Is it OK/normal to be knocked like this by fellow adults?
December 9, 2023 1:59 PM Subscribe
My cousin, 40, is undertaking training as a counsellor/psychotherapist.
She's fairly far along (about half way) what sounds like quite an involved, rigorous and academic process.
There are about 6 residential weekends a year that make up part of the training, where they practice counselling. They role play the counsellor/client relationship in front of others, but the issues they bring to the table tend to be real.
My cousin has just telephoned in tears because today at one session a man, in his 20s, remarked that he finds it hard to listen to my cousin as counsellor and his mind drifts and he doesn't get on with her 'heady' style. I think it's all in the intonation as 'heady' was delivered as a negative not in the positive sense of the word.
This prompted a faint echo from another woman, who my cousin had already noticed is reluctant to meet her eye/work with her.
Apart from these two, my cousin is thriving on the course both socially and academically. She has previously looked forward to residentials but I fear will now be very anxious before the next round.
I've prompted her to report this to the course tutor, but she's minded to take the problem on as a 'her problem' and try to correct whatever behaviour in her is prompting this response in them.
About my cousin: she has lots of friends, is generally very well liked and is seen as a genuine and loving person. She's slightly long winded in her style which personally is what I think is most likely to have got this young guy's nose out of joint.
Anyway, advice very welcome....
My cousin has just telephoned in tears because today at one session a man, in his 20s, remarked that he finds it hard to listen to my cousin as counsellor and his mind drifts and he doesn't get on with her 'heady' style. I think it's all in the intonation as 'heady' was delivered as a negative not in the positive sense of the word.
This prompted a faint echo from another woman, who my cousin had already noticed is reluctant to meet her eye/work with her.
Apart from these two, my cousin is thriving on the course both socially and academically. She has previously looked forward to residentials but I fear will now be very anxious before the next round.
I've prompted her to report this to the course tutor, but she's minded to take the problem on as a 'her problem' and try to correct whatever behaviour in her is prompting this response in them.
About my cousin: she has lots of friends, is generally very well liked and is seen as a genuine and loving person. She's slightly long winded in her style which personally is what I think is most likely to have got this young guy's nose out of joint.
Anyway, advice very welcome....
My advice to her would be to listen to what these two strangers are telling her and make adjustments. Two people told her that the way she's talking would make them not want to work with her as patients. I don't know what "heady" means but if you say she talks too much, that would make sense, since the point of her work is for her to be listening, not talking. That has nothing to do with whether her friends see her as a genuine and loving person.
posted by fingersandtoes at 2:13 PM on December 9, 2023 [27 favorites]
posted by fingersandtoes at 2:13 PM on December 9, 2023 [27 favorites]
You used the tag "bullying" but to me it looks like it's peer feedback delivered an academic/practical setting. And I'm sure it stings, but it doesn't even seem to be unkind. If she's long winded it might be difficult for some clients (both role playing ones and future paying ones) to stay focused. People break up with therapists because of personality mismatches quite frequently, so here's her first opportunity to try and improve her delivery and/or become okay with the fact that she won't be a good fit for some clients.
posted by kimberussell at 2:14 PM on December 9, 2023 [55 favorites]
posted by kimberussell at 2:14 PM on December 9, 2023 [55 favorites]
I give feedback to student healthcare providers in a similar format and it's literally our job to be able to notice and articulate things like that. Patient interaction is a skill that they're trying to help her improve. Sometimes I've disagreed with my colleagues about how someone came across, but in no case has a student "reporting" our feedback done anything good for their standing in the program. Unless the feedback was overtly racist/sexist/similar, I think she's correct to perceive it as something to work on in herself, even if the specific words those people used to describe the issue might miss the precise mark. I absolutely believe you that she's a wonderful, loving person, and it can be true that there are aspects of her work with patients that she could improve upon. If I found myself unwilling to make eye contact with a student, for example, I'd regard helping them fix that as absolutely crucial, because real patients almost certainly never will. And I'd actually be more personally invested in helping someone who seemed warm, caring, and so on than someone who did not seem to have the potential to be an excellent therapist, even knowing that the process of helping them might sting.
posted by teremala at 2:33 PM on December 9, 2023 [13 favorites]
posted by teremala at 2:33 PM on December 9, 2023 [13 favorites]
remarked that he finds it hard to listen to my cousin as counsellor and his mind drifts and he doesn't get on with her 'heady' style
This sounds well within the range of feedback that a psychotherapist might receive in the course of their work.
