We need to talk about class

I thoroughly welcomed the inclusion of the ‘Class and counselling’ piece in the April issue of Therapy Today. It raised important points about our role as a profession in acknowledging the impact that social, political and class issues can have on our clients – not least because of what we ourselves bring into the room with us.

I am very much the white, educated middle-class counsellor and my first training placement was in a local inner city community counselling service. It was very striking to me how so many of my clients had issues that directly related to or were severely impacted by poverty, both in terms of money and opportunity. I found myself thinking ‘There’s nothing I can do about this’ and so classed it as ‘not relevant’ to our work.

Over the years, as these issues have persisted in popping up regularly with clients, my position and practice on this has changed dramatically. Some of my current clients have been directly affected by the changes in the benefits system and I have seen first-hand how uncertainty about future finances can exacerbate pre-existing symptoms of depression and anxiety and how the social scapegoating of those with long-term mental health conditions can intensify feelings of shame and alienation. I believe it is possible to acknowledge the impact of social/political circumstances on a client’s life as a real obstacle and barrier to wellbeing without colluding with a stance of ‘You’re a victim and you have no responsibility for what has happened to you’.

I am acutely aware that, as counsellors, we are in a position of power that, from my own experience as a client, can be strongly felt between a client and counsellor who belong to the same social class. I am sure that the working-class client must be at risk of feeling this more acutely with the double whammy of professional and societal power being present before them. While I have a passion for learning and don’t see any shame in pursuing a Master’s or Doctorate, I do believe that, as a profession, we are over-valuing academic prowess at the expense of essential core personal attributes such as capacity for attunement, humanity and self-reflection – qualities that can be found among all sectors of society.

This area is vast and complex but I do think a good starting point would be further conversations, like Simone and Mike’s – particularly during training – in safe, non-judgmental spaces, about self-identity, class, assumptions we make about others, the social make-up of counselling trainees generally and potential/actual impact of counsellor background on different client groups. Class issues certainly seem to permeate every area of my life on a day-to-day basis and it would be good to hear more from our profession on this and great for BACP to take a lead in facilitating it.

Rachel Shepley, MBACP (Accred) counsellor and student mental health mentor

Rendered invisible

Thanks for a great discussion article (‘Class and counselling’, Therapy Today, April 2013). Mike and Simone are much-needed pioneers!

It reminded me of an experience I had when I offered to volunteer as an (unpaid) counsellor for a local staff counselling service. Another black woman and I were selected for interview. At the group interview the three white senior counsellors who managed the service gathered. The Head of Counselling started: ‘Let me tell you why you are here: all our paid staff are white so we are looking for a black volunteer.’

Said without a flicker of understanding, thought, empathy or sensitivity (let alone any grasp of equal opportunities policy and law). I really felt the sensation of not being ‘seen’ at all. I was struck by the fact that the majority of their clients are women from ethnic minorities and I wondered about the possible impact on clients of such a stance.

I can appreciate Mike’s discomfort at Simone’s use of the word ‘perpetrator’ as it suggests a concrete action against another rather than an unfortunate circumstance. However, I certainly experienced the Head of Counselling as someone spearheading inequality within their organisation (albeit unconsciously) and hence as a perpetrator of oppression.

It is great that Simone is suggesting that we actually change these structures by improving training standards. Ensuring that courses imbue all aspects of counselling training with understanding of the reality of issues such as racism, class issues, sexism, homophobia and poverty, for example, is crucial. Quite often those themes are the backdrop to all other issues a client may bring to therapy. In my opinion, it is crucial that each and every therapist considers his or her own issues around class, gender, race, sexuality, disability, transgender and creed, before we inflict ourselves on our clients or colleagues.

As the very brave and admirable Mike and Simone’s important discussion shows, if a therapist is worried that they may be viewed as a perpetrator, then what can ensue is a battle between client and therapist, re-enacting the painful battles that go on in other aspects of a client’s life. This battle can be a challenging but sometimes useful exploration for both parties, but in my opinion, it is not the client’s role to educate the therapist.

In response, I turn to In Our Own Hands: a book of self-help therapy by Sheila Ernst and Lucy Gooding.1 The quoted section below is about racism, but the writers note that you could work with other issues, such as classism or sexism.

