Personal Counselling PDF

 PERSONAL COUNSELLING PERSONAL COUNSELLING  J.M. FUSTER CONTENTS PART I First Session 13 Second Session 39 Third Session 78 Fourth Session 92 Fifth Session 117 Sixth Session 129 Seventh Session 148 Eighth Session 173...

 PERSONAL COUNSELLING PERSONAL COUNSELLING  J.M. FUSTER CONTENTS PART I First Session 13 Second Session 39 Third Session 78 Fourth Session 92 Fifth Session 117 Sixth Session 129 Seventh Session 148 Eighth Session 173 Ninth Session 188 Tenth Session 199 PART II Eleventh Session 215 Twelfth Session 227 Thirteenth Session 238 Fourteenth Session 249 Fifteenth Session 259 CHARTS I. A model of counselling 47 II. Counselling Process 65 III. Feeling words and levels of intensity 128 IV. All skill-steps 171 APPENDIXES I. Illustrations of counselling 273 II. Post-training test 292 III. Test in Self-Actualization 299 IV. Self-Training Programme 303 V. A way of helping the counselee to explore further her problem situation 306 BIBLIOGRAPHY 309 INDEX OF TOPICS 315 INDEX OF SESSIONS PART I : THE TRAINING OF COUNSELLORS Subject-matter in each session. I. pp. 13-38. Greetings. Self-introduction. Share expectations. What the course offers. High quality training. Five levels of functioning. Rationale of this training course. Time-table. Pre-training test. Background of counselling. Questions. II. pp. 39-77. Review, i.e., the trainer asks the students some questions to  check their correct understanding of what has been taught at the previous session, and allow them to put questions. A counselling model. Models of counselling. Xavier Institute of Counselling. The Counsellor. The process of counselling. Preparatory stage : Attending. Social skills, attending physically. Practice. Questions. III. pp. 78-91. Review. Attitudes: respect, genuineness, concreteness. Observing skills. Practice. Questions. IV. pp. 92-116. Review. Empathy. Self-disclosure. Spiritual dimension. Forgiveness. How to form the attitudes of respect, genuineness and empathy. Listening skills. Practice. Questions. V. pp. 117-128. Review. First stage : Responding. The skill of responding to feeling and content. Practice. Questions. VI. pp. 129-147. Review. Ways of responding to feeling and content. Skills of responding: with a summary, with a question, to a silent counsellee. Completion of the stage of responding. Comments: how to enter into the counsellee’s frame of reference. Practice. Questions. VII. pp. 148-172. Second Stage: Personalizing. Review. Personalizing the problem and the goal together. Explanation of the skill-steps. Suggestions to personalize the problem and the goal together. Comments. Practice. Questions. VIII. pp. 173-187. Review. Integrate other models of counselling into this model. Confrontation. Immediacy. Questions. IX. pp. 188-198. Review. Third stage : Initiating. Develop steps. Why the counsellor is competent to identify steps to the goal. How to motivate counsellee to take the first step. Formulate the first step. Comments. Practice. Questions. X. pp. 199-210. Review. Subsequent stage : Evaluating. How to motivate counsellee to take the steps. A simple programme. Recycling technique. Overall View of the model of counselling. Practice. Questions. PART II : THE COUNSELLOR’S PERSONAL GROWTH XI. pp. 215-226. Becoming yourself. Formation of the self-concept. The real and the ideal self-concepts. Becoming interdependent. Practice. Questions. XII. pp. 227-237. Review. Mental health. Stress. Adjustive resources. Sources of stress. Sources of adjustive resources. Practice. Questions. XIII. pp. 238-248. Review. Self-actualization. How to grow in it. Break some  structures. Be open to learn. Overcome shyness. Face growth-choice. Be spontaneous. Assume responsibility. Experience deep joy. Be committed. Be aware of your defence-mechanisms. Self-transcendence. Practice. Questions. XIV. pp. 249-258. Review. Conscience and Superego. What is conscience.Definitions. Origin of conscience. Conscience formation. What is Superego. Functions of the superego and functions of conscience. Conclusions. Practice. Questions. XV. pp. 259-270. Review. Professional ethics. Kinds of values. Breaking professional secrecy, when? Counsellor’s relationship to counsellees and to himself. Counsellor’s influence on counsellee. Conclusion. Questions. My Message to you. Trainees could share what they have learned in this course and how the new learning will help them in their life-situations. Thank God for the gifts you have received. PART ONE : THE TRAINING OF COUNSELLORS FIRST SESSION INTRODUCTION Self-introduction It will help if the trainees sit face to face in a closed circle. The trainer starts by greeting the trainees. Then the trainer may introduce himself or herself briefly. After this, he asks the trainees to introduce themselves covering these three points: name, residence, type of work they are doing. It is not advisable to ask somone to start and then the one sitting next to him or her. It is better to respect their freedom of choice of time to do this. Thus, the trainer could say: “anyone who would like to begin begins while the others listen attentively. When he or she ends, another follows without asking my permission.” Share expectations When the self-introduction is over, the trainees may be asked to share their expectations of the course. Something along these lines: “when you registered for this course you surely had some expectation or something you would very much like to get out of this course. It will help us if you kindly share your expectations with the group.” They follow the same procedure. What the course offers The trainer may share what he or she expects from the trainees in terms of serious application and a keen desire to learn and enrich themselves. Then he may add: “psychologists say that in the course of our lives we actualize a small fraction of our human potential. This may be around 30 per cent. This is sad to hear because we all could be much better persons than what we are now, had we actualized more of our human potential. We have it within ourselves, but do not exploit it. So, a great part of our human resources remains dormant.” What this course precisely teaches is a human technology of human resource development and it trains you to help others to develop their potential. Now, in 50 hours you cannot work wonders. But you can obtain a good theoretical grasp of the model and, also, an initiation into the practice of it. To achieve this goal, you will have to take the course seriously, be attentive in class, do your homework, take an active part in the practice and, also, practise outside of the sessions. The success of the course will depend on your ongoing formation once the course is over. High quality training To achieve high quality training, you must practise this model on real counsellees. Role-playing does not make for good training. Where to find real counsellees? Well, when you practise as counsellor, you will have one of your companions as counsellee. Then, he or she will speak of his or her problem. Thus, you will be in touch with a real person and a real problem. This offers you the opportunity to practise well the attitudes and the skills you are learning in this course. Then the feedback is more real and to the point. To be a real counsellee in a big group is not easy. Some trainees become tongue-tied. In order to facilitate this practice, it will help if everybody in the group commits himself or herself to professional secrecy. This will create mutual trust in the members of the group. The trainer may say: “I ask each of you to commit yourself to professional secrecy. This means that you may not speak to an outsider of what any trainee has shared or the way he or she has behaved in the group. Also, that outside of the session you do not approach any trainee and initiate the personal matter that he or she has shared in the group.” Then the trainer solemnly asks each trainee in front of the group if he or she commits himself or herself to professional secrecy, and he himself does the same. Be aware of how you feel now One exercise that helps is this. The trainer says: “it is natural at first sight to experience a spontaneous liking for some persons and a spontaneous dislike for others, or just a neutral feeling. If you become aware of how you feel now towards each trainee, you will be able to notice a positive change in these feelings when you come to know the person more in depth.” Five levels of functioning Another aspect of the training is the way one relates to the group. We can consider five levels of functioning in a group: 1. Detractor The detractor has a very negative perception on life: all is bad, there is nothing good, criticizes very severely, wishes to destroy everything. This kind of person is a mental patient. Perhaps in his or her life he or she has gone through very bad experiences and finds solace in lashing out at everything. On a lesser degree, sometimes some trainee may behave in a negative way. Such a person is usually an unhappy person and needs to change for the better. 2. Observer The observer watches what is going on and is not involved. He is like a spectator at a football game. The observer does not profit much from the training. 3. Participant The participant is committed to what he is doing and does all that is expected of him: attentive in class, does the homework, takes an active part in the practice, clarifies his doubts and, thus, learns much. 4. Contributor The contributor, over and above being a participant, is interested in the welfare of the group. Thus, he will discreetly point out the strengths and weaknesses of the training in order to keep it at a high level of quality. He is brave to speak out but at the same time is prudent not to hurt the feelings of anybody. 5. Leader The leader points out the goal to be attained and identifies the steps to achieve it. Sometimes some trainee can be a leader in the group by reminding his companions of the goal to be achieved, or by suggesting some practical step to reach it. In terms of training, trainees would do well to become aware of the level at which they are functioning at each session and try to raise it. However, they must bear in mind that they cannot skip any level. Thus, from being a participant they cannot pass on to be a leader without before being a contributor. Rationale of this training course We learn here attitudes and skills. These two concepts are very much linked together if we consider the skills as the outward expression of the attitudes. This means that counselling is not just a set of techniques which the counsellor uses at the time of counselling a counsellee. Rather, it is a way of functioning of the person of the counsellor who has trained himself or herself in those attitudes and, then, the skills flow from him or her with ease in dealing with the counsellee. This training begins with the first step, a very simple step indeed, and proceeds to the next step, and to the next, until the whole model is learned. It is something like learning to drive a car. The first step is to sit in the driver’s seat and look at the wheel, the gears, the mirror, etc. Later in the training, the learner will start the engine, and so forth. Training supposes uniformity, or a set of rules to be learned by the trainees. This obviously entails artificiality. The best way of learning is in the laboratory where everything is artificial. Many variables have to be controlled in order to study the independent variable. The learning done in those artificial conditions is then transferred to real life situations where there is no artificiality. Similarly, in training to do counselling, one has to follow the discipline of training and learn step by step, until one masters the model. Once you have learned well the model, you may adapt it to your own personality and to the nature of the problem you are dealing with, and to the personality of the counsellee. It would be foolish to criticize the model before you have learned it well; but it will be wise to assess it after you have mastered it, and then modify it according to your knowledge and experience in counselling. Time-table The trainer may consult the group about the time-table to follow. Pre-training test Before you read this book you may wish to test your counselling skills in relation to this model. The following example gives you an opportunity to assess your ability to communicate in a helpful way and your ability to discriminate helpful responses. Imagine a young married woman, Mary, sitting in front of you. She has come to you in the hope that you will be able to help her. In the midst of tears she tells you her problem. Read below what she says, then reflect and decide what you would say to her to encourage her to open herself more fully to you. (This is your first verbal response.) Write down the exact words you would use if you were actually speaking to this woman. This is what Mary tells you: “I don’t know what’s wrong with my marriage. We seem to be quarrelling all the time. These days he doesn’t seem to like anything I do: my work, the way I handle the children, even the way I dress. I try very hard, but nothing, nothing seems to please him.” Now, before reading any further, write down your response to Mary and put it aside. Discrimination of helpful responses To assess your ability to discriminate helpful responses, rate the following counsellor-responses which might have been given to Mary. Use the following rating scale. 