The First Year: Planning, Playing and Pitfalls

by Patricia Allen-Garrett

On September 7^th last year, I overcame the final obstacle in a three-year assault course of interviews, exams, mid-year reviews, group therapy, essays, tapes, verbatims and everything in between! This rather innocuous date was the one which signalled my qualification as a psychotherapist. The relief on opening the ‘verdict’ was astonishing even to me. I wept with the new ‘freedom’ conferred by the words. And, with a new confidence, I went back to my existing clients – clearly three years of therapy hadn’t rid me of my need for approval and validation from others – in this case, that of the college where I had trained!  What I would like to do in this musing is to recollect my first year post the safety-net of college and consider how different aspects of the year have been, from client work to supervision, to experiences of external training to my own personal work. Have my expectations changed from this time last year? Were the challenges different? How am I, a year on? In pondering these and other questions, I hope to integrate the very many parts of this first and important year.

Although it was difficult to leave the security of my training group, there was also elation at having finished – at having so-called ‘made it’! And I was fuelled by a new-found confidence to get out there! My training was humanistic and integrative and I relished the opportunity to continue to develop my own style and, in this, I knew my choice of supervisor would be important. Mearns and Thorne (2006) say that at the end of training, supervision, which had previously been just one of many supports, “now takes on particular importance because the developmental agenda is only just begun”.

For anyone reading this, who may be about to embark on such a quest – heed what everyone tells you! It’s really important to take time, talk to supervisors on the phone and make a couple of appointments. I was amazed by how much transference I experienced in relation to one supervisor I spoke to on the phone. In my utter naivety I thought that, newly-qualified, I was somehow ‘beyond’ this! Transference is a funny thing for me. When I first started my training, I either ‘stood up’ to or avoided anyone I found threatening. In my second and third years, I forced myself to examine what was going on, often putting myself in demanding and painful situations to have a better idea of the dynamics playing out. But in this case, I listened to my gut – I didn’t want to have a combatative supervisory relationship – even if I would learn something about myself in the process. Maybe it would have helped my client work but I just wasn’t sure enough to risk it.

So, on the 25^th September, I met with and started to work with my current supervisor.  Having been involved in group supervision, in my final year in college, it’s been quite a luxury to have a whole hour to myself! Having said that, there has been nowhere to hide either! Its been challenging, my supervisor is Gestalt-trained, which has served to bring me very much into the here-and-now when I’m discussing clients. I’m definitely not allowed to escape into my comfortable pattern of endless hypothesising, so it’s not always comfortable! But it is supportive and I find that the dynamics of the therapy room resound in the supervision room also. As Elke Lambers has said:

“In person-centred supervision, the supervision relationship can be conceptualised as parallel to the therapy relationship: offering a context where the therapist can become aware of the processes taking place in herself in the relationship with the client and enabling her to become more congruent in that relationship” (Lambers, 2003).

Certainly when I’m prepared to slow things right down and concentrate on how I’m feeling, I get a much better insight into what might be going on in my relationship with my clients. My supervisor manages to validate me in my work with clients without colluding with me and her years of experience have offered me real gems at times when I have become stuck with a client.  However, I would say that, having discussed the topic of supervisors with colleagues, there has been a great variety and difference in our experiences. Some have had really negative experiences with supervisors which, when voiced, have been almost disregarded by supervisors as ‘transference’ on the part of newly- qualified therapists. While I can assume that some of this may well be the case, I would also like to think that, perhaps in the true spirit of client-centred therapy, supervisors might think of new therapists as providing them with an opportunity of looking at their own transferences and counter-transferences too.

The end of my training signalled the end of nine years continuous studying for me.  And so I was determined not to throw myself into any more learning for at least a year! However, by January my brain was getting itchy and I registered for some different short workshops and training in areas such as rape and sexual assault, shame, working with adolescents, trauma and Hakomi.

The whole area of education and continuous professional development is clearly a very subjective one but, because of the work we do, I make no apologies for having high expectations when it comes to training and I have been surprised by the variance in standards I’ve encountered. Although it would be naïve (not to mention an administrative nightmare!) to have all CPD training assessed, I do wonder about the benefit of having some method of appraisal or a forum where training can be evaluated or at least discussed? Direct feedback is invaluable and I have no doubt it is considered but I can’t help but think a more structured approach to the evaluation of training could be even more helpful in terms of strengthening what’s being offered.

Having said that I have had a couple of wonderful training experiences this year. In March, The Borealis Group offered a residential weekend on ‘Shame’ and I found it really dynamic.  It was a mix of theory and experiential work and its format allowed for both structured learning and personal depth work in a very safe group environment. Similarly the Hakomi training, which I did in July, offered a gentle approach, suffused with beautiful humour and a deep appreciation of the human spirit, whilst being delivered in a way that was experiential and still utterly applicable and transferable to client work.  I am aware of my positive biases in relation to these two specific training experiences – i.e. they were both delivered in a client-centred manner, where the humanity and uniqueness of our clients was held and deeply respected.  There was no element of therapist as ‘expert’ but as fellow traveller.  And, in both, nothing was a mistake but an opportunity to look at our own fallibility and a genuine acceptance that, despite techniques which might help, the client really does know best. And, in each, it wasn’t that this message was being constantly spoken – rather it was my experience of being the client, which confirmed it for me as therapist.