I had quite similar feelings about my therapist — I would drift away into my own head when she was talking, and I felt she 'talked around' issues because she didn't have deep insight into them. If anything, she encouraged me to be more honest and open in saying that to her, because she could take it, and the politeness we're all trained into socially can be a barrier to moving forward in the therapeutic environment.
posted by Klipspringer at 2:41 PM on December 9, 2023 [23 favorites]
This sounds well within the range of feedback that a psychotherapist might receive in the course of their work.
I had quite similar feelings about my therapist — I would drift away into my own head when she was talking, and I felt she 'talked around' issues because she didn't have deep insight into them. If anything, she encouraged me to be more honest and open in saying that to her, because she could take it, and the politeness we're all trained into socially can be a barrier to moving forward in the therapeutic environment.
posted by Klipspringer at 2:41 PM on December 9, 2023 [23 favorites]
This sounds like the training working as it's meant to. I suspect the process already has a time or process built in for your cousin to work through feelings about how this went, but if not, sure, speaking to the supervisor makes sense. But the focus should be on how your cousin should respond to feedback like this, not on the idea that this other person did anything wrong.
posted by Stacey at 3:16 PM on December 9, 2023 [14 favorites]
posted by Stacey at 3:16 PM on December 9, 2023 [14 favorites]
This is pretty normal in these types of situations.
It is rarer once in the field that clients will get comfortable enough to articulate things they find difficult with a therapist especially with the cost involved. Sometimes leaving and finding a new one may be more expedent and less expensive.
Not everyone style is the same, but it is important to be able to make conscious decisions about clinical choices and interactions, and decide different ways of interacting with people who may not feel that a specific way is working with them. This takes an attuned, flexible therapist who doesn't take these things too personally but does make actionable change.
posted by AlexiaSky at 6:53 PM on December 9, 2023 [4 favorites]
It is rarer once in the field that clients will get comfortable enough to articulate things they find difficult with a therapist especially with the cost involved. Sometimes leaving and finding a new one may be more expedent and less expensive.
Not everyone style is the same, but it is important to be able to make conscious decisions about clinical choices and interactions, and decide different ways of interacting with people who may not feel that a specific way is working with them. This takes an attuned, flexible therapist who doesn't take these things too personally but does make actionable change.
posted by AlexiaSky at 6:53 PM on December 9, 2023 [4 favorites]
That sounds to me like good feedback that she would not be an effective therapist for these two, if they were paying clients. Rather than having a defensive emotional response to what seems (at least from what you've said) to be constructive criticism that she's having difficulty handing, it would be more useful for her education if she asked more questions to understand what they mean by their remarks. It would also be a good idea, after learning more details into what about her "chairside" manner they found off-putting, to inquire for feedback on this specific issue from those who she had as "clients" previously, and from her supervising instructors.
posted by stormyteal at 7:36 PM on December 9, 2023 [2 favorites]
posted by stormyteal at 7:36 PM on December 9, 2023 [2 favorites]
What you’re describing just sounds like negative feedback, and she’ll be getting a lot more just like it from some patients throughout her career. It’s good that she’s experiencing this now while she has skilled people to help her understand her feelings about it.