1. ineffective 2. somewhat effective 3. effective Rating Counsellor-Responses — 1. You are saying that your marriage is not going well and your relationship with your husband has deteriorated very much. He does not seem to appreciate anything you do. You are doing the best you know but without success in satisfying him. — 2. Why do you quarrel like that? You must be patient with him and love  him. — 3. Tell me, were you really in love before you got married? — 4. You feel hurt because your husband is disappointed in you. The experts gave the following ratings Response 1 was rated 2 because it was directly related to what Mary said, but it did not respond to the feelings expressed by Mary. Responses 2 and 3 were rated 1 because they were not responding to Mary but rather giving advice and seeking information. Response 4 was rated 3 because it responded to one of the dominant feelings of Mary and gave the reason for the feeling. By comparing your ratings with the experts’ you can see where you are in the ability to discriminate helpful responses. Your ability to communicate helpfully In the light of what has been said above, you may like to rate your own response to Mary. How do you feel now that you have your score on your current ability to communicate helpfully and to discriminate helpful responses? If you have done well, then you feel happy and encouraged to improve your ability in this course; if you have done badly, then you feel a bit depressed or discouraged. This is quite natural. But you will surely react to this feeling by reflecting that this is a pre-course test on some-thing you may not know much about. Therefore, resolve to take full advantage of the opportunity given to you to learn all that this course offers on counselling and, then, the post-course test will show your real ability in this area. BACKGROUND OF COUNSELLING Definition of terms The terms ‘counselling’ and ‘psychotherapy’ will be used interchangeably in this book. The difference between these terms is a controversial point. However, most psychologists today would agree to a difference of degree rather than in kind. That means that they can be placed mainly at the opposite ends of a line, though in practice they keep shifting along that line without any fixed limits. Psychotherapy is practised mostly by the psychiatrist, the clinical psychologist and, sometimes, by the psychiatric social worker. The goal of psychotherapy is to bring about a deep personality change in psychotic and chronic psychoneurotic patients, in terms of a more effective reorganization of the psychological processes. This requires many sessions and it may last for months and years. Personal counselling, on the other hand, is practised by counselling psychologists, marriage counsellors, pastoral counsellors, teachers, parents and friends. The goal is to achieve a better personal adjustment and growth in maturity, by stimulating the counsellee to exploit her potential and use more of her resources. The people who go for counselling are normal people who need help to cope with their personal problems. The personal changes to be achieved are not as deep as in psychotic patients. They consist mainly of a deeper self-knowledge, a change of attitude, a modification of self-perception and a modification of the perception of others. The length of treatment is much shorter than in psychotherapy. That is why I say that psychotherapy and counselling are of the same kind, in the sense that the approach and techniques are the same. They differ in degree because of the goals to be achieved, the types of patients, and the duration of treatment. Hence in this book, the two terms counselling and psychotherapy will be used as meaning one and the same thing. Historical Background Counselling in some way or another has been used by different people since the beginning of mankind e.g., by parents, teachers, friends, elders, etc. It was to the medical practitioner or family doctor that people went most frequently. Towards the turn of the nineteenth century, medicine was not so specialized as it is today. The family doctor was not in a hurry. He sat down by the bedside of the patient and gave his time to listen to what the sick person had to say. It was in those conversations that the family doctor was faced with problems which were not the usual medical problems of fevers and aches in different parts of the body. The problems presented by the sick person had much to do with worries, depressions, fears, anxieties and inner struggles. The family doctor was interested in helping his patient with these problems also, but did not know how to handle them. As he was by training and practice biology-oriented, he felt that there must be some underlying pathology of the brain or the nervous system which was responsible for these types of problems. Because these problems were of a different nature than the ones studied in medical colleges, they were labelled mental. Towards the end of the 19th century, the discoveries of Griesinger, Kraepelin, Golgi, Ramon y Cajal, and others established the so called ‘organic viewpoint’ on the nature of mental illness. The brilliant contributions of these scientists showed that the deep personality disorders known as ‘general paresis’, ‘cerebral arteriosclerosis’, and ‘senile psychoses’, were caused by some pathology in the brain. (‘General paresis’, is an organic psychosis or a severe mental disorder, which is caused by the microbe of syphilis. If this venereal disease is not successfully checked at the initial stage or the treatment is dis-continued, syphilis develops in the organism and reaches a stage when the microbe damages the brain of the patient. The mental disorder which develops is called ‘general paresis’.) With these exciting biological discoveries, it was thought that they could cure the patient by surgically removing the pathology from the brain. This view, though strongly supported in some cases, was not held by all medical men. The reason was that over 50 per cent of mental patients failed to improve by these means. This was a difficult puzzle to great thinkers, and various approaches were adopted to find the solution. Some held firmly to the organic viewpoint and said that further research would one day discover the pathology of those mental disorders, which could not be detected in many patients. Other thinkers, on the other hand, challenged the belief in brain pathology as the sole cause of mental disorders. This new current of psychological thought held that certain types of mental illness are caused by psychological factors. Thus, some mental disorders might result from the fact that the patient felt unable to cope with his inner frustrations and conflicts, and thus learned to adopt unhealthy responses in his efforts to adjust. Origins of counselling The psychological viewpoint became manifest in the use of hypnosis to treat hysteric patients. The doctor put an hysteric patient under hypnosis, who was unable to walk due to a paralysis. In that state, he suggested to him to get up and walk there and then. To the admiration of the observers, he got up and walked quite well. This type of experiment proved that the disorder was not caused by some organic pathology, but by psychological factors. Many medical men and scientists in various countries have contributed to the advancement of our knowledge on the nature of mental illness and how to cure it. A significant contribution was made by Breuer. He allowed the patient under hypnosis to talk freely about herself and her problems, and to display considerable emotion. On awakening from the hypnotic state, the patient felt relieved and improved. Here we see the beginning of a change in the mode of treatment, namely, to give importance to the patient and to what she had to say about herself, and to give her time to communicate her feelings. This change was enhanced by Freud (1856-1939). Freud was an Austrian. He lived in Vienna and left for London in 1939. He was the first to dispense with hypnosis altogether and to create the conditions favourable for the patient to relax and communicate freely her thoughts and feelings. Thus it was Freud who discovered what goes today by the name of psychotherapy and counselling. He demonstrated that the patient’s symptoms represented the outcome of her attempts to meet her problems. Thus, Freud showed great understanding and respect for the mental patient. This was quite a different perception of the mental patient than the one most people had entertained about her before. In this Freud had been preceded by Pinel in France in the 18th century, who had begun to change people’s views on mental patients towards a more humane approach in the understanding and treatment of them. According to Freud’s view, we can look upon the mental patient as a person who is struggling hard to adjust to her environment. In this very hard struggle she makes mistakes and adopts faulty ways of thinking and behaving which we call symptoms. This understanding of mental illness brings the mental patient much closer to us. It makes us accept her and bear with her and be willing to help her as one who is sick. We too could one day meet with a very subjectively hostile world and, in our efforts to survive, we too might develop strange ways of thinking and behaving, which might not be appropriate in the culture which surrounds us. Freud developed his method ‘psychoanalysis’ which dominated the field of psychotherapy for half a century. A great pioneer: Carl R. Rogers A great pioneer in 1942 was Carl R. Rogers in the United States. He rebelled against psychoanalysis because he felt that its mode of treatment was too subjective. He objected to the psychoanalyst’s way of gathering data about the client and of interpreting the causes of her illness according to his favourite theory. Rogers held the view that the client is the best source of information about herself, and that she could diagnose herself if she were adequately helped by the counsellor. Rogers did much to shift the focus of attention from diagnosis to the relationship between counsellor and counsellee. He was a pioneer in doing scientific research on the process of helping , i.e., on what is going on between counsellee and counsellor when the counsellee is being helped effectively. He tried to pinpoint the ingredients of the helping relationship which, according to him, is the main factor in helping people with problems. In 1942 Rogers published his first book, Counselling and Psychotherapy, where you can find the ideas just presented. In 1951 he put forward his theory of personality and offered a blueprint for counselling in his book, Client-Centred Therapy. In 1957 Rogers published a paper, ’The necessary and sufficient conditions of therapeutic personality change’, in which he says: “Drawing from a large theoretical context, six conditions are postulated as necessary and sufficient conditions for the initiation of a process of constructive personality change.” These conditions are as follows: 1. Psychological contact between counsellor and counsellee. 