glasser, Maisel takes a nonclinical look at depression and goes as far to declare that there really is no disorder of “depression” and that unhappiness, chronic or otherwise, need not be looked at from a medical model of pathology. Maisel makes a great case for this way of thinking and mentions how pharmaceutical companies have a lot to gain by making any state of human emotional or physical discomfort labeled as a disorder. Often depression/unhappiness is a normal reaction to what is occurring around you and is no way a disorder. Maisel’s goal is to help a client look at her unhappiness and aid her in making changes in her life.

Considering these ideas as a counselor in training I have to say I am absorbing them all like a sponge – and slowly formulating my own viewpoint regarding this issue. I’m strongly attracted to a non-medical model on which to build my practice. But what about a client who is so depressed they can’t get out of bed or function in any meaningful fashion? What if he or she is driven to suicide by unrelenting unhappiness? Would medication be a welcome component of therapy? Is a clinical definition of depression necessary? Human beings are meant to experience discomfort – even misery – often as a catalyst to change.

This is a fascinating subject and counselors in training have all points of view available to them. The more we know the better we’ll be able to serve our client. Here is on point of view.

http://www.psychologytoday.com/blog/rethinking-psychology/201202/rethinking-depression

The Path to Integration

rdanielburke — Mon, 30 Jan 2012 16:15:28 +0000

Susan Jennifer Polese

As I begin personal therapy at my graduate school student counseling center I realize that I am analyzing everything the therapist is saying. What is her theoretical orientation? Was that an open or closed question? Will we be goal setting? How much money does she make? Yes, I was more than a little “in my head” during that first session.

For years when I was in my twenties I went to therapy with a psychologist who was psychoanalytically oriented, although I didn’t know that at the time. I just knew I was experiencing a lot of difficulty in life and needed someone to talk to and work out my problems with and this therapist was available at my local mental health center.

I spoke a lot, she rarely did. I smiled nervously and often, she sat with a flat affect. I spoke of my dreams at length and about the intricacies of my childhood with her, albeit subdued, guidance. I made great insights into the serious issues I was facing at the time. I came to know why I was, well, the way I was – and to a certain extent, why I am the way I am currently. The insight has been priceless, but the therapeutic experience lacked direction and specifically lacked any kind of skill building to help integrate my insights into behavior change. Of course, not yet being a student of counseling I was unaware that other types of therapy existed and at the time psychoanalysis was all the rage. However, I keenly felt that something was missing and that thing was real-world application of what I discovered in session.

As I go through school and see, as both a healthcare consumer and a counselor-in-training, what modalities are reimbursed by insurance it is obvious that pure psychoanalysis is not made available to the masses as it was in the 80s. But I truly don’t want that road to insight and of the unconscious closed for good. There is so much to be gained by realizing your unconscious motivations and finding unhealthy patterns in your life that you can change.

Solution focused therapy and reality therapy certainly are amazingly useful methods to help clients improve their lives, but how can the road to the unconscious and the path to active creative change merge? Many therapists are doing just this. A wonderful starting point for those interested in an integrative approach is “Integrative and Eclectic Psychotherapy” edited by Stephen Palmer and Ray Woolfe. It covers the history of these approaches and each chapter is by a different author and puts forth a useful viewpoint.

http://books.google.com/books/about/Integrative_and_eclectic_counselling_and.html?id=pS03MeOamVEC

As I look forward to working in a agency and eventually launching my practice I hope that in addition to goal setting and problem solving the unconscious can be tapped into and insight can be gained by my clients this way as well – even if the sessions are limited by the demands of managed care.

Looking Forward to Surprises

rdanielburke — Mon, 30 Jan 2012 15:08:35 +0000

Susan Jennifer Polese

I admit it, I’m green. I’d like to think I possess good intuition and that a firm foundation for my counseling future is being laid in graduate school. But I feel very confused about which populations I want to ultimately work with. I alternate between an unrealistic wanting to work with virtually everyone and a steady yearning to find a more comfortable niche. My comfort zone is cradling me as I urge to break free.

A fellow counseling student and I had a discussion recently about what niche(s) we would like to focus on in regard to internship and ultimately work. I expressed concern about working with clients with whom I don’t share their experience – for instance those with substance abuse issues or veterans with PTSD. How could I counsel someone when I hadn’t been “there” myself? I know that this is on one level a silly question. Counselors can’t possibly share experiences with all of their clients and the desire to do so is futile. However, I still feel that as an intern and a counselor I should be familiar with what my client has gone through. Irrational thought, perhaps? I may be an ideal candidate for CBT!