Patients lay all sorts of things on their therapists, some of it projections of their own issues and some of it legitimate criticism. To do her job well she’ll need to be hear all of it and respond thoughtfully.
posted by Tell Me No Lies at 8:12 PM on December 9, 2023 [5 favorites]
Patients lay all sorts of things on their therapists, some of it projections of their own issues and some of it legitimate criticism. To do her job well she’ll need to be hear all of it and respond thoughtfully.
posted by Tell Me No Lies at 8:12 PM on December 9, 2023 [5 favorites]
Depending on her clients, she might just hear a lot worse once she’s out there :/
This is 100% useful feedback. Super important to be able to effectively communicate with all kinds of people, who are in all kinds of emotional states. Tone, gaze, and body language are at least as important as content. To me, “heady” sounds like maybe messaging is not sounding like it’s coming across on an emotional level (like it’s genuine, real, lived experience, coming from the gut) - to those two other students, anyway. (Meanwhile, to some others, a lot of emphasis might seem over the top or insincere. Can’t please everyone all the time, and of course people have to be themselves, but a little adjustment of delivery, or attunement to the client, might indeed be necessary once she’s working.)
posted by cotton dress sock at 9:12 PM on December 9, 2023 [1 favorite]
This is 100% useful feedback. Super important to be able to effectively communicate with all kinds of people, who are in all kinds of emotional states. Tone, gaze, and body language are at least as important as content. To me, “heady” sounds like maybe messaging is not sounding like it’s coming across on an emotional level (like it’s genuine, real, lived experience, coming from the gut) - to those two other students, anyway. (Meanwhile, to some others, a lot of emphasis might seem over the top or insincere. Can’t please everyone all the time, and of course people have to be themselves, but a little adjustment of delivery, or attunement to the client, might indeed be necessary once she’s working.)
posted by cotton dress sock at 9:12 PM on December 9, 2023 [1 favorite]
"Heady" in therapy language generally means being overly analytical, connecting with your head/brain, rather than connecting from the heart with emotional content, validation, unconditional positive regard, and empathy.
posted by lapis at 10:27 PM on December 9, 2023 [10 favorites]
posted by lapis at 10:27 PM on December 9, 2023 [10 favorites]
Does she also have her own psychotherapist? I have a friend training as a music therapist for whom this is a requirement of the course. This would be an example of why, I think.
posted by lokta at 1:19 AM on December 10, 2023
posted by lokta at 1:19 AM on December 10, 2023
From the perspective of a client/patient, this sounds like valid feedback I wish more of my health care providers had received in their training.
As the expression goes, we have two ears and one mouth for a reason. From my end of things, it can be very frustrating to have a professional going on at length and getting technical when I need them to be listening and looking at the big emotional picture.
That doesn't necessarily mean your cousin is overreacting, however. If the feedback was vaguely worded or didn't provide specific ideas on how to improve, I could see why she felt upset.
Good professional feedback is specific and actionable.
"I think the language you use might be too heady and overlong, and could alienate your clients. Instead, try saying XYZ and then pause and wait for a reply. I liked that you noticed ABC detail."
posted by champers at 4:26 AM on December 10, 2023
As the expression goes, we have two ears and one mouth for a reason. From my end of things, it can be very frustrating to have a professional going on at length and getting technical when I need them to be listening and looking at the big emotional picture.
That doesn't necessarily mean your cousin is overreacting, however. If the feedback was vaguely worded or didn't provide specific ideas on how to improve, I could see why she felt upset.
Good professional feedback is specific and actionable.
"I think the language you use might be too heady and overlong, and could alienate your clients. Instead, try saying XYZ and then pause and wait for a reply. I liked that you noticed ABC detail."
posted by champers at 4:26 AM on December 10, 2023
but she's minded to take the problem on as a 'her problem' and try to correct whatever behaviour
This process is being done for a reason, and she cannot safely go on to do this job if she can't process this with her trainer as designed. There should never EVER be a point in this training process that she can't or won't discuss an issue with her supervisors. That instinct is supposed to be broken in this process, or she will get killed or end up in jail.
She also can't flounce off petulantly into the woods alone and SHOW EVERYBODY every single time someone says something unpleasant or misogynist. Like, don't live in that stupid child-wizard story where the most insecure child in the world repeatedly finds reasons not to tell the most incompetent headmaster ever that the toilet is full of monsters or whatever so the story will last more than 4.5 minutes.
