Reflection of feelings: an essential counseling skill; Skill can be particularly difficult for recovering counselors.
As a counselor educator, I receive many inquiries from recovering individuals who wish to begin training for employment as addiction counselors. Generally, they are what are considered in higher education to be non-traditional students. They tend to be in their 30s and 40s, have families and jobs, may have completed some college, and are looking for a career change, but are concerned about their ability to compete successfully with younger students.
In all areas of the counselor preparation curriculum, individuals in recovery are successful, and are often the best students in class. However, one area in which they struggle is the utilization of the reflection of feeling skill that is basic to many communication models of counseling.
The difficulty recovering counselors-in-training have in using the reflection of feeling skill has its genesis primarily in their prior history of substance abuse. For the most part, individuals use substances as a method of changing the way they feel. When an individual has spent years, perhaps decades, using drugs to avoid uncomfortable emotions, their present ability to identify feelings and give verbal expression to them may be limited.
It is not unusual to hear individuals in treatment question their ability to feel, and express their fear that sobriety will be impossible because of all the attendant emotions that are part of living a drug-free life. For varying periods of time following the completion of treatment, recovering individuals are often tentative about emotion, and unsure about the appropriateness of their feelings. They are hesitant to express emotions, and look to others for validation that the feelings they experience are normal.
This reality causes anxiety for recovering counselors-in-training when they are required, during counseling skills acquisition courses, to reflect the covert emotions of clients.
Beginning counselors-in-training who are not in recovery also seem to have difficulty in reflecting feelings, but for different reasons. The unspoken rules of behavior that structure relationships in the social milieu are often assumed to be required in the counseling milieu. In the social milieu, because the boundaries are different, reflecting another person's unspoken emotion by pointing it out is often considered intrusive and impolite. Thus, counselors-in-training are uncomfortable in the counseling milieu when they perceive themselves to be "telling other people how they feel."
It helps to draw clear distinctions between what is appropriate socially and what is appropriate therapeutically. In the therapeutic milieu, clients are "stuck" when they are unable to identify how they feel about what is happening in their lives. Effective use of the reflection
of feeling skill helps clients gain the self-awareness needed to get "unstuck."
Four methods are useful in reflecting client feelings:
1. Step into the client's shoes.
This approach involves the counselor stepping inside the client's reality and attempting to experience it. As the client describes the unexpected end of an important relationship, the counselor silently asks, "How would I feel if this were going on in my life?" Whatever emotions occur to the counselor are then verbally reflected to the client: "You feel lost and lonely without your partner."
2. Use emotional recall.
Many individuals have common reference points--past experiences that are similar. One example of this is that most people have experienced a romantic relationship end before they were ready for it to end. When a client begins to discuss being "dumped," counselors may recall how it felt when it happened to them, and verbally reflect to the client: "You feel rejected and abandoned."
3. Interpret the client's vocal intonation and body language.
In the social milieu, we have been trained from childhood to respond to what is said, not to what we observe. Yet when people are emotional, it often affects the way they communicate non-verbally as well as verbally. Vocal modulation may be absent or extreme, intonation may be flattened, sighs or unusual pauses in verbalization may occur. Eyes may be wet or downcast, shoulders may be slumped, teeth may be clenched, or arms crossed. These clues to what a client may be feeling are often not interpreted and reflected by the counselor. "You're feeling overwhelmed and discouraged by the change in your relationship" might be an appropriate counselor reflection of feeling for the client who has had a relationship end and is sitting slumped with downcast eyes.
4. Use a synonym for a feeling the client has identified.
Clients may use feeling words to describe their internal reality. They might share with the counselor that the abrupt end of an important relationship leaves them feeling "unhappy." When the counselor reflects a feeling that has a meaning similar to the emotion identified by the client (for example, "There is a lot of sadness in this for you"), the self-awareness of the client is enhanced.
Often clients will tell the counselor how they don't feel. They will make statements such as, "Well, I don't feel good about it." In cases like this, the counselor may simply reflect any emotions that are the opposite of the emotion the client has rejected. An example would be, "You're feeling bad and worried about this situation."
Under the best of circumstances, the reflection of covert emotion is difficult. By definition, covert feeling is outside the client's awareness, and counselors-in-training are often fearful that they will not identify a hidden feeling correctly. This desire to be right can lead to the minimization or omission of the reflection of feeling skill, and limit the effectiveness of the client's counseling experience. When the client's emotional self-discovery--which is dependent in large measure on the validation that results from the counselor's frequent and appropriate use of the reflection of feeling skill--is neglected, successful treatment outcomes are diminished.
One method of helping counselors-in-training let go of their inhibition about using the reflection of feeling skill is to help them understand that if the reflection of feeling is genuine, then useful information will result even if the reflection does not resonate with the client.
Following a reflection of feeling, one of two things will happen: The client will or will not accept the reflection. If the reflection fits, the client will usually endorse it. If it does not, the client will deny it, and usually follow up by telling the counselor what he or she believes the feeling to be. Knowing this about client behavior allows the counselor-in-training to acquire a comfort level with the reflection of feeling skill more quickly, and, coupled with the understanding that what the client is not feeling may be as important as what is being felt, guides the counselor in facilitating the client's emotional self-discovery.
5. The language of feeling
The feeling-word vocabulary of many beginning counselors is limited. As a result, they risk falling into the habit of selecting their reflections of feeling from a limited menu of words. Consequently, some clients may not develop an ability to express their inner emotional reality in healthy ways, and may be limited to acting out their emotions physically, sometimes with devastating consequences.
Tasking each student with the responsibility of bringing to each class a list of five feeling words with definitions results in an explosion of vocabulary useful in counseling. Each student is assigned a different letter of the alphabet each time the class meets, and is expected to share the definitions with the other class members weekly. This is especially helpful for male students who, having grown up with the stereotype that men keep emotion to themselves, may not have developed a rich vocabulary of feeling words.
One responsibility of the counselor is to create the therapeutic space within which the safety exists for the client to risk thinking about doing things differently. This safety is a consequence of trust, and can be compromised if the counselor uses the reflection of feeling skill inappropriately. When the counselor uses the reflection of feeling skill to enhance the client's self-awareness too quickly, the client may feel threatened, become defensive, and abandon treatment.
Reconnecting clients to their feelings, and helping them develop the ability to express emotion in healthy, satisfying ways, is an essential counselor skill in the treatment of substance abuse. For many clients, this reconnection is often the most difficult step in the recovery process. The ability of the counselor to use the reflection of feeling skill appropriately is essential in helping clients understand the relationship between thoughts and the emotions and behaviors that result from them. When clients realize that they are in charge of how they interpret their world and give it meaning, an empowerment process begins that often leads to positive, lifelong change.
By Ed Phillipsen, MAC, LAC, LPC
Ed Phillipsen, MAC, LAC, LPC, is manager of quality assurance and training at Island Grove Regional Treatment Center in Greeley, Colo., and a faculty member at Aims Community College, where he teaches the courses required in Colorado for certification as an addictions counselor.
|Printer friendly Cite/link Email Feedback|
|Date:||Jul 1, 2004|
|Previous Article:||A message to the community of addiction professionals from the president and chief executive officer, Odyssey Pharmaceuticals, Inc.|
|Next Article:||Is managed care managing the care out of addiction treatment? One CEO's call to action.|