Luckily, my insightful classmate reminded me of something that is in a certain way obvious, yet is quite easy to lose sight of: we all, clients and therapists alike, share the human experience. We have all experienced loss, pain, joy, hopes, – the lows and highs that accompany life on earth. Although I may not have been in battle I can, with my counselor’s toolbox in-hand, empathize with a returning vet or relate to an addiction I haven’t suffered with. Along the same lines I am currently attracted to working in bereavement counseling largely because I my mom passed away this past May – it’s fresh and I feel I can relate. Seems that the pendulum swings both ways. But how to strike a balance?

My graduate advisor wisely told me that although as a counselor-in-training you may have misgivings in regard to working with a particular population and find yourself, for whatever reasons, drawn to another if may not be indicative of whom you ultimately work with. He explained that once you are out there interning and through early work experiences you’ll discover that you enjoy working with clients in settings that surprise will you. I, for one, am looking forward to those surprises.

Take The Next Right Onto Dysfunction Junction

rdanielburke — Sun, 29 Jan 2012 22:06:16 +0000

Susan Jennifer Polese

I recently watched the original film version of Neil Simon’s “The Odd Couple” and it was as funny and touching as when I first saw it. Viewing the classic flick as a counselor-in-training I have rediscovered Felix as a person with obsessive compulsive disorder who would benefit from a combination of cognitive behavioral therapy and medication. And Oscar? Clearly Mr. Madison has executive functioning challenges and really could use some help from a professional organizer. On a more psychoanalytical note: I don’t even want to consider how either of these two were toilet trained!

Being a playwright I am aware that both comedy and tragedy are built on emotional dysfunction. The rule of thumb is: comedy happens when somebody slips on a banana peel and doesn’t get hurt and tragedy ensues when somebody trips on a banana peel and breaks his or her neck. The great Irish playwright Samuel Beckett said there is nothing funnier than unhappiness – true, at least in fiction.

Take the old sitcom “I Love Lucy,” for example. Ricky, her band director husband, doesn’t let Lucy perform in his shows – she keeps trying and gets herself in hilarious predicaments and the audience laughs because we identify with Lucy. Could these two use couples counseling?

Oh, yes! As could many a sitcom couple. Veering off into the world of animation The Simpsons would benefit greatly from more than a few sessions of family sculpting.

I’ve spent my writing career creating characters that ache for something and face obstacles on stage. This conflict always creates an energy for the both the actors and the audience. I’ve come to sometimes view counseling through a similar lens – one that is neither comic nor tragic, but simply focused on our shared human condition. We are all in this together.

Like characters on a stage our clients are faced with a myriad of obstacles. I feel a counselor is kind of a guide, or perhaps more of a companion, to help a client experience, overcome and move past such obstacles. Through this pursuit behavior change can occur and more meaning may be found in life. As counselors, our theories may be used as a roadmap to enable our clients to get where they want and need to be. On this roadmap you can’t avoid dysfunction junction because everybody faces adversity.

Relationships are nuanced and perfection doesn’t exist. Awareness and acceptance of as well as the willingness to face the dysfunction is the work of the client and is the essence of therapy.

Never Stop Asking Questions

rdanielburke — Wed, 18 Jan 2012 16:53:10 +0000

Susan Jennifer Polese

As I embark on the middle leg of my second year of graduate school in clinical mental health counseling a course looms on the horizon that I’m simultaneously excited about and simply wish I didn’t have to take at all. That class is Intro to Psychopathology with an emphasis on psychopharmacology. Both words are packed with oomph and leave me with an array of mixed feelings.

As I blog I look to the left of my computer and on my desk is “Abnormal Psychology, An Integrated Approach” by David H. Barlow and V. Mark Durant. At $125 used, this behemoth will serve as my text for the aforementioned course. I am training for this class by taking extra vitamin supplements and running three miles a day. Okay, maybe that’s an exaggeration. I am getting my exercise solely through worry and an occasion jump on an elliptical machine. I’ve never subscribed to New Year’s resolutions.