Don't go to school if you aren't going to participate in the lessons. This is super-ultra high-stakes shit, both for her safety and for her patients' process and well-being and she is SUPPOSED to feel shit and work through it within the pedagogical framework where there is safety.
posted by Lyn Never at 5:37 AM on December 10, 2023 [7 favorites]
This process is being done for a reason, and she cannot safely go on to do this job if she can't process this with her trainer as designed. There should never EVER be a point in this training process that she can't or won't discuss an issue with her supervisors. That instinct is supposed to be broken in this process, or she will get killed or end up in jail.
She also can't flounce off petulantly into the woods alone and SHOW EVERYBODY every single time someone says something unpleasant or misogynist. Like, don't live in that stupid child-wizard story where the most insecure child in the world repeatedly finds reasons not to tell the most incompetent headmaster ever that the toilet is full of monsters or whatever so the story will last more than 4.5 minutes.
Don't go to school if you aren't going to participate in the lessons. This is super-ultra high-stakes shit, both for her safety and for her patients' process and well-being and she is SUPPOSED to feel shit and work through it within the pedagogical framework where there is safety.
posted by Lyn Never at 5:37 AM on December 10, 2023 [7 favorites]
My cousin has just telephoned in tears because today at one session a man, in his 20s, remarked that he finds it hard to listen to my cousin as counsellor and his mind drifts and he doesn't get on with her 'heady' style. I think it's all in the intonation as 'heady' was delivered as a negative not in the positive sense of the word.
Exposure to this kind of feedback is so important for a therapist. She should definitely process it with her own therapist/supervisor - but she should not approach this as "reporting" this person. She should approach it as an opportunity to process her own response to this feedback and to decide how to incorporate it. "Long winded" (as a therapist) is something that will probably not be great for a lot clients.
I've spent so many years in various kinds of therapies. It took so many tries for me to find my current therapist. And one of the reasons he is such a good "fit" as a therapist for me is that he never gets defensive, and he takes feedback so well. If he says something that upsets me, I can lay it out for him and we process it and sort it out. If something in his style or approach isn't working, I bring it up and we work it out.
A really good therapist should welcome this kind of feedback from clients. B/c on the client side, it's hard to voice these thoughts, and the last thing I would want is for my therapist to get defensive or upset or whatever in response.
posted by litera scripta manet at 7:10 AM on December 10, 2023 [5 favorites]
Exposure to this kind of feedback is so important for a therapist. She should definitely process it with her own therapist/supervisor - but she should not approach this as "reporting" this person. She should approach it as an opportunity to process her own response to this feedback and to decide how to incorporate it. "Long winded" (as a therapist) is something that will probably not be great for a lot clients.
I've spent so many years in various kinds of therapies. It took so many tries for me to find my current therapist. And one of the reasons he is such a good "fit" as a therapist for me is that he never gets defensive, and he takes feedback so well. If he says something that upsets me, I can lay it out for him and we process it and sort it out. If something in his style or approach isn't working, I bring it up and we work it out.
A really good therapist should welcome this kind of feedback from clients. B/c on the client side, it's hard to voice these thoughts, and the last thing I would want is for my therapist to get defensive or upset or whatever in response.
posted by litera scripta manet at 7:10 AM on December 10, 2023 [5 favorites]
I don’t see any issue in the feedback besides your cousin’s refusal to bring this obvious countertransference-related issue to the supervisor. This is Therapist 101 stuff, and taking it personally instead of reflecting and discussing her emotional response with the supervisor is the Amateur Hour part of this.
posted by asimplemouse at 7:59 AM on December 10, 2023 [12 favorites]
posted by asimplemouse at 7:59 AM on December 10, 2023 [12 favorites]
What I wasn't expecting about my training as a therapist was just how *personal* the feedback was. I was used to grades and being evaluated on my work, not on my personality/relational style. In the first week of my program, my supervisor told me they would also be watching our interactions with each other, would be providing feedback on our interpersonal interactions etc.
While uncomfortable, I think it's important. Being a therapist is about building and maintaining relationships and being very attuned to interpersonal dynamics. My cohort at times struggled with (and rebelled against) the feedback, but I see now how much it helped each of us, and was likely crucial to our development.