‘This exercise is based on the idea that in order to have become oppressors... we were ourselves first badly hurt: the racism masks grief. By starting from a position of pride in who we are and a sense of unity with all oppressed people (by recalling how we are or have been oppressed), we can discharge the grief and let go of the racism [...]

  • Stage 1 – How was/am I oppressed? (Get in touch with a particular incident) [...]
  • Stage 2 – When was there a time I stood up against racism? (If you can’t remember, make up a fantasy with yourself as hero/heroin)
  • Stage 3 – When was there a time I colluded with racism and did not stand up against it? (Describe a specific incident)
  • Stage 4 – Re-tell Stage 3 as a fantasy the way it should have happened.’

Akum Uwahemu, MBACP (Accred). Twitter: @akumefulee

References

1. Ernst S, Gooding L. In our own hands: a book of self-help therapy. London: Women’s Press; 1981.

Meaningful debate

I have just read your article on class and wanted to thank you as it helps me to delve deeper into this topic with my student colleagues. I am a second year CYP training psychotherapist, with a social work background. I always leave my experiential groups with a deep sense of frustration, as my colleagues cannot acknowledge that black/working-class people tend to have different experiences of the external world. It probably doesn’t help when the facilitators enact this lack of understanding by terming my responses ‘angry’ or ‘prejudiced’. They too seem unable to make ‘space in their minds’ for this idea.

Just to highlight that I am the only working-class, black female in a year group of 20. There are no lecturers reflecting this demographic. How do I support a meaningful debate among my colleagues who will be working with young, working-class black CYP without being labelled as a ‘trouble maker’?

Name withheld

History of oppression

I was interested to read the debate about class in April’s issue of Therapy Today as it touched on many of the themes I found when researching this topic. I agree with Simone that class is a neglected issue when compared with other aspects of client–counsellor difference such as gender, sexuality or ethnicity. Social class has its own powerful history of oppression that, as counsellors, we cannot afford to ignore.

In 2005 I carried out a research project (for an MSc in counselling) into how clients’ experiences of perceived differences in social class between counsellor and client affect the therapeutic relationship.1, 2 I interviewed five clients who identified as working class (and who identified their counsellor as middle class).

The imbalance of power in the relationship that Simone talked about (pp16–17) was mentioned by all the clients. One client described it as: ‘It felt like she [therapist] was the figure of authority and I was this wee person that needed help.’ Another client described it as a huge barrier in the room that was never acknowledged. These feelings effectively disrupted the therapeutic work for the clients, as they were unable to trust the therapist.

As Simone mentioned, clients’ conditions of worth were linked with their background: one client felt ashamed when she did not understand a word the therapist used; another felt unable to cry in therapy, for fear that this would confirm to the therapist the shortcomings of her working-class upbringing. One client described how she took great care to dress well when she attended a counselling session. Alternatively, another client’s pride in her background meant that she adopted a more combative attitude to the therapist and refused to cry in sessions, as it might seem like ‘capitulation’ to the power of the middle-class therapist.

All the clients spoke of how being working class felt like another world for their (perceived) middle-class therapist, and one client reported how his therapist found his values quite novel, and expected him to educate her on what it was like to be working class. The therapists could not or would not move outside the ‘protective bubble’ that Mike describes in the debate. Inside this bubble everything is secure and cannot be challenged; as one client said, to be middle class is to be ‘on safer ground’ than to be working class.

While I agree with Simone that more diversity among trainers would be welcome, I also feel that, as therapists, we each have a personal responsibility to address class for ourselves and become aware of how it affects the political values we bring (albeit subconsciously) into the relationship with clients. It is all too easy to take refuge in the feeling that ‘helping people’ is non-political and ignore the covert assumptions that clients may be making about how we speak or where we live (if the counselling is in the therapist’s home); these assumptions may in turn affect what the client voices or withholds in therapy.

When I asked the working-class clients if they would prefer to have therapy with a counsellor of a similar class, most of the clients expressed a wish rather for their counsellors to be aware of the difference and acknowledge it. In this way, the power dynamic can be addressed in the relationship, rather than covertly reproducing old patterns of oppression.