2. The counsellee is in a state of incongruence. 3. The counsellor is integrated in the relationship. 4. The counsellor experiences unconditional positive regard for the counsellee. 5. The counsellor experiences an empathic understanding of the counsellee’s internal frame of reference. 6. The counsellor communicates to the counsellee his empathic understanding and unconditional positive regard at least to a minimal degree. “If these six conditions exist,” Rogers says, “and continue over a period of time, this is sufficient. The process of constructive personality change will follow.” In 1961 in his book, On Becoming a Person, Rogers modifies his thinking in the light of research findings and reduces the above six conditions to four conditions, three on the part of the counsellor and one on the part of the counsellee. These conditions are: 1. The counsellor must be congruent, that is, his words must be in line with his feelings (congruence). 2. The counsellor must have a warm acceptance and esteem of the counsellee as a separate person (acceptance). 3. The counsellor must have the ability to see the counsellee and her world as the counsellee sees them (empathy). 4. The counsellee must experience herself as being fully received. That is, that whatever her feelings, silence, gestures, tears or words, whatever she finds herself being in this moment, she senses that she is psychologically  received just as she is by the counsellor (communication). Summarizing, we could say that Roger's model of counselling is a two- dimensional model. It includes the person of the counsellor (one dimension), and the person of the counsellee (the other dimension). The counsellor must, in his relationship with the counsellee, adopt these three attitudes of congruence, acceptance, and empathy. He must be able to communicate them to the counsellee. On the other hand, the counsellee must feel that she has been fully received by the counsellor. From the mid-forties to the late sixties, Rogers held a very influential position in the field of counselling. His client-centred therapy or non- directive counselling inspired many training programmes and influenced counselling practice in various countries. We owe much to Carl Rogers for bringing to the attention of counsellors the need to focus on the interpersonal relationship between counsellor and counsellee. The challenge In 1965 Eysenck, a Psychology Professor at London University, challenged the value of psychotherapy and counselling. He showed statistically that there was no significant difference in the recovery between treated patients and patients who underwent no psychotherapy at all. He pointed out that, as far as constructive change in the counsellee is concerned and on the average, the counsellee has as much chance of changing constructively over a period of time without professional help, as she has with such help. These findings created a crisis among psychotherapists and challenged them to give an answer. The Answer to the Challenge The answer to the challenge covers four points: 1. To meet the challenge put by Eysenck, psychotherapists shifted the emphasis of research studies from outcome research to process-research. The aim was to discover what kind of persons proved successful psychotherapists and what kind had little success. They felt rightly that this area of research might give us a clue to answer the challenge put by Eysenck. These studies concentrated on the ingredients of the process of psychotheray both of successful psychotherapists and of unsuccessful psychotherapists, i.e., their attitudes and their approach to patients. Thus, Rogers (1967) found that helpful psychotherapists were more human in their approach to patients, and were focusing on the here and now dynamics. Unsuccessful psychotherapists concentrated on diagnosis and on categorizing patients, and showed little interest in the human approach and the here and now dynamics. Other studies were done by Carkhuff and Berenson (1967); Berenson and Mitchell (1969). The findings of these studies support the statement that counsellees of counsellors who offer high levels of facilitative and action- oriented conditions improve, while those of counsellors who offer low levels of these conditions deteriorate. By 'high level of facilitative and action-oriented conditions' is meant that the psychotherapist uses the human technology taught in this book to help counsellees. 2. In 1980 a team of psychologists summarized the findings of 475 studies comparing patients to untreated members of a control group. After treatment, the average psychotherapy patient was better off than 85 per cent of comparable untreated people. The evidence overwhelmingly supports the efficacy of psychotherapy (The New York Times Magazine, Aug. 8, 1987). 3. According to psychiatrist Scott Peck, "the essential ingredients that make psychotherapy effective and successful are not magical words, techniques or posture; it is human involvement and struggle. It is the willingness of the therapist to nurture the counsellee's growth... to actually struggle with the patient and with oneself. In short, the essential ingredient of successful, deep and meaningful psychotherapy is love" (The Road Less Travelled, p. 186, 1980). 4. Again, according to Scott Peck, the crucial determinant of success or failure in psychotherapy is the counsellee's will to grow or to change for the better (Ibid, p. 320). Conclusion. These findings suggest the answer to the challenge put by Eysenck. It is not true to say that there is no significant difference in the recovery between treated and untreated patients. What is being established is that the quality of the person who functions as psychotherapist is of supreme importance to differentiate success or failure in psychotherapy. And, also, that the will of the patient to change for the better is very significant to the success of psychotherapy. Effective Counsellors If the quality of the counsellor is the essential requirement in counselling, then, there is a serious obligation on the part of the counsellor-trainee to ascertain which kind of person he is. He should find out whether he is a helpful person, i.e., one who can stimulate personal growth in others; or whether he is unhelpful, i.e., one who with his approach discourages others from using their own resources and thus inhibits personal growth. Obviously, only helpful persons should assume responsibility for counselling, training young people and, in general, for the helping professions. The thing to bear in mind is that the counsellor in all circumstances has an impact on the counsellee. This may be either for her improvement or for her deterioration. There seems to be no neutral impact. Therefore, counselling may indeed be for better or for worse. This quality of the counsellor which is labelled ‘helpful’ in the sense given above, seems to be a natural gift. Some people, without training, possess it and use it for the good of others. That is why we hear at times people say, “Everybody goes to consult him or her.” Other people may have the capacity for counselling, but they need training in order to actualize their potential. And there are still others, even though gifted in other fields, who do not seem in their interpersonal relations to possess this special gift of stimulating personal growth in others. In the search for helpful counsellors, Truax and Carkhuff (1967) found that the process of one individual attempting to help another is not the exclusive domain of professional counsellors. Research findings show that some lay persons with a short period of training can effect significant constructive change in distressed people. These research findings are reinforced by Scott Peck when he writes: “A minimally trained lay therapist who exercises a great capacity to love will achieve psychotherapeutic results that equal those of the very best psychiatrists.” Revolution in the neurosciences The present revolution in the neurosciences is changing some of the previously held ideas on abnormal behaviour. We are seeing less discussion of normal and abnormal behaviour being on a continuum which differs only in the matter of degree. Increasingly, normal and abnormal behaviour are seen as different in kind, requiring different approaches and different conceptualizations. A powerful influence in such trends is the growing understanding of brain chemistry and its role in mental processes, including those associated with various types of mental illness.  An increasing body of evidence suggests that neurotransmitters play a crucial role in many brain disorders. These are chemical molecules that occur naturally in the brain and spinal cord. They convey messages from nerve cell(neuron) to nerve cell in the synaptic cleft or space between cells. The mechanisms of transmission from neuron to neuron may be faulty in schizophrenics. The present challenge is how to modify the genes which are responsible for illness in the human body. Neurotransmitters ‘dopamine’, ‘serotonin’ are involved in depression; ‘endorphines’ and ‘enkephalines’ are pain-killers and mood elevators. Both are more powerful than morphine. Some viruses, also, wreak havoc within the nervous system. Today many scientists believe that some schizophrenia is the result of bio-chemical imbalances in the brain and not of psychological factors as it was thought before. When chemical imbalance is implicated in such mental illnesses, medication, not counselling is the treatment of preference, although counselling can play a supporting role for patients and their families. Scientists say that, “each small step forward with ‘clozapine’ must be carefully nurtured with psychological counselling. Without it, the awakened patients can slip back into mental confusion” (Time, 6.7.92). Again, “Most studies show that drug treatment works best when administered along with some form of talk therapy” (Time, 6.7.92). When chemical imbalance is not implicated, mental health theory is moving towards understanding behavioural problems in terms of skills which are required in handling stress in living. Skills can be taught as a means of eliminating interpersonal deficiencies or teaching new behaviours. Personal competence is seen as a series of skills which an individual either possesses or can learn through training. Life-coping skills include cognitive and physical skills; interpersonal skills such as initiating, developing and maintaining relationships; intrapersonal skills such as developing self-control, tension management, relaxation, setting goals and taking risks. Crisis is a mental state arising from stress beyond the coping capacity of the individual. These conceptions of life-coping skills are gaining in credibility as research is unfolding the importance of specific types of skills.  The human technology taught in this book will enable the counsellee to acquire the required life-coping skills. Evolution of Counselling We have seen how counselling started at the turn of the nineteenth century with an understanding of the patient’s symptoms as attempts to adjust to a hostile environment. In this light, Freud did away with hypnosis and emphasized the interpersonal relationship between therapist and patient. Through psychoanalysis, he stimulated the patient to communicate freely all that was in her mind. Then he interpreted the data thus collected in the light of his theory of development of human behaviour. In 1942, Carl Rogers found the psychoanalytic interpretation too subjective. He maintained that, if the therapist can create the required facilitative conditions, the client is in a better position than the therapist to understand herself and make her own diagnosis. The emphasis was transferred from the therapist’s interpretation to the client’s self- understanding. In the late sixties, Robert Carkhuff accepted all that Rogers had to offer and developed it further by personalizing the client’s contribution to her own problem, changing that into a goal, and identifying appropriate and systematic steps for the client to attain the goal, and thus solve her problem. Present day counselling is moving towards teaching the client ‘life-coping skills’, both intrapersonal, and interpersonal, and involving the client’s family in the process of counselling. Questions: 1. How did Freud understand the symptoms of mental patients? 