People rarely come to counselling when they are feeling fantastic. They come to counselling because they want to change something; they feel out of balance or they are stuck in a pattern. In short, they come because of some problem. So naturally the first step is to identify the problem. While it is reasonable and feasible that some problems can be resolved, other problems may not be easily addressed and still others may be what couples therapy experts John and Julie Gottman calls “perpetual problems.”
Regardless, people are in a relationship with the problem, whether they like it or not. It might be really useful to think about how to change that relationship to the problem.
Lets make up an example of a realistic scenario. I come into counselling because I hate my high-paying job but I am afraid to quit because of the wages, the pension and the medical benefits. I also get paid holiday time and I can take time off work if my child is ill. But I am not using my skills and it is not a good match for my working style. I love the buzz of people working around me and take great joy in addressing people’s everyday concerns. I thrive in a team, and when I am mediating between people and soothing potential conflicts. In this job, however, my office is separated from others; I am in charge of writing assignments that require long hours of focused time alone and I have little interaction with others. The problem, then, is that I want to quit but I value the income and benefits to my family.
We could use an illustration like this to explore possible new ways to relate to the problem.
Starting at the top and working clockwise, we could talk about ways we escape from the problem and whether or not that is helping or hindering.
Sometimes escaping can be really helpful. If I am overwhelmed by the weight of the decision, escaping for an hour to join my co-workers for lunch might be helpful. Here a narrative approach might be helpful to help me tell a different story about my work, namely, the story about the connection to my co-workers built over our rich lunchtime conversations.
If I am hoping to reclaim my life from the chains of the problem that might mean finding ways to live with less money so I can take a lesser-paying job that will bring me alive. The therapeutic next steps might involve an exploration of times in my past that I have felt that charge and what that enlivening job might involve.
Educating the problem might involve researching my career options and do a strengths assessment.
A truce with the problem might mean making peace with not knowing what to do next. That would ease the pressure I have been putting on myself and just give my head and heart break. This could be reinforced with some Buddhist psychotherapy.
Negotiating might involve making a deal with myself such as staying in the position until my child’s orthodontic work is complete, or agreeing to leave after I have saved x amount to ease the transition. Here we might benefit from using a solutions-focused approach.
Undermining the problem might not be a useful metaphor for this particular problem.
Finding balance with the problem might involve building up other areas of my life such as friendships or sports so that I feel like I have other things at the forefront of my life that I care about. I might benefit from examining my values and commitments and exploring the parts of myself that I have neglected since taking the job.
Finally, taming the problem might mean taming the self-defeating thought patterns that arise when I try to address the problem such as:
- I am stuck
- I am stupid for taking this job in the first place
- Nothing will change
- I don’t have any value
Here some skills from cognitive behavioural therapy (CBT) and mindfulness practices would be really helpful.
This conversation might lead us to look at the ways that we are using all or nothing thinking. This sort of illustration might help:
This could be filled in with some examples of all or nothing thinking that pendulums between extremes, when a more grounded approach would acknowledge that there is a lot of truth in the middle and in the nuance between the two extremes. It might look something like this:
All of these are just some samples of ways I can work with clients using illustrative techniques. Note that these would be drawn in advance of or after the session but not during a session. In-session sketches are far more simple. See this post for examples of the quicker in-session sketches and diagrams.