Both of these workshops built on the foundations of my initial core training because they reinforced one of the main aims of therapy – i.e. to offer clients a different way of being, in how we are in our relationship with them. And they were timely reminders of how important that aim is and the potentially transformative nature of the therapeutic relationship when we can allow ourselves to be truly authentic because “It is only by providing the genuine reality which is in me, that the other person can successfully search for the reality in him.” (Rogers 1961). 

As I will explain below, our own work in therapy is extremely important both for our own work and for work with clients. If we aren’t prepared to undergo therapy, how can we expect our clients to go deeply into their process and how can we possibly understand how hard and dangerous and ultimately how rewarding it can be? However, I also believe that we must work from a standpoint of ‘established’ learning too. As new therapists particularly, I believe we need to be building not just on the therapy skills we learned in our training but also on our knowledge of the ‘issues’ (for want of a better word) which clients may present with – abuse, post-traumatic stress disorder, eating disorders, grief and bereavement, etc. Again, it is our responsibility as therapists to seek out such knowledge, through keeping up to date with the therapeutic journals, books, etc, but I am surprised at the lack of expectation from our governing/accrediting bodies on this front. I do not believe in reductionism or rationalism, that there is a root cause for everything or that reading is any substitute for experience or that we need to prove anything to the so-called ‘scientific community’, but if one of our guiding ethical principles is that of non-malificence, I believe there is a need for CPD and that we should have a more structured approach to it and a requirement for it – particularly for newly qualified therapists.

There is no doubt that our own therapy work is extremely important for our client work as well as our own growth.  There are many reasons for this but I shall leave it to Yalom to explain a fundamental reason: “Therapists must be familiar with their own dark side and be able to empathize with all human wishes and impulses” (Yalom 2001).

Well, if that’s the case, then I’m ready to meet a lot of dark sides because I’ve spent the last year dealing with mine! I have worked with my therapist since I began training in October 2003 and she and I have explored a lot of my process together. Her empathy has been key in my healing process. Initially her acceptance gave me courage to experience aspects of myself which were painful. Her willingness to stay with me, coupled with her ability to empathically understand my experience, helped me move beyond my usual rationalizations and brought both huge healing and growth. So it was really difficult to find myself in conflict with her for the first time because of choices I was making in my life and interestingly it coincided closely with the time I qualified. It threw me entirely, I felt misunderstood by the one person I expected would understand me. This, coupled with being without a process group for the first time in three years, left me feeling on many occasions stranded in the middle of the ocean without a life buoy. The benefit of hindsight has shown me that most of my feelings of being misunderstood and not accepted were my projections and, although I spoke of not wanting to be colluded with, in reality it was exactly what I wanted. It was extremely painful to listen to her feedback on my actions and it was far easier to blame her for not ‘getting me’, to accuse her of potentially projecting her issues on to me. And it was much simpler to be angry with her because then I didn’t have to look at how I was relating.

Any of these awarenesses that I may realize now have not come about quickly or through an introjection of my therapist’s views, which is what I may have done in my early work as one of my key defense mechanisms. It has come through really checking things out with her and it has been her patience, through this process of my disbelief, that has helped me separate out the very fabric of our relationship and allowed me to own my projections.  She never forced me to take her views on board and, in that, I was able to work with her to find a way to work with me, to find my voice to say what I needed from her. And, although we still have areas of disagreement in terms of approach, I have learned a huge amount with her, not just about my own process but also how my clients may experience me in my interactions with them. And, importantly, I have also learned to trust my inner voice. If ‘it’ wasn’t working between us from my perspective, I learned to say it and this has also had a knock-on-effect and been vital in my client work.

Perhaps this next statement will seem obvious to more experienced therapists but it has really hit me this year that although we work hard to develop an empathic relationship with clients, there have been times when I’ve realised how difficult it is to really know how another feels and how much easier it is to project my own feelings or expectations of how something is on to a client. It’s not that I didn’t have an inkling of this in the past but, without the benefit of a core group where the focus is on therapy and process, I found myself sometimes losing sight of it. Bearing in mind the powerful work that can be done in groups, I wonder if it might be a useful requirement for new therapists working towards accreditation to continue in some sort of process/group work.  Again, this might be the voice of the part of me that still feels the loss of support of my training group. Although we must all take responsibility for the therapists we are becoming, I can’t help but feel that anything that helps our client work should be encouraged. Peer supervision is of course an option and something which I have dabbled in this year, and it is a great support, but I can’t help but think for me it doesn’t have the same power as group work.