2. Why is Freud the originator of modern psychotherapy? 3. Why did Rogers rebel against psychoanalysis? 4. What are the conditions laid down by Rogers to help counsellees? 5. What was Eysenck’s challenge to psychotherapists? 6. What is the answer to Eysenck’s challenge? REFERENCES Berenson, B.G. and Mitchell, K. Confrontation for Better or Worse. Amherst, Mass.: Human Resource Development Press, 1974. Carkhuff, R.R. and Berenson, B.G. Beyond Counselling and Therapy. New York: Holt, Rinehart and Winston Second Edition. 1977. Carkhuff, R.R. Helping and Human Relations. Vols. I and II New York: Holt, Rinehart and Winston, 1969. Carkhuff, R.R. and Others, The Art of Helping —Trainer’s Guide, Amherst, Mass.: Human Resource Development Press, 1977. Coleman, J.C. Abnormal Psychology and Modern Life. Bombay: Taraporevala, Fifth Edition, 1976. Eysenck, H.J. ‘The effects of Psychotherapy’, Intl. J. Psychiatry, 1965. Fuster, J.M. Helping in Personal Growth. Bombay: St Paul Publications, 1974. Kiesler, D.J. ‘Some myths of psychotherapy research and the search for a paradigm’, Psych. Bulletin, 1966. Rogers. C.R. Counselling and Psychotherapy. Boston: Houghton Mifflin, 1942. Rogers. C.R. Client-Centred Therapy. Boston: Houghton Mifflin. 1951. Rogers, C.R. ‘The necessary and sufficient conditions of therapeutic personality change’, J. Consult. Pschol., 1957, 21, 95-103. Rogers, C.R. On Becoming a Person, Boston: Houghton Mifflin, 1961. Rogers, C.R. and others. The Therapeutic Relationship and Its Impact. Madison, Wisc.: University of Wisconsin Press, 1967. Truax, C.B. and Carkhuff, R.R. Toward Effective Counselling and Therapy. Chicago: Aldine, 1967. SECOND SESSION A COUNSELLING MODEL Many people think of counselling as ‘giving advice’ or ‘offering solutions to problems’. However, as defined in this book counselling is neither of these. A little story will illustrate this. A hungry man comes to you for help. You give him a fish. He eats it and feels satisfied, but tomorrow he will come for another fish. Are you then helping him to develop himself? Certainly not. You are creating in him a dependency on you and, so, you are inhibiting his using his own resources. Give him, instead, a fishing rod and teach him how to fish. Then, he will not come anymore to you, for he has learnt to use his own resources and stand on his own feet. This is what the counselling taught in this book is about. Let us see what happens to the counsellee in successful counselling. When a counsellee comes for help with a personal problem, she has to change something in herself to solve it. This may be a change of attitude, of perception of self or of others, of habits or in general a change of behaviour. There is no permanent solution to a problem without some change in the counsellee. Then, the question is: How do we change ourselves? Learning process: E U A The answer is that we change ourselves through a learning process which consists of three stages: self-exploration leading to self-understanding leading to action. How do we know this? We have come to know this through observation of human behaviour and personal experience. For instance, you are given a new transistor of a make which you have never seen before. What do you do first? You explore it looking at one side then the other, identifying the controls for volume and stations and turning these controls one by one. Thus your exploration leads you to an understanding of how the transistor works. Once this understanding is clearly grasped, you readily act to adjust the controls for the stations and volume desired. This learning process — EUA — that we use for acquiring all kinds of knowledge, we also use for changing our behaviours. For example, John realizes that he is losing his temper too often and wants to control it. The first thing he does is to explore himself by asking, “What makes me get angry so many times?” By asking himself this and similar questions, John comes to understand where he is in his world with respect to where he wants to be, i.e., controlling his temper. Guided by this clear understanding he acts to devise steps which will take him from where he is to where he wants to be. In other words, John explores himself to understand himself to enable himself to act or do something to control his anger. How can C introduce E U A in c? Now, if we change ourselves through this learning process of E U A, then the question is: How can the counsellor introduce and sustain in the counsellee this learning process? The answer is: by entering into the counsellee’s frame of reference and initiating action from within the counsellee’s frame of reference. The term ‘frame of reference’ means the way in which the counsellee sees herself in relation to the world around her.  The following illustrations may help to clarify these points. A. Irrelevant Response In the example of the pre-training test, Mary has come to you with her problem (See p. 19). If you have listened only to what she is saying and then offer advice, this is graphically what you are doing: Your response: “Why do you quarrel like that? You must be patient with him and love him.” Response from C’s frame of reference to what Mary is saying The small c stands for the counsellee, Mary, the circle for her frame of reference and the arrow for her intervention. The capital C stands for the counsellor, in this case you reader, the circle for your frame of reference and the arrow for your response to Mary. Mary’s frame of reference is quite different from your frame of reference. Mary has a unique personality, which is quite different from your unique personality. Both of you have different perceptions of yourselves and the people around you; different personal histories and different ways of reacting to the stimuli around you. When you respond to Mary from your own frame of reference, this response makes sense to you. But Mary’s frame of reference is quite different, she may not then be able to understand the wisdom enclosed in your advice. Thus, your response runs parallel to Mary’s intervention, as shown in the drawing, and does not register in Mary’s mind as it has no relevance to her frame of reference. Therefore, it is not helpful. B. Relevant Response A more effective way of helping Mary is not only to listen to what she says, but also to guess how she is feeling when she says these things, and to communicate this understanding to her, and check your understanding with Mary’s reaction. Then you enter into Mary’s frame of reference, and understand where she is in her world. For example: C’s response : “You feel hurt because your husband is disappointed in you.” c’s reaction : “Yes, that is the way I feel.” The process of entering into the counsellee’s frame of reference is graphically illustrated below. You can see in the drawing the long arrow (C’s response) going straight into c’s circle (c’s frame of reference). C first of all attempts to understand how Mary feels and why. The counsellor’s response pinpoints Mary’s feeling — you feel hurt — and the reason for that feeling — because your husband is disappointed in you. Understanding is checked with Mary. If she replies “Yes, that is the way I feel”, then she confirms the counsellor’s entry into her frame of reference (long arrow). This response may stimulate further exploration and understanding but will not be enough to initiate action towards changing the counsellee’s behaviour. C. Relevant Response and Initiation The most effective way of helping Mary is to, not only listen and enter into her frame of reference but to take her one step further and initiate action from her frame of reference. Only after Mary has confirmed that your understanding of her is correct — “Yes, that is the way I feel” — should you proceed to suggest what she might do. Your suggestion should derive from your understanding of Mary’s frame of reference and not from your own frame of reference. Only then will your suggestion make sense to Mary and appear relevant to her need. For example. C’s response : “You feel frustrated with yourself because you cannot find out what it is about you that displeases your husband so much and you want to.” c : “Yes that’s it exactly.” C : “You want to find out what it is about you that displeases your husband. A first step may be to explore all the areas of your personality in relation to him, and delve deeper into the most significant area.” The process of entering into the counsellee's frame of reference and initiating action from her frame of reference is graphically illustrated below. C initiates action from within Mary’s frame of reference.  The counsellor’s response communicates an understanding of Mary’s feeling — frustrated — and the reason for that feeling — cannot find out what it is about her that displeases her husband. When Mary answers, “Yes, that’s it exactly” — she confirms the counsellor’s entry into her frame of reference (long arrow). The counsellor then suggests an action that originates from Mary’s frame of reference (small c-circle) — explore all the areas of your personality in relation to him... — and is therefore, relevant to her need. This relevant action is represented by the double arrow from c circle. The arrow in c’s circle is double to show that C’s suggestion meets c’s need (the first arrow) and takes c a step further in the same direction (the second arrow). The counsellee Mary is now set upon a course of action that can result in a constructive change in her behaviour and thus a solution to her problem. Obviously the counsellor cannot do this in his first response. It takes many responses and the use of many skills, as we shall see later in this book, to reach this point. Two basic skills From the above analysis two basic skills or factors emerge as essential to counselling: Responding first in order to correctly understand the counsellee and then Initiating action from within the counsellee’s frame of reference. Many people initiate action without responding or understanding. They are not helpful. Other people respond and communicate correct understanding, but do not initiate action. They are helpful to some extent but not truly effective. The model of counselling taught in this book stresses these two essential skills or factors — Responding and Initiating — in the proper sequence. The model of counselling presented in this book is an integration of Carkhuff’s models which appeared in 1969 and 1977, with some modifications in the light of my experience in conducting many counselling courses. It includes both attitudes and skills. Appropriate attitudes support skills and helpful skills are the outward expression of appropriate attitudes. Both are needed in the helpful counsellor. The term ‘model’ here means a structure that shows relationships between the components and tells what is done in counselling and in what sequence. Chart I below depicts the various stages that both the counsellor and counsellee pass through during the counselling process. It attempts to show the causal relationship expressed by the arrows between the skills of the counsellor, and the learning process of the counsellee. First the attitudes are listed that must be adopted by the effective counsellor, needed to create and sustain an atmosphere of respect and trust that will encourage the counsellee to open herself fully to the counsellor. We see that during the preparatory stage the attending skills of the counsellor effect the involvement of the counsellee in the counselling process. Once the counsellee is involved, the central stages can begin. Here we find that the responding skills of the counsellor stimulate self-exploration in the counsellee. This deepening self-exploration enables the counselling process to pass on to the personalizing stage. Here the counsellor’s personalizing skills stimulate self-understanding in the counsellee. A clear understanding makes it possible for the counselling process to move into the initiating stage where relevant action steps can be formulated to solve the counsellee’s problem. Thus we have a fully integrated model of counselling that includes the attitudes and skills of the counsellor as well as the learning process of the counsellee, with the causal interaction between these elements constituting the counselling process. Definition of Personal Counselling Briefly the basic questions which have been raised above are: 1. How do we change ourselves? 