Types of Counseling
By Bill McDonald
The terms Therapist or Counselor have different meanings, often depending on the background and training of the professional you’re dealing with. Here is a list of some standard terms for the people and the processes – and a description of what they each mean.
The People who do therapy:
Psychiatrist:
A psychiatrist is initially trained as a Medical Doctor (M.D. or D.O.). After their medical training, they obtain additional training through a psychiatric residency or training institute. Today’s psychiatrist is most highly specialized in the use of medication for the relief of psychological problems. Some psychiatrists deliver direct one-to-one psychotherapy services, but they most commonly have their expertise these days in the management of medication. A technical name for this is “psychopharmacology.”
Psychologist:
Social Worker (That’s how I am licensed, so I may have some prejudice here):
A Social Worker usually has a graduate degree in Social Work – the most common being am MSW (Master’s in Social Work). Social workers generally work in one of two primary settings – agency or clinical work. The original social workers were mostly professionals who worked among the poor or disadvantaged population of society. And most social service agencies still use social workers both for direct delivery of care and for administrative work. Our training makes us excellent in both areas. However, because we are trained in the awareness and intervention in larger social systems, we are also excellent in a clinical setting. In most psychiatric clinics, the majority of actual clinical care is given by social workers. A psychiatrist will often head or “own” a clinic, and provide medical (medication) supervision for all the other workers. Some psychologists are usually on staff, but the majority are social workers.
One of the “advantages” of hiring a social worker, other than that they can make excellent therapists, is that they are cheaper (which means that insurance companies can pay them less). When I’m in a testy mood, I’ll often describe psychiatrists as primarily “pill people” who memorize pharmaceutical manuals, psychologists as people who learned their skills primarily from have studied the behavior of “rats” in graduate school, and social workers as people who have studied what happens in city slums and ghettos. The general income level follows the same progression. Social workers are at the bottom – and know from the outset they will never get rich doing therapy. If they want more money, they have to go into administration work and supervise their poorer colleagues. They can also go back to school and get a PhD (or M.D.).
Now for a list of the kinds of therapy available, and the language of kinds of therapy:
Therapy 
This is a word that essentially means the treatment of bodily, mental, or behavioral disorders by using remedial agents or methods that provide or assist in a cure. So it assumes something wrong, or at least not suitable, with a person – and a therapist then offers skills to help make it ideal for the person. (As a social worker, that can include a couple, family, organization, or other social system.)
My interest and study of systems theory (Google that if you want to know more) has helped me understand or “map” what goes on inside a person and what goes on in a more extensive ‘system’ like a marriage or family.
Counseling
Generally, “counseling” means giving advice tailored to the client’s needs or situation. (This is the same sense as an attorney being a “counselor at law”). It assumes (1) the client’s ability to act on that advice and (2) a professional setting for such a consultation. Merriam-Webster (11th Collegiate Dictionary) spells it out further: “professional guidance of the individual by utilizing psychological methods, especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes.” This is technically distinct from Psychotherapy, which is often assisting the client or patient who has a functional inability to act or think in certain situations so that whatever is psychologically blocking the person can be encountered and hopefully removed.
Analysis or Psychoanalysis
These terms refer to analyzing psychological phenomena and treating emotional disorders. It involves treatment sessions during which the patient is encouraged to talk freely from their profound experiences and with feedback from the analyst that inspires and enlightens this process. Classical analysis (generally beginning with Sigmund Freud) involves the analysand (the technical word for the one being analyzed) talking freely about personal experiences and often focusing on early childhood and dreams. I have specific clinical credentials to analyze in a field called Transactional Analysis.
Analysis or Psychoanalysis
These terms refer to the method of analyzing psychological phenomena and treating emotional disorders, which involves treatment sessions during which the patient is encouraged to talk freely from his or her deep experiences, and with feedback from the analyst that encourages and enlightens this process. Classical analysis (generally beginning with Sigmund Freud) involves the analysand (the technical word for the one being analyzed) talking freely about personal experiences and often focusing on early childhood and dreams. I have specific clinical credentials to do analysis in a field called Transactional Analysis.
Psyche
Some analysts use this term to refer to the soul or personality. Technically, the word is directly translated as “soul” – not in the ordinary religious sense, but in the sense of a person’s vital essence or deep self. Different schools of psychology use this term somewhat differently. The word “psychology” basically means “the (understanding, or logic) of the psyche.