All right, I am using humor to avoid the actual issue here which is: Where will psychopharmacology and it’s the parent “the medical model” fit into how I function as a counselor? I am fully aware that although we as counselors cannot prescribe it is of the utmost importance that as counselors-in-training we learn about psychotropic drugs and understand what mental illnesses they can be used to help.

Intellectually, I know this is true, but the coach and the bright eyed idealist in me believes that we are all basically healthy and the majority of mental disorders are created through normal reactions to abnormal circumstances. These circumstances may be physical and verbal abuse, war combat, poverty, sexual assault – the list is endless. If this is the case, than nobody is really emotionally “sick” in the true sense of the word. Within this construct what part does biology play?

And, of course, this line of thinking inevitably leads to considering the work of William Glasser – which my classmates and I did in a class this past semester in what was a heated, and I mean HEATED discussion (which is often the best kind!). Dr. Glasser developed Choice Therapy and Reality Therapy which emphasizes personal choice, personal responsibility and personal transformation. As a renegade psychiatrist he rejects the medical model of diagnosis and prescribing medications to treat a particular illness when, in fact, the patient may simply be acting out of unhappiness, not a brain disorder. He has written many bestselling books explaining his position, which is utterly unmovable. No meds under any circumstances – which led to said discussion in my class.

In graduate school these debates have been endless – often intriguing and sometimes tiresome. In the behavioral wings of hospitals there are many patients who hallucinate, hurt others and/or self harm – there are also outpatients with severe symptoms. How are they to function without medication? Medication often aids in therapy for clients with certain conditions – how is this bad? Where would we be without the medical model? Without psych meds? What role does positive psychology play?

It seems that this blog is devolving into a series of questions, but maybe that’s a good thing. Perhaps that’s the best aspect of being a graduate student. You are not yet confined by agency quotas or managed care restrictions. You can freely ponder these questions and get many valuable points of view from a variety of sources while you formulate your own opinion which will inform how you navigate your career.

Licensed counselors working out in the field reevaluate their positions on these issues continuously. It seems to me at this juncture that flexibility is key and knowledge is power…and one thing is for sure – we must never stop asking questions.

Sage Advice from the Frontlines

rdanielburke — Tue, 10 Jan 2012 19:27:57 +0000

Susan Jennifer Polese

In the latest issue of Counseling Today there is a great article exploring counselors in transition by Lynne Shallcross, a senior writer at the publication. This cover article is a tour de force focusing on interviews with various counselors in certain phases and experiencing different transitions in their careers. As I read and thoroughly enjoyed the piece I pondered my own impending transition: that one being from the classroom to an internship in the fall – which will be the start of my final year of graduate school. Hmm, it gives me the willies just thinking about it.

I can sense similar anxiety from my fellow students on the cusp of taking a giant step into the active field of counseling. As the existentialists say anxiety can be a motivator, but it can also leave you shaking in your boots. Moving forward I feel, as always, that information is power – but where to look for sage wisdom? Our professors, of course, are a source of support and our families will always be our cheerleaders. But where else can we find encouraging words?
Just this week I applied for one of my first choices in internships – time will tell if that is where I end up doing my “basic training.” Consumed with this reality and having read the wonderful piece in Counseling Today, I’ve chosen to speak with a very good friend of mine, Laura Davi, who graduated from Western Connecticut State University’s graduate program in clinical mental health counseling and is now employed in the field working with children and families as a Masters level clinician.

I asked Laura what advice she would give to counseling graduate students who will be interning. She didn’t hesitate – she rarely does – and was forthcoming with some sage tidbits from the frontlines of mental health care. Here ‘tis: Seek out your own therapy because you will have to deal with a lot in your internship and it’s important to continually work out your own issues. –At your internship you may feel that you don’t know what you are doing. Be comfortable with this and don’t judge yourself. – Seek out additional mentors in addition to your supervisors. They will bring new perspectives to what is going on. – If it turns out that the internship is not the right fit for you and you don’t feel supported but merely criticized talk to your advisor as adjustments can be made. You should feel challenged, but basically supported as well.

All good points and food for thought – Thank you, Laura.

It seems that in all phases of becoming and practicing as a counselor, communicating with our peers and especially tapping into the knowledge of those who are a few steps ahead of us on the journey is valuable. Being open, flexible and working towards maintaining our own mental health is essential.