2. How can the counsellor introduce and sustain in the counsellee the learning process of E U A? 3. How does the counsellor enter into the counsellee’s frame of reference? The answers to these questions define personal counselling. It can be formulated thus: Personal counselling is a complex interaction between counsellor and counsellee where the counsellor adopts certain attitudes (See Chart I) and uses certain skills to introduce and sustain in the counsellee the learning process of self-exploration leading to self-understanding, leading to action, so that the counsellee changes her behaviour and solves her problem. Or in other words, personal counselling is a human technology to help the counsellee realize where she is in her world, leading to understanding where she is with respect to where she wants to be, and to identify the steps which will take her from where she is to where she wants to be. Models of Counselling Definition of model The term ‘model’ can be understood to be like a road map showing where you are, where you are going, and how to get there. It tells also of those involved in it. In other words, a model is a functional relationship between the variables that make the structure work. It tells you how to do something and helps to predict and control the future from the present. A model of counselling explains the interaction between two persons and the content and sequence of this interaction in order to make sense and help the counsellor to be effective. Nowadays the models of counselling are legion. However, the major categories or recognized psychotherapy are: psychodynamic psychotherapies, interpersonal therapy, humanistic therapies, cognitive therapy, behavioural therapy and marriage and family therapy. Different models of Counselling Many models have been devised to help counsellees, but in all these models the outcome of counselling is some change in behaviour. In order for that change to be achieved, the counsellee must act in some way in relation to her environment. She must demonstrate some action. And that action is what is meant by behaviour change. If we accept, now, that the counsellee’s learning process in changing passes through the stages of exploration, understanding and action, then we can attempt to categorize the various models of counselling according to the emphasis they place on one or several of these stages. 1. Emphasis on action alone Behaviour Therapy brings about the counsellee’s change in behaviour through action alone. The Behaviourists condition the counsellee to act in a particular way. They shape the counsellee’s behaviour instrumentally by operationally reinforcing particular kinds of behaviour. They can, also, systematically countercondition the behaviour without any necessary understanding on the part of the counsellee. In other words, they can manipulate the counsellee to behave in a certain preferred way, without her realizing why they are doing this to her. This model may prove useful in treating some types of mental patients with whom communication is very difficult. Behaviour therapy has been successful in removing certain fears and compulsions in counsellees. This model of counselling emphasizes action without the counsellee’s previous understanding of herself and of what is being done to her. 2. Emphasis on exploration and understanding. Most models of counselling centre round the counsellee’s self-exploration and self-understanding, as well as some sort of understanding of the process of counselling and her involvement therein. The following models of psychotherapy and/or counselling seem to belong to this category: Psychoanalysis, Client-Centred Therapy, Trait and Factor Counselling, Existential Therapy, Transactional Analysis, Gestalt Therapy. 3. Emphasis on exploration, understanding and action In terms of the three stages of the counsellee’s learning, we see that Behaviour Therapy is stressing action without consolidating the behaviour change with the counsellee’s understanding of the counselling process and her involvement therein. Many models of counselling emphasize exploration and understanding, but without following the understanding with a systematic action programme that flows from that understanding. Carkhuff has attempted to integrate the three stages of exploration, understanding and action. Exploration and understanding help to plan action effectively. A systematic action programme translates insight into the desired behaviour change. Rational Emotive Therapy also uses this integrative approach. The Emergence of Carkhuff In 1969 Carkhuff appears on the scene with his two volume work, Helping and Human Relations. In this book, he presents a model of counselling which is both a recognition and an enriching extension of Roger’s model. This model centres on the new emphasis, namely, the level of functioning of the counsellor. In fact, Carkhuff states that, in order for the counsellee to be helped, the counsellor must function at a level higher than the counsellee’s level of functioning. Otherwise the counsellee will deteriorate. Functioning at a higher level means that the Counsellor himself keeps actualizing his human potential. Guided by research findings, Carkhuff later modified his 1969 model and published his updated model in 1977 in The Art of Helping III. The main difference between these two models is that the 1969 model is concept- oriented while the 1977 model is behaviour-oriented. Xavier Institute of Counselling Training in Carkhuff’s models of counselling is available in India at the Xavier Institute of Counselling, Bombay. This is how this Institute started: during my Sabbatical year, 1971–72, in Baltimore, I became acquainted with Carkhuff’s model of counselling. On my return to Bombay, I began to share it with others in the field. Their highly positive feedback encouraged me to offer more counselling courses. On the other hand, training programmes for personal counselling are extremely limited and of poor quality in Indian universities. This situation together with the demand for training in personal counselling prompted me to start in 1972 the Xavier Institute of Counselling. 50 - hour training courses in personal counselling are conducted regularly at this Institute and, also, abroad. The objective is not to train candidates for the post of counsellor, but rather to assist professionals in the ‘helping professions’ to enrich the quality of the services they are already rendering to society. Xavier Institute of Counselling confers Certificates on successful trainees, that is, on those who have attended all the sessions and have secured at least 60 per cent of the total score of the three tests which are given during the course. At the moment of writing, 158 training courses have been conducted for 2,237 professionals in the helping professions in India and in eight other countries. THE COUNSELLOR Suitable candidates In common with every other profession, the counselling profession demands certain requirements in prospective candidates. The question is: Who can be considered a suitable candidate? The American Psychological Association has put forward certain criteria for the selection of clinical psychologists in general. They can serve as guiding principles for the selection of counsellor-trainees for they are not culture-bound and their contents are worth pondering. They are as follows: 1. Superior intellectual ability and judgement. 2. Originality, resourcefulness, and versatility. 3. Fresh and insatiable curiosity; self-learner. 4. Interest in persons as individuals rather than as material for manipulation — a regard for the integrity of other persons. 5. Insight into one’s own personality characteristics; sense of humour. 6. Sensitivity to complexities of motivation. 7. Tolerance: ‘unarrogance’. 8. Ability to adopt a ‘therapeutic’ attitude; ability to establish warm and effective relationships with others. 9. Industry: methodical work habits; ability to tolerate pressure. 10. Acceptance of responsibility. 11. Tact and co-operativeness. 12. Integrity, self-control and stability. 13. Discriminating sense of ethical values. 14. Breadth of cultural background — ‘educated person’. Personal adjustment As well as academic qualification, something more essential is required and that is a well-balanced personality. This does not mean that the candidate is not to labour under any personal problem. He may have a problem, as many people do, but he should be aware of it, and should develop some technique to prevent the problem from interfering with the counselling relationship. Those who have had serious problems and have resolved them, may be highly capable of helping others. In this connection Rogers writes: “The person who is to carry on therapy needs security within himself, and this may come in part from having thought through some of the basic questions regarding human life, and having formulated tentative but personally meaningful answers.” Mowrer requires in trainees ‘personal maturity’, but admits that there is no trustworthy method for measuring it. St Paul writes: “God helps us in all our troubles, so that we are able to help those who have all kinds of troubles, using the same help that we ourselves have received from God” (2 Cor 1:4). The candidate for counsellor should have a broad culture and an open mind and so appreciate the values of other people even when those values may differ from his own. This requires a deep and sympathetic understanding of individuals, and of the environment in which they have been brought up. Psychological counselling aims at personality growth, therefore the whole person with his manifold relationships is involved. To play his role effectively, the counsellor needs something more than mere scientific psychology. He must take help from other branches of knowledge such as history, sociology, philosophy and theology. Thorne says: “Philosophy and religion have important roles in personality counselling as they relate to the solution of problems beyond the realm of science.” The whole person is involved in the counselling situation. The counsellor must have an insight into the counsellee’s way of life, i.e., her goals, her values, ambitions and cherished traditions. Some people are able to be aware of all these things, and to respect them, and to appraise the part they play in the counsellee’s life. These people are the right candidates to become counsellors. Those who fail to appreciate the above, should not become counsellors. Awareness of one’s own needs An essential element in the training of counsellors is that the candidates should be helped to develop an understanding of their own needs and the effect of these needs on their counselling. The term ‘needs’ means here some compulsion rooted in one’s biased attitudes and feelings. Because of these attitudes, one may feel the need to act in a certain way, but this way of acting may not be appropriate to the circumstances. For example, a counsellor may feel the need of avoiding emotional contact, and under its influence he adopts a distant and impersonal attitude towards the counsellee. The counsellee may resent this type of attitude and feel disappointed when she expected a warm relationship. In this case the counselling relationship is impaired due to the influence of a counsellor’s need. Lack of understanding of such a need would certainly be a handicap for the counsellor. Even if a counsellor has such a need, he may still be warm and accepting while keeping a check on getting too involved with the counsellee. It is essential that the counsellor should train himself in this regard. No counsellor is free from biased attitudes and