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Confession-Ethics For Counselors

9/25/2014

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I have a couple confessions to make. I am that person. I am a rule follower, sometimes even when the rule is stupid, wrong, not thought out. There is progress being made on that front.

Next confession, I like to learn. Knowledge is power, or something like that. 

I just finished 13 hours of ethics training- not mandated, not required, just because I wanted to learn more. The first 7 hours really bothered me in that we looked at ethics from a "thou shall not" perspective. The next six asked us to really think things through. "What makes sense to do in this situation? Does touching the woman who is sobbing make more sense or does not touching her make sense? What is the context and what is your motivation in doing or not doing it?"

Let's just say that the best treatment/counseling is sometimes right on the edge. There are a bazillion times that the "right" thing to do is not clear because the risk management training I received in the past scared the dickens out of most counselors. Something happened in the 1980s as a backlash against the 1960s loose sexual boundaries and it was assumed that all counselors would have sex with all their clients unless we imposed some extreme rules. We all recognized that it was overkill. 

We learned that we had to protect ourselves from our clients rather than give great counseling. I challenged that over the years, but had some trainers and bosses come down pretty hard on me. They did not want to get sued, so it did not matter that the clients were getting better. Big beaureacracies can get a bit rigid.

One day last year, someone brought me a cup of hot chocolate (with mint). The old way of looking at things was that sharing a meal or food was to be avoided. I had a really hard time hearing that and appreciated hearing, in the training,  that we are now realizing that sometimes a client might bring a cup of hot chocolate with no ulterior motives. They are not trying to buy extra counseling time, not trying to seduce us and we can be human. 

Use common sense and consult with your supervision group or an ethics expert/lawyer if you are unsure, then document it. What a relief!
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Boundary Violations and Self Care

9/18/2014

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Just finished 7 more hours of Ethics training (6 to go). To be perfectly honest, I was not looking forward to it- just doing it to make sure I have enough continuing education units. I consider myself to be pretty darn ethical.

Obviously, in the field of counseling we need to be at our best. What happens when we are not at our best? We don't make great decisions and can cross boundaries. Think of nurses, doctors, priests, counselors etc- who are really run down, then try to keep good boundaries. It takes a good deal of energy to maintain boundaries, even on a good day. 

The training emphasized that we all need to take better care of ourselves on a regular basis, but when we do not, we are more likely to make decisions that get us into trouble. From good food and exercise, to regular supervision and a good night's sleep, we all have room for improvement. We are also modeling for our clients how to take good care of ourselves. We owe it to them to be in good shape.

One part of the training highlighted Dr. Melfi from The Sopranos (never seen it) TV show. She was being chased by the Mafia at one point, and was unhinged, crossing many boundaries at once, fearing for her life. Sounds like it made for good TV.

What was fascinating to me, was listening to the other counselors in the training from many different disciplines (Psychology, Marriage and Family, Social Work and Psychiatry) and counseling orientations, different states within the USA pick apart Dr. Melfi. (They had done the training awhile back and I was listening to a rebroadcast.) There were some really easy things to say she did wrong, some were a bit gray and some were just that she was doing marriage counseling from a psychodynamic perspective. Counseling is very tough ethically, from how we greet people we may know in a public place to advice we are asked for in a social setting, like a party. We absolutely need to stay on our toes to be of best benefit.

There is tremendous benefit from opening yourself up and having other people look at how you are practicing, give their feedback and ideas and yet it can be a bit intimidating. There is always room for improvement, no matter how long you have been doing it and how much training you have received. Let's all take better care of ourselves, too.
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Repression, Suppression and Stuffing

9/16/2014

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Thank you for the comment regarding why we do not go into our emotions.

I think there may be more generational differences than we care to admit on this. We were often explicitly, and implicitly, taught by our role models in our family and in our society to not delve into our feelings, that they were dangerous.

 When we do this on purpose, we call it suppressing feelings. It is a conscious, active process.

When it happens and we had no idea that we were doing it (unconscious) we call it repression.

The current wisdom suggests: Go right into the pain, contact the pain, breathe into it and learn from it. We do not need to fear pain, whether it is emotional or physical or otherwise.

When I am ignorant of my emotions and how to cope, I may inadvertently attach danger to them. I may be afraid for no good reason at all. They are physical sensations and thoughts and they pass.

Let me know if that answers the question.
Thanks,
Don
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Fear No Evil- excerpt

9/11/2014

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From the Book- Fear No Evil
"You will realize that your attempts to protect yourself from your problems actually create more problems.
If you attempt to arrange people, places, and things so that they do not disturb, it will begin to feel like life is against you.
There will be competition, jealousy, and fear. You are either trying to figure out how to keep things from happening, or are trying to figure out what to do because they did happen. "

We all have challenges, difficulties that we must face; that we cannot control. Can we respond with integrity? We are given chance after chance, opportunities keep arising...
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How Sensitive is Your Insula?

9/3/2014

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Yes, this will help you in business.

Turn your attention toward a certain part of your body. Do it repeatedly and the insula, right behind the frontal lobes, becomes more sensitive to that area. You “tune in” by tuning in. Makes sense…

As someone who teaches relationship building and improving communication to managers, this information is vital. Consider the manager who is not quite self-aware at this stage of the game. He can learn to pay more attention to his own emotions, his inner workings and not only help himself, but help everyone with whom he interacts. The more he tunes in to his body, ie his heart rate, his gut, his feelings, the more sensitized he becomes. It becomes a great source of information for him. The more sensitive the insula is to your own inner workings, the easier it is to understand the inner workings of others- a key managerial skill or deficit.

Dan Goleman calls it the “inner voice” in his book The Triple Focus. (What is the triple focus?- Understanding self, other, and the larger systems within which we operate)  

I have worked with people for years to “trust their gut.” There is something beyond logic and rationale that often tips the scales in favor of a certain decision. We may have no idea why we should follow it, but when we do, we get it right. When we go against our gut, the results are often poor. Thank your insula for that.

Practice: How are you feeling right now? How do you imagine the other person is feeling right now?

If you practice, get feedback on and communicate about this process, you get better at reading not only yourself but others. Read others better and your chances of being better in the world of business improve.

Business is a series of relationships, if you want to be better at business, get better at relationships. Try on what the other person might be feeling and build your ventromedial prefrontal area. According to Damasio, it is what guides our most complex decision making.

As with any habit, the more you repeat it (correctly), the stronger and better it gets.

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    Don Boice
    Don Boice, LCSW-R, specializes in gender communication with couples in conflict.  

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