Private Practice
Many clinicians will say they have a private practice while working within a psychiatric or psychological clinic. This may or may not include psychiatric supervision, depending on the structure of the clinic and the contract with the particular therapist. However, a pure private practice is just that. It is a solo practice, legally and structurally independent of management or supervision. That is what I have had since 1977. I contract for them independently if I want or need outside management, supervision, or other resources. If I need the assistance of a psychiatrist or psychologist, I have resources with whom I have a private agreement or contract for those purposes.
“Patient” or “Client”
In what is commonly called the “medical model,” the term patient is most widely used. It assumes (though it is by no means still completely operative) that the “doctor” is the one who “does something” and the “patient” is the one who (passively) has “something done” to them. The term client, however, assumes a greater parity between the professional and the person seeking assistance. Lawyers use this language. And it is the preferred language of the social work community as well. It can be assumed the person being worked with is a full partner.
Individuals
You may be going through a specific crisis or difficult life transition. Maybe you’re suffering from a chronic long-term dysfunction and want to finally make some healthy and/or necessary changes in your life. Or perhaps you’re responding to a deep desire to live life more fully. Or you’re hungry to become a more honest, authentic person. Maybe there is “stuff” keeping you from living a full and good life, keeping you from more successful relationships, keeping you from living creatively and confidently in the larger world.
Each of these is what we’re about.
Some background perspective:
From the very beginning, psychotherapy (psychological counseling and therapy) has focused on the individual. Initially, this work would focus on the specific problems or suffering of the individual – as a visit to your physician’s office will focus on your own specific physical problems and well-being.
However, something has gotten lost these days when the entire culture seems to want to focus on the individual. Today, the usual focus on the individual is for the sake of that individual. I want to become a better person and live a better life to enjoy life more. And we live in a world and culture which increasingly believes this is a natural right for each of us. We even attempt to transport this culture and lifestyle to the rest of the globe, often assuming it’s our best gift to the world. And maybe this is true.
Nevertheless, behind this focus on the individual’s health is an older and deeper meaning. The focus on the individual is for the sake of the collective. By “collective,” I mean the family, the community, the workplace, the government, the environment, the universe – what indigenous folks may call “The People.” My best purpose in the world is for the sake of the larger world. Ask a policeman, a fireman, a soldier, all who are willing to put themselves in harm’s way, why they do this – and their primary answer is that he or she does it for the safety and well- being of others.
This is why much individual therapy, beyond the immediate relief of one’s own pain and suffering, involves the question of “what is my purpose in this life?” Every mature culture throughout human history has maintained ways of asking this central question – and often in much more mature ways than our own. I’ve discovered, in my many years of psychological practice, that to focus on one’s life purpose is often the means of relief from much individual suffering. What others will see as the diagnostic name of a particular mental illness to be cured (or controlled), I will also view it as the soul/psyche’s way of asking to live more relevantly for the sake of the larger world. The ancient healers knew this.
There is an interesting transformation that takes place when a person gets his or her life together and begins living the way he or she wants to live. Some therapists will speak of the goals of therapy as gaining greater success and power. And that’s a common focus. But the deeper ethics of therapy will also insist that with success and power comes a greater social or cultural responsibility. I have found that one way or another, the self discovers a desire and ability to give of oneself in the larger world. As you can see, there are many different languages that speak of this work.
Call me – Bill McDonald, Phone 810 629-0760
Couples/Marriage/Pre-Marriage
Only within the last half century has couples or marital therapy become a distinct discipline. (Notwithstanding, some of the secrets of good marital counseling have existed for hundreds or thousands of years.)
Many therapists who do excellent individual therapy will avoid “marriage counseling.” It is a very different kind of therapy involving unique skills. Many therapists are not interested in “trying to manage couples who must argue endlessly.” It takes special skills (and patience!).
From my specific family background and a unique undergraduate program at the University of Iowa in the 1960s, I was fortunate to have implanted the ability to translate between numerous different personal and professional “languages.”; This skill is of singular value in marital counseling, where it’s as if one person speaks Greek and the other Swahili. Even the alphabet is different – and they both think they speak English! When this is not a significant handicap (though it usually is when a couple comes to see me), it can be a resource of tremendous energy and creativity – as the French say, Vive la difference!