Jane Balmforth, PhD; MBACP (Accred)

References

1. Balmforth J. Clients’ experiences of how perceived differences in social class between counsellor and client affect the therapeutic relationship. In: G Proctor, M Cooper, P Sanders, B Malcolm (eds). Politicizing the person-centred approach: an agenda for social change. Ross-on-Wye: PCCS Books; 2006 (pp215–224).
2. Balmforth J. weight of class: clients’ experiences of how perceived differences in social class between counsellor and client affect the therapeutic relationship. British Journal of Guidance and Counselling 2009; 37: 375–386.

Relationship and class

I was so pleased to see ‘Class and counselling’ as the main headline on the front cover of April’s Therapy Today – this subject has been of particular relevance to me in my personal process – and so I was disappointed to find but one article.

Only when I read Simone’s answer to Mike’s question ‘How should class be looked at in training?’ did I fully engage with her and her viewpoint (up till then, disliking her stance as victim). As much as I appreciate the importance of looking at how our identity affects the way we experience the world, looking at how the way we experience (and have experienced) the world affects our sense of who we are seems equally important.

To assess anyone’s background, including one’s own, as privileged or under-privileged is surely subjective and loaded with prejudice. Indeed, it was hearing my therapist utter the word ‘privileged’, after I’d disclosed my private boarding school education, that unleashed my fury at being utterly misunderstood about this very matter – which started the lengthy process of my identity deconstruction-reconstruction.1

All aspects of relationship contain power dynamics, class no more no less than age, gender, race etc. Raising this as a separate issue is valuable but only as part of integrating this particular aspect of selfhood with the greater whole, so it doesn’t remain split off as the ‘green-eyed monster’ of our culture and society.

Jane Barclay, MBACP; AHPP; therapeutic counsellor

References

1. Barclay J. Class, prejudice and privilege. Self & Society 2002; 30(4).

They've seen enough tears

I wonder why such a little report on therapists crying (News, Therapy Today, March 2013, p5) had such an impact on me. Maybe it’s because recently I saw one of my clients, who comes to me as his drug counsellor, and he told me about what a freak he felt when he told his life story to a private therapist and she burst into tears.

When this client told me his story, I felt tears forming in my eyes. I went to a great extent to keep my eyes dry, but wanted to let him know that I was very moved by what he told me. I had just managed to express this when he told me about his previous experience with the crying therapist and how that made him lose trust in her. He never went back.

His said that if an experienced therapist, accustomed to all sort of stories, situations and life dramas, felt so sad for him to the point of crying, what kind of freak did that make him? Was she not concerned for how he was feeling?

Perhaps he also felt that, if she could not contain herself and get a grip on her emotions, how would she be able to contain him?

I am not sure this demonstration of emotions has a helpful effect in a therapeutic relationship. Many of my drug-using clients look at me as a solid and rational agent in their tremendously chaotic and emotionally charged lives. I feel that it is not my place to feel the comfort of expressing my own emotions. Many of them have seen enough tears.

I would be happy to be challenged. I may be missing something. Maybe spontaneity has more room than I give it credit for in a therapeutic setting and a client could see the therapist’s tears as the humane side of the profession. I am not sure. I will try, however to keep my eyes dry for the time being.

Alberto Pavan, CBT counsellor

Multilingual client study

I was pleased to see Dick Blackwell’s letter in Therapy Today (March 2013) in response to Lysanne Sizoo’s article (October 2012), where she comments on her decision to allow therapists only to work in their mother tongue. I run a multilingual and multiethnic counselling service called Mothertongue. All our counsellors and therapists are multilingual and they work in their native languages as well as in other languages. Not only are they able to work fully in a range of languages; they raise a different issue about training.

Multilingual therapists interviewed for a recent research project1 mentioned the problems of training in English and then working clinically in their native languages where they did not have access to the professional vocabulary or experience in relating professionally in their native language. Therapists who answered an online questionnaire identified that there were also potential benefits of working in an additional language.

