›› Some Thoughts On Counseling

        by John Warren

1. Counseling is an art form that is never truly mastered.
2. Your level of expertise will be directly proportional to your ability to learn from your patients. This never changes.
3. A counselor is a guide that leads the patient patiently to enlightment or freedom from suffering. There are many ways home.
4. A counselor demonstrates healthy boundaries and a healthy life style.
5. A good counselor never gets caught counseling.
6. Often times a counselor presents information in a fashion that lends itself to being the patients idea. In other words a good counselor knows how to stroke an ego.
7. A counselor often times plays the game until it’s time to set the hook. Counseling is a lot like fishing.
8. A counselor avoids ego traps and lives to play another day.
9. A counselor always trusts the process and in so doing role models a healthy coping skill to the patient.
10. A counselor acquires the ability to see the blessings in any misfortune and presents this concept to the patient as a new coping skill.
11. A counselor is geniune. Patients will see right through anything else.
12. A counselor is a mirror reflecting to the patient a unique perception of self. A first time introduction perhaps. The patient is introduced to the concept of perceptual change as a valued coping skill. Moving to a new seat in the bleachers, so to speak, allows the patient a new perception of the game. Wow!
13. A good counselor avoids the pitfall of owning the patient. No one understands this patient the way that I do. No one else knows better than I whats best for this patient. Horse pucky!
14. A counselor shows the patient both sides of the coin. A counselor helps the patient to see, accept and own his or her part in any situation, thus introducing them to a new coping skill.
15. A counselor guides a patient through their feelings pointing out that they are rarely upset for the reasons that they think and thus introducing them to a new coping skill.
16. A good counselor develops the skill to read group and individual energy that is not always obvious. Helping the patient or group to see this is again a new coping skill.
17. A counselor knows when to cut bait, or when helping is no longer helping.
18. A counselor knows how to make an appropriate referral. If you are over invested in any patient, letting go will cause you both much grief.
19. A good counselor has learned how to maintain a therapeutic distance from the patient because, see #20.
20. A good counselor has made many painful mistakes along the way.
21. A counselor accepts the process no matter what.
22. A counselor knows how to use [trust] the treatment team, the alumni, and community resources.
23. A good counselor has developed a working understanding of personal and family dysfunction and has acquired the ability to present this information to the individual and to the family in a user friendly fashion.
24. A good counselor knows how to waltz with the ego and how to slam dunk the disease. These are acquired skills. If you get a thank you at the end, you did it right. If not, someone is bleeding all over the place and shame on you.
25. There will be times when you will bow to insanity and wait patiently for the outcome.
26. A good counselor has learned painfully to stay out of the results.
27. If it ain’t broke, don’t try and fix it.
28. If it looks like a duck, walks like a duck, quacks like a duck and do do’s thru feathers, it’s a duck. Trust your instincts.
29. One insight does not a recovery make. Don’t be jumping up and down.
30. Chances are that it will not be anything that you said that made the difference.
31. Working in this field, a counselor understands that one on one they are outnumbered. A seasoned counselor uses the group and uses the treatment team.
32. A counselor is ever aware of transference and counter transference dynamics.
33. A counselor models detachment. You will encounter patients looking for a breast and praying for lockjaw.
34. Often times the truth will reveal itself without intervention.
35. A good counselor knows when to watch and wait.
36. Confrontation when applied with love, care, and concern is an awesome tool. Without it you wind up with another bloody mess. Costly lessons.
37. A good counselor has a mentor with lots of bandaids.
38. A counselor is aware of his or her ego needs, his or her assets, his or her deficits, his or her motivators.
39. A counselor helps the patients to see themselves as separate from their disease, thus introducing them to forgiveness/acceptance and another effective coping skill.
40. An experienced counselor does not respond to a patient’s defiance, arrogance, anger, rage, defensiveness, hostility or judgment as a personal affront, but rather as the dynamics of addiction that need treatment.