feelings, and therefore no one is free from the influence of one’s needs. Here, following Patterson we shall mention some of these needs and the way they influence counselling. (a) The need for social companionship: may influence behaviour towards counsellees of the opposite sex. This need if not controlled may turn a counselling interview into a ‘date’ and thus thwart its purpose. (b) The need for recognition and prestige: one naturally wishes to please others and to appear important. If the counsellor yields to this need, he will indulge in displaying his knowledge and in adopting a self-centred attitude. (c) The need for security: the counsellor with this need may get the counsellee to praise him, and to say that after a long time she has found a real counsellor, one who understands her, etc. (d) The need for being helpful: this may lead the counsellor to do things for the counsellee such as protecting the counsellee and manipulating the environment for her. (e) The need for teaching: this may prompt the counsellor to elaborate non- pertinent points and thus to bother the counsellee. (f) The need to solve personal problems: this may sensitize the counsellor to certain problem areas, or may lead him to project his own problem on to the counsellee, thus rendering himself unable to listen intelligently and to understand what the counsellee is saying. These are some of the needs of counsellors. It is very important that trainees should achieve some insight into themselves, their motives, needs, biases, and some recognition of how these affect their counselling. The counsellor’s approach Trainees vary in their approach to counsellees and their personal problems. An analysis of the various ways in which counsellors respond to counsellees reveals the following approaches: 1. Evaluative: the counsellor passes judgement on what the counsellee says, “This is right and that is wrong,” “If you do this, that will happen, you ought to do this and avoid that.” 2. Interpretive: the counsellor assigns causes to the problem the counsellee is talking about. He teaches the counsellee how she ought to think. 3. Supportive: the counsellor pacifies and re-assures the counsellee. He reduces the counsellee’s intensity of feeling, telling her that she need not feel the way she does. 4. Probing: the counsellor asks for further information and indulges in some curiosity to know more about certain things. 5. Understanding: the counsellor tries to understand correctly how the counsellee feels, how she looks upon her problem, and what she has to say about it. The following example (taken from the Author’s experience in India) will help clarify the difference between these five approaches. Example A college girl, twenty years old, comes to the counsellor very tense saying: “Last night I could not sleep. I was puzzled as to what I should do. I learnt from my sister-in-law that my parents arranged for me to get engaged to a boy whom I do not like. I saw that boy at home and did not like him because he is short, fat and has a flabby face. Moreover he showed no interest in me outside that visit.” An evaluative response would be: Marriage is a contract for life and therefore something very serious. You are young and inexperienced. You place value on things which are not so important. Your parents know better than you, and you should value their choice. An interpretive response would be: You feel so disturbed because you have seen other boys who attract you more than he does, and you keep thinking of the others. You should forget the others and try to like this one. A supportive response would be: Don’t bother, you are not the only girl to go through this difficulty. This kind of thing is not uncommon. So many girls have accepted this situation and they have been happy. You need not feel so upset. You will see that after some time everything will be all right. A probing response would be: Who is this boy? How much education has he? Does he belong to a very respectable family? Has he any vice? How long have you known him? You should know all these things before going ahead. An understanding response would be: You feel hurt because your parents have not consulted you before arranging the engagement, and now you are struggling with yourself about whether you should accept or reject their decision. The understanding response communicates your understanding of this girl’s feeling experience and the reason for the feeling. Such a response results in the counsellee feeling understood and this feeling of being understood forms the basis for a relationship of rapport between the counsellor and the counsellee. Feeling understood by the counsellor, the counsellee is encouraged to reveal more of herself to him. Trainees should strive to acquire this understanding approach to counsellees. The counsellor’s limitations A very important point in the training of counsellors is to instruct them how not to go beyond their area of competence in counselling, and how to refer such cases to the competent person or agency. We shall consider here two kinds of limitations: 1. Limitations arising from lack of rapport. 2. Limitations arising from inability to help. 1. Limitations arising from lack of rapport. The counsellor cannot be expected to be able to help each and every counsellee. There are many reasons such as inability to get on with certain temperaments, previous connections with the counsellee, etc., that will hinder the establishment of rapport and thus jeopardize success. Such cases can be detected at the first interview, and the counsellor can politely refer the counsellee to some other counsellor. This procedure seems good because it prevents a frustrating experience both in the counsellee and in the counsellor. 2. Limitations arising from inability to help. The primary purpose of counselling is to help the individual. These individuals may also be psychoneurotic to a mild degree. But the chronic psychoneurotic and the psychotic are definitely outside the field of competence of the counsellor. These counsellees belong to the psychiatrist. Now, the question arises, how can the counsellor detect major mental disorders? Here we shall give some criteria to help the counsellor in this area. Abnormality may assume any of the forms shown below: emotional instability : psychoneurosis personality disintegration : psychosis limited intelligence : feeblemindedness moral imbecility : anti-social personality or psychopath The psychoneurotic exhibits a variety of mental and physical symptoms such as anxiety, obsessions, phobias, inferiority feelings, oversensitivity, worries, different kinds of aches, etc. But none of these disorders disrupts her self-management or her social adjustment, nor prevents the individual from holding a job and going through her everyday activities. The psychoneurotic retains contact with reality, is aware of what she is doing, understands to a point her difficulties, can distinguish right and wrong, is legally responsible for her actions, is not a danger to others, can work, and can establish rapport with the counsellor.  The psychotic suffers from severe mental disorders such as major mental and emotional disruption that renders her incapable of adequate self- management and adjustment to society. The psychotic has lost touch with reality, uses incoherent speech, is confused, cannot establish rapport with the counsel-lor, may be depressed or violent, has delusions and hallucinations, is unpredictable and constitutes a threat to the society. She is not legally responsible for her actions and needs hospitalization. The feeble-minded or mentally retarded is abnormal in her intellectual development. There are various degrees. The lowest type are incapable of self-management, need supervision and are socio-economic liabilities. The psychopath is seriously retarded in her moral development. She is selfish, emotionally unstable, unconcerned with the future consequences, and in-capable of conforming to ethical and social standards. At the first interview, the counsellor can suspect or detect major mental disorders that fall outside his field. In such a case it is the counsellor’s duty to suggest the kind of help needed and the person or place from which such help can be obtained. This brings us to the next point, i.e., how to avail oneself of community resources. Resources for help The counsellor should be acquainted with the resources which are available in the community. In Bombay, for instance, we have, A Directory of services for those in need, called HELP, which acquaints us with a rich variety of services available, such as mental health services, alcoholism and drug addiction, community welfare services, and a number of other services. PROCESS OF COUNSELLING Introduction Chart I showed the model of counselling which is taught in this book, i.e., the interaction or dynamics between counsellor and counsellee, and its ingredients. Chart II below presents the process through which counselling passes, i.e., the various stages, the skills the counsellor has to use in each stage and the sequence of stages he has to follow in order to introduce and sustain in the counsellee the learning process of self-exploration leading to self-understanding leading to identifying the steps which will take her from where she is in her world to where she wants to be. Finally, the Subsequent Stage: Evaluating. This takes place during the following sessions after the counsellee has taken the first step and comes to report to the counsellor on her performance on her Action-Programme. CHART II COUNSELLING PROCESS Preparatory Stage : Attending Attitudes: Skills: —Respect — Social skills —Genuineness — Attending physically —Empathy — Observing — Listening First Stage : Responding Attitudes: Skills: —Respect — Responding to content —Genuineness — Responding to feeling and content —Empathy — Responding with questions —Concreteness — Making summary responses —Self-disclosure — End this stage with a neat summary of the dominant feelings and their reasons, and get it checked by the counsellee Second Stage : Personalizing Attitudes: Skills: —All the above plus: — Personalizing the problem and the Confrontation goal together Immediacy Third Stage : Initiating Attitudes: Skills: —All the above — State the goal clearly — Identify appropriate steps to reach the goal — Formulate the first step Subsequent Stage : Evaluating Attitudes: Skills: —All the above — A week or so after the counsellee has taken the first step, evaluate with her her performance and modify the plan of action in the light of her feedback — Sustain her motivation using reinforcers In this chart we see listed the stages of the counselling process: Attending, Responding, Personalizing, Initiating and Evaluating; and the attitudes the counsellor should adopt at each stage. These labels represent two things: the various stages of the counselling process and the skills that are used by the counsellor at each stage. Thus, the preparatory stage is called Attending and the skills used by the counsellor during this stage are called Social skills, Attending physically, Observing and Listening. Here the attitudes are respect, genuineness and empathy. The first stage is labelled Responding and the skills practised in this stage are: Responding to content or to feeling and content, Responding with questions, Making summary responses and a Neat summary at the end. The attitudes are all the above plus concreteness and self-disclosure. The second stage is Personalizing and the skill is Personalizing the problem and the goal together. All the above attitudes plus confrontation and immediacy. The third stage is Initiating and the skills used by the counsellor are named initiating skills, which include Stating the goal clearly, Identifying appropriate steps to the goal and Formulating the first step. All the above attitudes. The subsequent stage is Evaluating. This includes: the skills of assessing the counsellee’s performance on the action programme, modifying it in the light of the counsellee’s feedback and sustaining the counsellee’s motivation by means of reinforcers. All the above attitudes. There is no time limit for each stage. The counsellor