There will of course always be those who share Perez Foster’s concerns that work in English with non-native English speakers could be ‘a “pseudotherapy” which simply sides with the patient’s resistance to the mother tongue and the mother era, or a “quasitherapy” where the essential material is lost in the complex cognitive traffic of bilingualism…’2

We are currently collecting information for a research project on the experiences of multilingual clients and would welcome input from anyone who is interested in improving services for people from diverse cultural and linguistic backgrounds. The questionnaire can be found at http://bit.ly/Questionnaire_Patients

Beverley Costa, CEO and Clinical Director, Mothertongue multiethnic counselling service

References

1. Costa B, Dewaele JM. Psychotherapy across languages: beliefs, attitudes and practices of monolingual and multilingual therapists with their multilingual patients. Language and Psychoanalysis 2012; 1 (Autumn/Winter): 19–41. http://dx.doi.org/10.7565/landp.2012.0003
2. Perez Foster R. The power of language in the clinical process: assessing and treating the bilingual person. New Jersey: Aronson; 1998

Counselling hearing loss

It is estimated that 150,000 individuals have ‘profound or severe’ hearing loss (July 2011, Action on Hearing Loss). These individuals have lived in the hearing world and have gradually or suddenly lost their hearing due to a variety of causes. The impact of this loss can be likened to being at the centre of an earthquake, when everything that has been taken for granted is no more. The sound of a loved one’s voice, music, traffic, the wind blowing through the trees and the easy ability of being able to communicate with another are no longer available to them and this is often combined with difficulty with balance.

It is not only the individual who is subject to this impact but also those closest to the epicentre of that shock wave of change. This means their partner, family members and friends all experience the loss of the familiar and the ordinary. The loss of hearing is life-changing for all involved and can be regarded as a hidden disability.

Hearing Link is a UK-wide charity that responds to the needs of the deafened, their partners, family and friends through support and advice and, significantly, through the provision of a week-long residential rehabilitation programme. The Intensive Rehabilitation Programme (IRP) offers an opportunity to explore ways of overcoming the difficulties presented by the loss of hearing. An integral part of the IRP is the opportunity for participants to use the services of a counsellor. It is acknowledged that there are limitations to what can be achieved through these sessions. But often it is the first opportunity made available to people with hearing loss to talk through their experiences so, while it may well be just the one session, this short input can still be of great value.

The need for ‘deaf aware’ counsellors has become apparent through our work with Hearing Link and it is our wish that this be addressed. BACP is exploring the possibility of setting up a sub-section of their directory to identify counsellors who would be able to respond to this need.

[Editor’s note: And also a sub-section of counsellors with particular experience of working with people who are visually impaired.]

Equally Hearing Link would be pleased to receive names of those counsellors who have experience of working with the deafened and, also, would be pleased to hear from those who would be interested in attending deaf awareness training. 

Caroline Bickerton, MBACP (Accred); RSLI
Dick Hill, MBACP (Accred); MA

Moira Walker (1948-2013)

All of us who knew Moira in person, which is a great many people, or through her writing, will be saddened to hear of her death on 25 March.

Throughout much of the time I have known Moira she was Head of the Counselling Service at the University of Leicester and a major contributor to BACP committees and initiatives, particularly around supervision and ethics.

One of the delights of working with her on ethical issues for BACP was her warmth, sense of fun, insight and thoughtfulness around a wide variety of topics.

Her contributions combined creativity with good judgment. Her style was to understate the significance of what she was offering, so I often found myself reflecting on what she had said after a meeting as its significance continued to grow. She was a very easy person to like, instinctively friendly and collegial, and a lot of us liked her a great deal.

Moira also published extensively, authoring over six books, including one with her husband Michael Jacobs, and made many other contributions to edited collections and journals. She is probably best known for Women in Therapy and Counselling: out of the shadows (Open University Press, 1990) and Surviving Secrets: the experience of abuse for the child, the adult and helper (Open University Press, 1992). Surviving Secrets was shortlisted for the Mind Book of the Year and is now in its fourth reprint. Moira also founded the charity Dorset Action on Abuse.

Moira died after a long illness. In his email informing BACP of her death, Michael talked about her struggles with her illness before slipping away peacefully. He concluded: ‘She was a fighter to the end, this time for herself, having over her lifetime fought for so many others.’

Tim Bond