ACA Blog

Marianela Medrano-Marra
Aug 06, 2012

The Current Era of Counseling and Psychotherapy: Upheaval and the Pleasure of Practice

After a few sessions, a client I’ll call “Paul” looks at me with tears in his eyes and says, “I wish I had known this years before. I can help myself if I learn to watch my mind—it’s so simple that it’s almost silly, but what a difference it makes for me.”

A woman, I am going to call “Amy” says to me, “I know life isn’t easy, but at least now I know that I can do things to live it in a different way and that means the world to me. I am amazed at how learning to breathe has helped me learn how to live my life and how to be more compassionate with myself.”

Another client, we can call her “Sammy,” has spent most of her adult life under strict psychotropic treatment, and after several months of bi-weekly sessions says to me, “Why didn’t anybody tell me how helpful I could be in helping myself?”

As I’ve written in past blogs, my clients are a source of knowledge for me, and I trust them more than I trust myself in designing a course of interventions for them. Of course, in order for them to get to that point, I need to show them first how to access that generous source of strength each one of them undoubtedly has.

As a transpersonal practitioner, I am in the business of “creating” and further developing consciousness—in the sense of expanding what the client is conscious of, and in turning that expansion into a spiritual quest. The creation of that consciousness though, starts with empowering* individuals to seek their own truth, which implies identifying their own values, meaning and purpose in life. I cannot facilitate such empowerment without the full contribution of the person I am attempting to empower, and that person’s willingness to learn and take charge of life. Rather than an authority figure, I see myself as a mentor, a teacher if you want, but one highly invested in facilitating self-knowledge. In this way, I keep fresh in mind Maslow’s suggestion that good teaching is about directing children to look within themselves, and that from this self-exploration originate a set of values. The exchange with my clients is no different; I want to point them in the direction of self-knowledge so they can create their own values and therefore crystallize their own purpose in life, and their very own pathway to change, but always relying on themselves as the masters of that change.

When I assess the work I am doing, I feel confident that the conversations that occur in my sessions are the ones I want to be having with my clients, and the ones that can truly elicit their commitment to change. However, the ever-shifting demands of an all-encompassing, integrative approach to counseling and psychotherapy presents us with great challenges. The intensity and the diversity of “situations that daily walk through the door of my office” are a constant reminder that the work we do has no place for stagnant knowledge or skills. Our profession should never be one that has reached its peak, but one that is in constant re-vision and re-making because the human being, the subject of our work, is forever evolving and shifting. The view of the human body from a mechanistic Newtonian frame is no longer acceptable; there is ample research showing that a great number of modern ailments are directly connected to emotions; therefore our job has to include an understanding and embrace of this paradigm shift. It is our ethical obligation to prepare ourselves in a more holistic manner to respond the need of our clients.

We need the flexibility of an integrative approach and the willingness to stretch our possibilities and a commitment to being hikers along the path with our clients, to point things out, and to hold them when they, or we, are tired; to teach them trust in their intuitive knowledge rather than compelling them to subdue to the authority of the title, specialty or degree we represent. This approach corresponds with what Dr. Larry Dossey refers to as the Era III of medicine, where the mind-body connection is taken to a new dimension, implying that the mind is a factor in healing both within and between individuals, but at the same time, mind transcends time and space and is ultimately part of all consciousness. The task at hand goes beyond teaching or modifying behaviors, beyond understanding how the mind works, how thoughts breed feelings and so on, and it requires the ability to hold the multiple parts of a person’s life in perspective, to stand side-by-side with the person and together recognize the way the pieces are both separate in one sense, but also a whole. In other words, we need to understand first the physical plane, the personal or egoic plane, and then grasp those aspects that transcend time and space, like a sense of connection with the greater Self, and how that greater Self walks about, embodied as each of us, on earth and establishes meaningful connections with the mundane, day-to-day life.