allows the counsellee to move on at her own pace. Thus, the preparatory stage may take one interview or just a few moments at the beginning of counselling. Some counsellees may pass through all the stages up to evaluating in one hour. Others may take several interviews spread over some months. The skills mentioned in the preparatory stage, Attending, are the skills the counsellor has to use during this stage. However, the skills of attending, observing and listening have to be practised throughout all the stages of the counselling process. The skills of the counsellor are cumulative, i.e., the skills of the preparatory stages must be carried over to the first stage and to all the stages. The same applies to responding. Thus, when the counsellor responds to the counsellee, he must also attend, observe and listen. When he personalizes he must also attend, observe, listen and respond. When he initiates, the counsellor should also attend, observe, listen, respond and personalize by making the counsellee aware of her deficit behaviours in implementing the plan of action. These stages are not rigid compartments. One gently flows into the next and, some times, the counsellor has to go backwards to a prior stage, say from initiating to responding and then proceed again to the next, personalizing. The whole process of counselling is meant to help the counsellee to get from where she is to where she wants to be. In the following chapters of this section, the skills of each stage will be explained and also the procedure the counsellor should follow within each stage and how to pass from one stage to the next. PREPARATORY STAGE: ATTENDING If you go to a counsellor with a personal problem and he says, “Sit down”, but keeps reading the book he has in his hands, it is highly likely that you would feel that he is more interested in what the book says than in what you want to say. You would not feel encouraged to share what is troubling you with him. Attending is paying attention to another person. Attending is the name of the preparatory stage which includes: social skills, attending physically, observing and listening skills. It effects in the counsellee getting involved. The preparatory stage is very important because, unless the counsellor gets the counsellee interested in beginning counselling, nothing will happen. So the question before us is: How does the counsellor involve the counsellee in the counselling process? There are many factors which influence the counsellee to want to confide in a counsellor. Let us try and enter the frame of mind of the average counsellee. Let us call her, Niti. Niti has been for some time troubled by a fear which at times gets uncontrollable. She has tried on her own to keep it at a tolerable level but without success. This fear interferes with her teaching work, going to and returning from school, and she feels miserable. Under this pressure, Niti begins to think, “Who could help me?” After some discreet and impersonal investigation, Niti decides to go to a counsellor named Rajesh. After this decision Niti begins to think, “Will he be kind to me? Will he understand me and respect me? Will he be able to help me? What will people say when they come to know that I need a counsellor?” These and similar thoughts grip her mind and she is in a state of anxiety. However, Niti is determined to do something effective about her fear and, so, one day rings up Rajesh. Her voice on the phone sounds anxious and insecure. But Rajesh’s voice is kind, understanding and reassuring. So, Niti makes the appointment and goes to his consulting room. Upon arrival, Rajesh greets her warmly and is very kind to her. He answers all her preliminary questions and puts her at ease. The room is well ventilated and private, and the chairs are comfortable. Rajesh shows with his behaviour that he is very interested in helping her. In these circumstances, Niti begins to feel somewhat relaxed and hopeful that she will be all right with Rajesh. Thus, Niti has become interested in going through counselling with Rajesh. How has this interest been created in Niti? The answer to this question is complex, but it can be formulated in terms of various skills. The first basic skills of the counsellor are called Social Skills. The word skill means the ability to do something well. People who are really able in various professions are called experts. They have mastered the skill of doing their job to perfection. I. Social Skills Let us briefly review these social skills and, consider the ways in which you use them. They fall into the following sub-divisions. — Greeting skills — Politeness skills — Kindness skills Greeting skills are shown in using the customary ways of greeting people nicely, “Good morning!”, etc.; in mutual self-introduction, such as “My name is..........”, in acknowledging other people and what they want to say. Politeness skills are an expression of one’s sensitivity to the feelings and opinions of others, of one’s respect for others, of one’s gratitude to others. Thus, you do not say everything that comes to your head, but discern what is appropriate to communicate. Use the expressions “excuse me”, “please”, “thank you”, “how kind of you”. Kindness skills express one’s good wishes for others and readiness to do something for others. Kindness is like sunshine on a cold day. Social skills facilitate interpersonal interaction and give a chance to explore each other and the goals of the relationship. They generate trust by showing that one is not preoccupied with oneself and one’s own things alone. Then one is genuinely interested in the other. Thus, social skills pave the way to a deeper interpersonal relationship. Some of you may be asking: “How can I improve my social skills?” Often it happens that, though in principle you want to be kind, in practice you are not. Research studies have shown that there is a high correlation between social skills and physical fitness. A tired counsellor is a bad counsellor. If you are overworked, if you do not get proper rest, if you are rushing from one occupation to another, then you cannot be a good counsellor. Physical fitness flows from discipline skills. These skills include the ability to organize your life and your time so that you meet your basic needs adequately: rest, diet, health, hygiene, exercise, reading, prayer, etc. You must acknowledge your own limitations and within these limitations do your utmost. Some people need to be reminded that they cannot do everything and that no one is indispensable. In counselling, limited efficiency is more valuable than unlimited mediocrity. II. Skills of Attending Physically When we talk of attending physically to the counsellee, we must realize that we communicate nonverbally more with our body language than with our words. Unconsciously through our body language we send messages to the counsellee such as, yawning, looking at the wrist watch, narrowing the eyes, raising the eyebrows, suddenly leaning forward, changing the tone of voice. All these non-verbal messages are picked up by the counsellee without our being aware of them. It has been said that 80 per cent of our interpersonal communication is done through our body language and 20 per cent with our words. The fact is that our tone of voice, our eyes, our lips our hands, the way we stand or sit send non-verbal messages to the counsellee telling her that we are very interested in her, or the other way round, that we have no time for her. If we want the counsellee to receive the message that she matters to us, we must convey it through our attitudes and behaviours. Behaviours such as smiling or saying certain polite phrases flow naturally from our attitudes. In this and the following three chapters behaviours are considered. 1. The skill of attending physically consists of the counsellor’s ability to give his full attention to the counsellee and to communicate his interest to her in non-verbal ways. Attending physically includes the following: a) when the counsellee calls you on the phone or comes personally to make an appointment you must welcome her. Your tone of voice, your behaviours should show that you are really interested in her. b) answer her questions. Inform her as to time and place of the meeting, how to get there by bus, train, etc. c) when she comes for the interview, receive her in a clean and ventilated room, which is private and quiet, with comfortable chairs, and give her your full attention. d) motivate the counsellee by showing her the potential benefit she can derive from counselling. Promote her attentiveness by paying full attention to her. 2. The purpose of attending physically is to involve the counsellee in the counselling process. 3. The skill-steps of attending physically are four actions or behaviours, which should flow from the attitudes of respect and genuineness, as explained in third session and empathy in fourth session. Further, these steps should be practised in a relaxed manner, for nothing relaxes the tense counsellee so much as to see and experience the counsellor relaxed himself. — Sit facing the counsellee in an appropriate position. — lean forward. — make eye-contact if the counsellee feels comfortable, else look down and occasionally look at her face. — eliminate any distracting behaviours. In taking these steps at the interview with the counsellee, you should keep in mind her specific culture and what she would expect and not expect of you. You should remain at a distance which is comfortable for both you and the counsellee, and yet be able to see and hear effectively. Three or four feet apart is an appropriate distance. You lean forward at the beginning or at moments of expressing deep feelings, but you need not keep leaning all the time, else it would be too fatiguing. Our posture often reflects our thoughts and feelings. When we posture ourselves for others, we tend to think of others. When we posture ourselves for our own comfort and convenience, we tend to think of ourselves. We must seek in every way possible to communicate our full and individual attention. We communicate attentiveness when we maintain eye contact with the counsellee or often look at her face. The counsellee is then aware of our efforts to make psychological contact with her.  When you are intense but relaxed, you communicate attentiveness. When you are nervous and fidgety, you communicate that you do not want to be there. When you are consistent in attentive behaviour, you communicate your interest. When you blush or turn pale, you confuse and disturb the counsellee. The counsellee has many unspoken questions in her mind, such as, Is the counsellor interested in me? Is he willing to give me time and listen carefully? Can I share my intimate thoughts and feelings with him? Do I dare to put the real thing before him? Has the counsellor anything I can use? Would he be successful in my world? Can he help me? Attending physically to the counsellee answers non-verbally many of these questions. When you follow all the above steps, you are attending physically. In this way you involve the counsellee in the counselling process. Practice If the training session lasts 2 hours, the first hour could be for theoretical inputs and discussion; and the second for practice in this way: one trainee performs as counsellor and another as counsellee. They sit facing each other in front of the group and practise the skill that has been explained. Then feed back is given to the counsellor from the group and from the trainer. For the readers who do not have the opportunity to attend a training course, there are some suggestions after each explanation to improve these skills. You do not learn the art of helping by reading alone. You learn by practising what you read and by getting feedback as to how well you implement what you have read. You can practise these steps in your daily work when you meet people. For example, you could fix an hour during the day when you are going to practise the above steps. Be very clear in your mind as to what you have to do. Practise the steps with the people who come to meet you during that hour. Then review your performance by noticing the strengths and weaknesses. Resolve to improve on the weaknesses the following day. Again, practise, review, resolve. Do this for several days until you are pretty sure that you do it well. Then, get someone reliable to give you feedback on your performance. Objective feedback validates your perception of your own performance. If you understand the purpose of attending, learn the skill-steps correctly, practise them, and get feedback on your performance, then, you will master the skill of attending, so that you will involve the person in the process of helping. Application You may apply the skill of attending physically to any situations in which a person comes to talk to you. People like to be attended to, and they respond to attention. You could try to change some of your ways with your charges and your colleagues, and see what happens. Questions: 1. How do we know that we change ourselves through a learning process? 