Each of the areas I have discussed; supervision, training and my own work have ultimately been to help me work with my own clients and each has contributed in different ways. I had the opportunity this year to broaden out my client work and work in a temporary capacity in an inner city project with teenagers addicted to drugs and alcohol. Even the concept of this work frightened me! I hadn’t felt very comfortable with teenagers when I had been one and I’ve never quite shaken that. But I accepted the position because it was different, I liked the ethos of the centre and I figured my inner adolescent could do with a challenge!

I knew going in that it was going to be tough but, in my naivety, I presumed over time once I made a connection things would be smoother. And therein lay the rub; I thought that my being willing to be there and offer space would be enough. I very quickly learned it wasn’t – and no amount of training had prepared me for that or for the fact that, on many occasions, my room was empty. Over time, as I became a more familiar face, the sessions became more regular but there were times when I felt completely de-skilled by the hostility of some of the young people and my inner adolescent certainly showed herself on occasions. At a thinking level, I knew that several of the young people didn’t want to be there for many different reasons and I realised that in some way, although well-intentioned, I was actually being a little patronising to think that therapy with me was going to be something that they could embrace, just because I was coming from a good place!

Although I always recognised the huge resources of each young person, it was only when I let go of my impossible, subconscious expectation (and my saviour complex!) that our relationship was going to be transformative and believed that whatever we had in the time we had together was good enough, that an honest relationship had a chance to emerge. We still struggled but there were also so many times when I was amazed by the young peoples’ ability to cope in horrendous situations and their great humour.

I continued to work with my existing clients and took on new ones too during this, my first year. Yes, there have been times when I wished a particular client wouldn’t come back and I’ve felt like tearing my hair out every now and then when I just ‘couldn’t get it’! But there have also been moments where my clients and I were in synch, where the hour seemed to fly. For me these are the ‘flow’ states which Csikszentmihalyi discovered. Flow happens when we face a challenge that tests our skills but which our skills and capacities can just about meet. So both our challenge and our skills are at high levels – stretching us almost to the limit.  In these moments I have felt whole, integrated, aware of myself and of my client. Mearns and Thorne call these times of “relational depth” (Mearns and Thorne, 2006). I find this type of relating only happens when I can communicate to the client that I want them to be exactly who they are, that who they are is absolutely enough. When I can offer the type of relationship which positively affirms “the client down to the very essence of their being, a confirmation of their uniqueness, individuality and humanity” (Mearns and Thorne, 2006) then we can meet at a level when trust can begin because then the relationship can build in robustness and can allow both of us to be who we are; oftentimes fallible, scared and, ragefull but also inspirational, joyful and human. This is the ‘realness’ of the relationship, which we can offer.

At the beginning of this deliberation I said I would review my first year, taking into account my experiences of client work, external training and my own personal work, all of which I have done. I have also highlighted some areas around supervision, training and continuous professional development where I pondered if our governing/accrediting bodies should take a more active involvement. I also posed the questions; had my expectations changed from this time last year?  Were the challenges different?  How am I a year on? Perhaps the last question answers the first two. I don’t feel as shiny and new as I did this time last year, I’ve faced real challenges with clients particularly with the young people I have worked with, I’ve had to face up to not having the answers for some clients who sought endlessly for them and the subsequent impact on our relationship. That there were some dynamics which entered the therapy room that I’ve been unprepared for, some aspects of people’s lives where good intentions on my part were not enough, that a more solid understanding of a theoretical approach could have helped my empathic response.

And yet, the last year has been professionally my most fulfilling one to date. I’ve been challenged certainly, but I have also had the great privilege of being allowed into clients’ lives in often very painful times but also in times of great joy and sometimes great fun! I have marvelled at the strength of clients who I have sat with and I have been humbled by it. I’ve raged at myself for not knowing what to do, where I wished for a technique, any technique which might help, rather than having to rely on a much more seemingly ambiguous resource – that of the relationship. But I have also learned that its ok, I’m still learning! And also I’ve learned the very valuable lesson that

“Technique has a very different meaning for the novice than for the expert.  One needs technique in learning to play the piano but eventually, if one is to make music, one must transcend learned technique and trust one’s spontaneous moves” (Yalom, 2001)

I have had the opportunity this year to tentatively start trusting my “spontaneous moves”. Sometimes they have worked, sometimes they have crashed and burned but, once I can check in with myself and answer that they have come out of a genuine wish to meet a client where they are at, then I feel ok. And I’ve learned that, if accepting a client where they are at is to be anything more than just tolerance, then I also have to accept where I’m at too.

Patricia Allen-Garrett is a pre-accredited member of IAHIP and a psychotherapist in private practice.

References:

Lambers, E. (2003) ‘Looking after ourselves: keeping Fit to Practice’, in D. Mearns, and M. Cooper, (2006) Working in Relational Depth in Counselling and Psychotherapy. Sage:London

Kennedy, E., and Charles, S. (2001) On becoming a counsellor. Newleaf:Dublin.

Mearns, D., and Cooper, M., (2006) Working in Relational Depth in Counselling and Psychotherapy. Sage: London

Rogers, C. ‘On becoming a person’ (1961) Constable and Co.:New York

Yalom, I.D. (2001) The gift of therapy, reflections on being a therapist. Piatkus:London