Q
Qualifications, ‘Queer’, Questions, Quiet
Qualifications
There’s only really one thing that matters about a therapist’s qualifications: make sure they have some.
The entry level for qualified counsellors is membership of the BACP. For psychotherapists – which means we have a Masters and therefore have received a further couple of years of training – the person may be UKCP-accredited instead of BACP (a relatively small number of us stay with both). If in doubt, you can look up the counsellor on the website of the governing body they are accredited with and get a sense of what’s what. Child Psychotherapists and those with particular specialism are sometimes registered with other bodies.
Qualifications give no guarantees about how helpful a therapist may be for you – that’s something only you can judge. But it guarantees a certain level of training, an ethical code which the therapist has agreed to abide by (confidentiality etc), and also a place to which you can turn in the (hopefully very rare) event that you feel you’ve been mistreated and wish to lodge a complaint.
Qualifications offer some safety and reassurance. Make sure you see someone who has them.
‘Queer’
While observers might have noticed the many ways in which people in leadership roles have encouraged a regressive attitude to social evolution in recent years on both sides of the Atlantic, one realm of progress has been the ability for those with different sexual identities, tastes and awarenesses to discuss these topics which, once, were inexpressible or illegal.
What was once a slur and then a reclaimed slang, “queer” is now generally taken to encompass a broader scope: an umbrella for those who are not heterosexual and/or are not cisgender (those whose gender identity corresponds to the sex assigned at birth). It remains controversial: for some, so broad as to be meaningless; for others, so associated with generations of oppression and prejudice as to make the word invalidating.
The availability of such topics to be raised, explored or debated, however, in no way makes them easy or makes the problems that come with them evaporate. I have learnt – occasionally the hard way – that making any assumption about the sexual or gender identity of my clients can accidentally foreclose a topic which is looking for an opportunity to present itself to our interest.
In the therapy room, what counts the most is the client’s definitions and language. But, crucially, those definitions and associations are going to bear the imprint of the wider culture. Sometimes this is problematic. Maybe the therapist behaves in a way which embodies some of those wider trends. Maybe their gender or sexual identity is fundamentally important for a client to feel understood; maybe it’s crucial for the client not to know.
All of those responses, and the many others which issues of sexual and gender identity can provoke, are valuable subjects to explore.
Questions
The right question from a therapist can really open up a new layer of understanding. The wrong one can take us away from what really matters.
If there was a list of rules about asking therapeutic questions, my vote for the number one spot would be “Does this question get the client closer to their own experience?”
For instance, if a client talks about having a row with their fiancée over a burnt pizza “How did you end up burning the pizza?” may be interesting if you were talking in a pub but is probably of limited value in therapy. Asking “What was going on for you when you saw he’d burnt the pizza?” may get closer to why something so seemingly mundane should elicit such a strong reaction.
Here are some more examples:
Client: I hate my boss; he’s always having a pop at me. I don’t know why I keep working there.
Bad Q: What’s he got against you?
Good Q: What’s it like when he’s having a go at you?
Client: I find these sessions really frustrating at the start. I don’t know how to get going.
Bad Q: Why don’t you make a plan beforehand?
Good Q: What is it about the start that’s frustrating for you?
Quiet
As a rule of thumb, the cliché of the therapist sitting quietly, leaving pauses and when they speak they speak relatively quietly is probably not that far off the mark. Sometimes, at least.
We leave space for the client to sit with a feeling or develop a thought, or to reflect on our response rather than being unhelpfully spontaneous. We speak calmly because often the client will have avalanches of thoughts and feelings all the time and we want to provide a gentler, less impatient kind of space.
But sometimes the reverse is true. Sometimes a client’s depression or despondency can lead them to communicate in low tones, low energy, slow pace. In that case, sometimes, it may be more helpful for the therapist to try and encourage a more energised, less placcid dynamic in the room; to help the person reconnect with their enthusiasm and hope.
But yeah, in the main, therapists are a pretty quiet breed. But we’re not all dullards.
Next Week: R (Part 1)
Regression, Rehearsal, Relationship, “Remembering, Repeating and Working Through”