In this world of cybernetics and virtual realities, in which faster is not fast enough, how do we help individuals find their centers of gravity so they can stand still and experience what needs to be experienced, the self, in order to be in the position to move beyond it, to dive into the depth of being the full manifestation of the divine in our humanness. The first thing is to be fully conscious of how defining the way, rather than allowing them to discover it, is an ambush, as Frances Vaughan would say. Individual truth cannot be prescribed; neither can the access to it be facilitated from a one-size-fits-all approach to counseling and therapy. In turn, what we want is to facilitate our client’s access to intuition and their very own ways of knowing. For that, we cannot be passive but active learners, always willing to stretch ourselves a bit more, in order to have a wide array of approaches with which to meet our client’s individual needs.

With the more individuals than ever before looking and accessing mental health treatment, it is imperative that we look at the ways in which we are fulfilling such demands. We now have layers and layers of complexities added to what it means to be human. Despite technology and science having produced sophisticated modes of sustaining life and keeping individuals living longer, we seem to be submerged in the most excruciating collective pain and depression of the spirit. Approaches that are not integrative, that ignore components of a person’s life, such as spiritual practices or a need to establish them, the socio-political components of that person’s environment, i.e., gender, sexual orientation, etc. contribute to the perpetuation of mental health disorders and chain individuals to diagnosis and conditions they feel unprepared and unable to overcome.

Recent studies revealed that 15 million Americans suffer from social anxiety that interferes with leading normal social and romantic lives. For instance, the National Institute of Mental Health (NIMH) offers startling statistical figures: 9.5% of U.S. population age 18 and older in a given year suffers from a mood disorder—that is 20.9 million Americans. Mental health disorders are the leading cause of disability in the U.S and Canada. The number of individuals with chronic to mild depression is around 1.5% among young people and around 3.3 million American adults. About 5.7 million American adults and about 2.6% of U.S. youngsters suffer from bipolar disorder. An approximate number of 2.4 million American adults, that is 1.1% of the population suffers from schizophrenia. The majority of individuals suffer from multiple disorders at once. While some disorders are more prevalent among one gender than the other, the overall picture reveals a pervasive, massive epidemic of disorders that are crippling the nation.

It should not come as a surprise then that the Centers for Disease Control and Prevention reports 36, 909 individuals died by suicide in 2011. More than 90% of people who kill themselves have a diagnosable mental disorder and most of them have received mental health treatment at a given point in their lives. The ratio between women and men who attempt suicide used to be higher among women but the latest findings shows the gap is closing.

What I find most difficult is to help individuals trust themselves so they can go inward to fetch what they need. This, of course, as Alan Watts would say, is the biggest challenge, because it means I have to be able to trust myself, to go inward and fetch what I need to trust and see myself as a facilitator. If I don’t trust what I do and who I am in the therapeutic relationship, how can I then expect my clients to trust me as a co-guide on their paths?

Today’s mental health professionals need to be widely informed in order to untangle the intricate nature of issues and disorders that challenge us. In sessions with my clients I cover a wide range of topics, from how the brain, heart, emotions, and mind work (so the person can know to trust his or her brain, heart, emotions and mind to do the work of restoring order; we can only trust what we know, right?), to how they can assess their styles when reacting to problems and life’s tribulations. In other words, I follow Martin E.P. Seligman’s invitation to understand the lenses from which my clients are looking at things and see how the color of those lenses informs their perception and their reactions to things, be that pessimism or optimism.

Empowering individuals to take part in their own process is the difference between relational exchanges that empower and relational exchanges that disempower individuals. I typically start sessions with a centering or breathing exercise to take the person inward, to touch that inner part that always knows. I invite clients to allow that intuitive part of them to be the one speaking in sessions. That to me accounts for the tears of joy, the gratitude I often hear from clients as they begin to formulate their own truth, as they begin to reclaim their sanity, which is nothing more than the ability to trust oneself. Trust is the first thing that gets lost when we exclude the person from their own process by withholding information about how mind and body work—treating the individual as a machine with separate parts that can be replaced as needed, and stealing away any chance for them to exercise their autonomy to know the interconnections and complexities of their existence.

*The word “empower” has been criticized because it is interpreted by some to mean grant power from the outside. I use it in the sense of guiding others to recognize the power that they already have.



Marianela Medrano-Marra is a counselor and Dominican writer living and practicing in Naugatuck, CT. She writes poetry, essays, and creative non-fiction; with publications including essays and four books of poetry.

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