2. How to introduce the learning process in the counsellee? 3. Which are the two most important skills to help the counsellee? 4. Why is nonverbal communication important? 5. What is the purpose of attending? 6. Why are social skills necessary? 7. Which are the skill-steps of attending physically? REFERENCES American Psychological Association. Committee on Training in Clinical Psychology. American Psychologist, 1947, 2, 539-558. Fuster, J.M. ‘The Counsellor’s Attitudes’, J. Vic. Educ. Guid. 1961, 7, 105- 112. Mowrer, O.H. ‘Training in Psychotherapy’, J. Consult. Psychol., 1951, 15, 274-277. Patterson, C.H. Counselling and Psychotherapy: Theory and Practice, New York, Harper, 1959. Rogers, C.R. Client-Centred Therapy, Boston, Houghton Mifflin, 1951. Sheth, Kamini Help. A Directory of services for those in need, Bombay. 3rd Edition 1982. All Saints Church, Bombay. Thorne, F.C. Principles of Personality Counselling, J. Clinical Psychology, 1950. THIRD SESSION ATTITUDES: RESPECT, GENUINENESS, CONCRETENESS Introduction  Attitude is different from thought. A thought comes and goes, whereas an attitude stays with us. Attitude can be defined as a mental set, a habitual way of thinking and perceiving persons and events. Attitude includes our mental processes many of which are unconscious. Attitude incorporates our self- image and our beliefs about people and things. We form attitudes under the influence of our own culture and upbringing. In India, for instance, caste-consciousness influences some people’s attitude towards harijans, or untouchables, or dalits. Another important factor in the development of attitudes is our personal experience with certain people. If as a tourist you happen to be cheated or treated rudely in a particular country, you may develop an unfavourable attitude towards the inhabitants of that country. Our favourite books, magazines and newspapers also go a long way in forming our attitudes. It is a known fact that our attitudes towards people influence our behaviour towards them. If we think kindly of our companions, we behave kindly towards them; if we think unkindly, we behave unkindly. Since the counsellor is required to behave in a helpful way towards counsellees, he must form appropriate attitudes towards people in general and towards those seeking help in particular. We could ask this question: What are the attitudes which the counsellor should have, and how does he form them? Research studies in the field of personal counselling and specifically, in what goes on between counsellor and counsellee when the counsellee is really being helped, have been done by Rogers (1961), Carkhuff (1969, 1977) and others. In 1969 Carkhuff presented his conclusion that nine variables or attitudes were very important to the counsellor. These were, empathy, genuineness, respect, concreteness, self-disclosure, confrontation, immediacy, self-actualization and potency. The first three are considered below and some others in later chapters. Part I: Meaning and importance of these attitudes In explaining an attitude, I follow these steps: first, define the attitude; second, why it is effective; third, how to train in that attitude. Respect The attitude of respect towards counsellees emerges in the counsellor from a belief in the sense of worth of the human being, that there is something sacred about a person, something intangible. The Bible says that man was made in the image of God; male and female he created them (Gen 1:26-27), and all human beings are called to share divine life with and through Jesus Christ. Respect here also means acceptance of the counsellee as she is and appreciation of her as a person. In the counselling situation this attitude of respect has an ever greater significance. The counsellor who respects the counsellee has faith in her potential for personal growth and for solving her problem. If the counsellor does not have this faith in the counsellee, then he will not be able to help. Respect, also, implies that the counsellor recognizes the counsellee’s freedom and her right to make her own decisions. Why respect is effective. The communication of respect shatters the isolation of the counsellee and helps to establish a relationship based upon trust and confidence. The counsellor’s respect for the counsellee is a great help to empathy. By communicating respect, the counsellor helps the counsellee to respect herself and also to respect the other people who are connected with her problem. Communication must aim always at preserving the self-respect of the counsellee as well as of the counsellor. If the counsellor gives willingly the allotted time to the counsellee, allows her to make decisions, and communicates her faith in her potential for personal growth, then, the counsellor through showing respect to the counsellee makes her feel respected. Therefore, the counsellor can establish a helpful, relationship with her. Example Counsellee : I would like to join the Carkhuff counselling course, but there is a seminar on T.A. at the same time and I can’t decide which to take. Counsellor responses 1. (No respect) : Follow my advice. Go for the T.A. course. 2. (With respect) : You feel restless because you can’t make up your mind since you don’t see clearly now which is best for you. With further inquiry, you will be able to. Training in Respect — suspend all critical judgements concerning the counsellee. Encourage her  to express herself freely. — speak in modulated and warm tones. — concentrate upon understanding the counsellee correctly. — gives her credit for what she is doing well. For example, if she says that she has already made some efforts towards the solution of her problem, the counsellor gives her credit for that. — communicate in a genuine, spontaneous manner. — communicate to the counsellee your faith in her ability to solve her problem. Genuineness Genuineness is willingness to be real and not hide behind a professional facade, to be non-defensive, to be reasonably role-free. The goal of helping is constructive change in the counsellee, enabling her to become a more genuine or authentic person. Thus authenticity is an important aspect of the goal of counselling. Authenticity is also the means of helping. The basis for the helpful relationship is genuineness between counsellor and counsellee. Genuineness means being congruent. In other words, there is consistency between these three levels of the person: level of experience, level of awareness of experience, and level of communication of awareness. E.g., a girl feels jealous of another girl. She is aware of her feelings of jealousy, and communicates her awareness of these feelings by speaking ill of her. This girl is genuine in a negative way and people understand that she is jealous. Joe discusses with someone and raises his voice, but says he is not angry. He is incongruent in his communication, for he is not aware of his experience of anger. A guest is bored at a party, but on leaving the place he compliments the hostess effusively. He experiences boredom, he is aware of his feeling of boredom, but he puts on a mask to communicate with the hostess. He is not authentic. Genuineness in the counsellor means honesty with oneself and with the counsellee. It means also being spontaneous and non-defensive. Genuineness must be constructive. The counsellor must be aware of all his feelings towards the counsellee, both positive, such as love, attractiveness, as well as negative feelings such as anger, hatred, jealousy. Neither positive nor negative feelings should be communicated by the counsellor when such communication would not be helpful to the counsellee. Therefore, the counsellor must be genuine to the extent that he can help the counsellee. If she is not going to be helped, then, the counsellor remains with the awareness of his feelings and does not communicate them because they would not help the counsellee. This is called facilitative genuineness. The counsellor’s genuine interest in helping is put to the test when the counsellee is disrespectful towards him. Then, the counsellor must use the counsellee’s hurtful responses constructively to open up further areas of inquiry in his relationship with the counsellee. The counsellor’s caring for the destructive counsellee actively indicates non-verbally that he does not encourage negative behaviour in the counsellee. Thus the counsellee learns to extinguish such behaviour. Why genuineness is effective. It can be assumed that a high degree of harmony in the counsellor between the levels of experience, awareness of experience, and communication of awareness, will facilitate the growth of congruence in the counsellee. Thus, authenticity in the counsellor stimulates the counsellee’s authentic behaviour. In the early stages of counselling, however, it is quite natural for the counsellor to use some techniques or stereotyped modes of responding. Indeed, it would be quite unnatural to be fully oneself with someone whom one does not yet know. In later stages, the movement is from technique to person. That is, the counsellor moves towards becoming more fully and freely himself in helping and, accordingly, enables the counsellee to become more fully and freely herself. If the counsellor’s words agree with his feelings and way of thinking; if he minimizes his role facade and comes down on level with the counsellee; if he is spontaneous and authentic in a constructive way; then, he will be genuine in his relationship with the counsellee, thus facilitating the establishment of a good relationship with her. Example Counsellee : I have a feeling that you are not quite frank with me. You seem to be hiding something from me. Counsellor responses 1. (Genuine) : You want to know whether I have been completely honest with you. No, I have not. I have told you certain things, but other things could be postponed for a more appropriate time. 2. (Not genuine) : Counsellors should communicate as much veracity as  possible. Training in Genuineness — come down from your professional throne and be a man on a level with the counsellee. — try to be always authentic in what you say. — be as open and free within the helping relationship as is possible. Move from technique to person, from rigid boundaries to a growing and spontaneous openness and freedom. — if you experience difficulties in relating to the counsellee, ask yourself: what goes on in me that makes me feel reluctant or hostile or whatever, towards the counsellee? Further, if you sense hostility in the counsellee, inquire concerning the sources of the counsellee’s experience: Is it I? Is it she? Is it both of us in interaction? Concreteness Concreteness is an ability to be down to earth, practical, without resorting to theoretical abstractions, but to respond from the framework of lived experience, with one’s feet on the ground. It happens sometimes that counsellees talk a lot about different things, but it is difficult to understand what exactly they are trying to say. The material they deal with has little relevance to their problems. In such cases, the counsellor may also be entangled in vague and abstract generalizations which lead nowhere. In order to help the counsellee, the counsellor must understand exactly what is bothering her. Hence, the need for concreteness in the communication between coun