41. An experienced counselor sees all that is not love as a cry for help.
42. A counselor models the above as an effective coping skill.
43. An experienced counselor knows how to extract the very best qualities from the patient and how to display these for all to admire.
44. A good teacher never terrorizes the student.
45. An experienced counselor is able to introduce the patient to his or her self, with dignity.
46. An experienced counselor is familiar with the state of personal ambivalence and self doubt and will defer to the treatment team, am I doing the right thing here?
47. Counseling has nothing to do with saving the world and everything to do with facilitating acceptance, forgiveness, open mindedness, humility, willingness, patience, tolerance, honesty, kindness, love, fellowship, community, grace, and dignity.
48. A seasoned counselor will play on the patient’s strengths until they are together enough to address their deficits and connect the dots.
49. The experienced counselor is first, a student.
50. There are times when the counselor will sense that the message is not being heard. The clues will be the patient is sporting a glazed over look or it is quite evident that their mind is exploring another galaxy or given their history you know them to be shame based. In any event the question is, “What are you hearing?”
51. In the case of the shame based individual the message was, “You are the most amazing person in this universe. Your insight and ability to love is beyond measure. By the way, did you have onions for lunch?”
52. What they heard was, “One more time they are not cutting it. They will never amount to anything. They are not good enough. They are not smart enough. They do not deserve to be happy and so on.”
53. And you, now the antagonist, tormentor, inquisitor, jerk, lack the power to turn this around. See how quickly this happened.
54. You could have said anything. The point is that this kind of situation can and does happen in a heart beat.
55. Now what Mr. or Mrs. Meany Pants?
56. The experienced counselor moves on accepting his or her powerlessness and trusts that the power of the group will prevail.
57. Yes, a practiced counselor practices the 12 steps in daily living.
58. An experienced counselor recognizes despair, resistance, denial, and procrastination as first steps in healing or changing.
59. A good counselor will lend themselves more to the unacceptable patient.
60. The novice counselor will set out to save all of humanity, with an especially keen interest in saving those with no interest in being saved.
61. A borderline patient will test your serenity. At first you are the savior. Next you are the beast. This could be followed by indifference or perhaps deep, deep resentment. If you are truly blessed there might be a hallelujah, or not. The experienced counselor takes this all in stride thinking “This is a patient that I definitely want to share with my team members.”
62. The astute counselor recognizes each patient as a truly unique spiritual being. Each patient presents with their individual cognitive processes, ability to abstract, individual wounds, individual skills, strengths, and needs. Each will receive an individual treatment plan.
63. The counselor introduces the patient to their disease, to themselves as separate from their disease, to treatment, to sober support groups [fellowship], to the twelve step process, to recovery, and to a spiritual way of life.
64. A counselor teaches addiction to be a family disease and strongly encourages family participation. The family is the patient. The family is made to be a valuable part of the treatment team. The power of the family often times turns the tide in what would have been a lost cause.
65. Should the patient leave treatment against medical advice or against treatment team advice a wise counselor continues to work with the family knowing that the patient will likely return when there is no one left to cosign their nonsense.
66. A good counselor understands that there is only one true therapist. Look up.
67. The experienced counselor values the input and insight of the novice counselor as refreshing and objective.
68. Often times the experienced counselor will direct the information he wants to deliver to the resistant patient to the patient two seats to their right or left in the group setting, thus avoiding the head on, in your face experience.
69. The counselor manipulates the individual and or the group by asking leading questions that will cause a subtle shift in perception allowing the individual and or group to mentally shift seats in the stadium and view the game via a new interpretation.
70. When in doubt, the counselor will error in favor of the patient.
71. The counselor assimilates the patient’s process into his own, stirs gently, allows to settle, flavors with wisdom and serves with love.
72. Counseling is an art form that is never truly mastered.
73. Your level of expertise will be directly proportional to your ability to learn from your patients. This never changes.