Sounds like she is getting feedback that is reasonable, if unpleasant/hurtful. It doesn't mean she has to completely change herself or her style - different things will work for different clients - but it probably is worth reflecting and experimenting with being less long winded or heady so she can expand and then decide where to land.
posted by EarnestDeer at 10:28 AM on December 10, 2023 [3 favorites]
While uncomfortable, I think it's important. Being a therapist is about building and maintaining relationships and being very attuned to interpersonal dynamics. My cohort at times struggled with (and rebelled against) the feedback, but I see now how much it helped each of us, and was likely crucial to our development.
Sounds like she is getting feedback that is reasonable, if unpleasant/hurtful. It doesn't mean she has to completely change herself or her style - different things will work for different clients - but it probably is worth reflecting and experimenting with being less long winded or heady so she can expand and then decide where to land.
posted by EarnestDeer at 10:28 AM on December 10, 2023 [3 favorites]
I'm a therapist and have a friend who's currently in a program like this, so I feel well prepared to respond. I think there are a couple of things to consider:
First, doing therapy as a newbie, even in a role-play exercise with a fellow student, is so hard. It's sort of like what I imagine trying standup comedy feels like, if the audience needed to laugh in order to heal from trauma. The stakes are SO HIGH. Or, at least, they feel that way. You feel like you're going to either actively harm someone or harmfully waste their time and prolong their suffering if you don't get it right. You're not, but that's how it can feel. So these exercises can feel incredibly intense and vulnerable. To be trying your best, enduring this very stressful exercise and thinking on your feet, and then your peer criticizes something like your "heady" style... it doesn't have to be intended as a harsh statement to feel bad. At this point in the process, it's almost like if the other student said, "I think your vocal fry would distract a client"--not something your cousin can meaningfully change because it's so personally specific.
Second, peer feedback is valuable but hard to do well. People tend to naturally be too timid and gentle, which sometimes prompts instructors to focus on the importance of giving realistic, even negative feedback so that one's peers can learn and grow. But actually giving good, useful feedback is quite hard to do. (Also, some people are oblivious and just give harsh feedback.) I don't know what's up with the student who made the "heady" comment, but unless there are other reasons to think he's being purposefully antagonistic, this reads to me like someone trying to give substantial feedback (to help your cousin? to impress the instructor? who knows?).
It IS worth thinking about how one's personal style comes into the therapy room. But the way this younger guy shared his feedback clearly fell flat. It doesn't mean he's a malicious jerk, or that your cousin is going to be a bad therapist.
posted by theotherdurassister at 12:36 PM on December 10, 2023 [8 favorites]
First, doing therapy as a newbie, even in a role-play exercise with a fellow student, is so hard. It's sort of like what I imagine trying standup comedy feels like, if the audience needed to laugh in order to heal from trauma. The stakes are SO HIGH. Or, at least, they feel that way. You feel like you're going to either actively harm someone or harmfully waste their time and prolong their suffering if you don't get it right. You're not, but that's how it can feel. So these exercises can feel incredibly intense and vulnerable. To be trying your best, enduring this very stressful exercise and thinking on your feet, and then your peer criticizes something like your "heady" style... it doesn't have to be intended as a harsh statement to feel bad. At this point in the process, it's almost like if the other student said, "I think your vocal fry would distract a client"--not something your cousin can meaningfully change because it's so personally specific.
Second, peer feedback is valuable but hard to do well. People tend to naturally be too timid and gentle, which sometimes prompts instructors to focus on the importance of giving realistic, even negative feedback so that one's peers can learn and grow. But actually giving good, useful feedback is quite hard to do. (Also, some people are oblivious and just give harsh feedback.) I don't know what's up with the student who made the "heady" comment, but unless there are other reasons to think he's being purposefully antagonistic, this reads to me like someone trying to give substantial feedback (to help your cousin? to impress the instructor? who knows?).
It IS worth thinking about how one's personal style comes into the therapy room. But the way this younger guy shared his feedback clearly fell flat. It doesn't mean he's a malicious jerk, or that your cousin is going to be a bad therapist.
posted by theotherdurassister at 12:36 PM on December 10, 2023 [8 favorites]
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posted by ojocaliente at 2:10 PM on December 9, 2023 [68 favorites]