Although most couples seek counseling initially because of a crisis in their relationship, some seek our services to enrich an already good (or at least adequate) marriage. It’s not yet that common, but time and energy (and money) are well spent.
One crucial difference in doing couple or marital counseling is that the therapy contract is with the relationship, not with each separate individual.
In a good relationship, the relationship itself nurtures the individuals within it. It’s the marriage itself that keeps and cares for the two married persons. And each party’s best care is the care given to the relationship, not just to the other person. (Here is also a secret of conflict resolution within the relationship.) I honor and reinforce this reality by making the relationship (or marriage) itself my client.
When one party leaves the relationship (i.e., by divorce, infidelity, addiction, death), the relationship itself has collapsed. When it is possible (i.e., the parties are still alive and not re-committed elsewhere), and there is some compelling mutual desire, the work of our therapy may be the decision and struggle to rebuild the relationship.
Years ago, I learned that when therapy becomes fuzzy (unfocused), it’s often because the contract is fuzzy (unclear). There are times when, after marital counseling, one or both parties may enter into individual therapy with me. (And to answer a frequently asked question: yes, I am comfortable and competent to see married (or cohabiting) persons separately with separate therapy contracts. It does involve an exceptional boundary-keeping ability on the therapist’s part.)
The process of couple or marital counseling begins by calling me for an appointment. If possible, I like to see both parties together for a first session. At that first session, I get to know both of you, and you get to know me. If I believe I can work with you effectively, I will offer my services for future work. And if you feel likewise, we then have a working therapy relationship. Next, I will often meet with each of you separately to gain further information and acquaint myself with your background and family patterns. I do this because many or most difficulties in a relationship originate from family backgrounds, and it is my art to see and disempower them for you when they “get in the way.”
The duration of the therapy varies widely, and I generally can’t offer much of an estimate at the beginning. But even a short time of counseling can benefit many couples.
persons. persons. And each party’s best care is the care given to the relationship, not just to the other person. (Here is also a secret of conflict resolution within the relationship.) I honor and reinforce this reality by making the relationship (or marriage) itself my client.
When one party leaves the relationship (i.e., by divorce, infidelity, addiction, death), the relationship itself has collapsed. When it is possible (i.e., the parties are still alive and not re-committed elsewhere), and there is some compelling mutual desire, the work of our therapy may be the decision and struggle to rebuild the relationship.
Years ago, I learned that when therapy becomes fuzzy (unfocused), it’s often because the contract is fuzzy (unclear). There are times when, after marital counseling, one or both parties may enter into individual therapy with me. (And to answer a frequently asked question: yes, I am comfortable and competent to see married (or cohabiting) persons separately with separate therapy contracts. It does involve an exceptional boundary-keeping ability on the therapist’s part.)
The process of couple or marital counseling begins by calling me for an appointment. If possible, I like to see both parties together for a first session. At that first session, I get to know both of you, and you get to know me. If I believe I can work with you effectively, I will offer my services for future work. And if you feel likewise, we then have a working therapy relationship. Next, I will often meet with each of you separately to gain further information and acquaint myself with your background and family patterns. I do this because many or most difficulties in a relationship originate from family backgrounds, and it is my art to see and disempower them for you when they “get in the way.”
The duration of the therapy varies widely, and I generally can’t offer much of an estimate at the beginning. But even a short time of counseling can benefit many couples. Also, over the years, I have found it possible to work on the marriage or relationship even when only one of the partners comes to see me.
Sometimes, my schedule and energy will not allow me to take on a new client couple right away. But call me to see what we can work out.
Call me – Bill McDonald, Phone 810 629-0760
Young People
In my early years of counseling, I didn’t regard myself as “good with kids” – and I know counseling them is a distinct therapeutic art in itself (hence all the courses and books on child development, etc.). But over the years, and with advice and guidance from others who were “good with kids” and myself being a good storyteller, it turns out I was definitely under-rating myself.
Generally, I’ll accept young people 12 and over. Sometimes, just a few sessions may be all that’s needed, maybe only one. Having children of my own certainly taught me a lot, and I always seemed to like kids, especially when one-to-one with them.
High school kids seem to work well with me – and my early college years were preparing me to be a High School teacher. (Later, Robin Williams was long an inspiration for me.)
Also, the ‘Grandfather’ age in me can allow a specific ‘wisdom element’ that gives me generational credibility with adolescents. I ‘know stuff’ from a softer distance. Plus, I enjoy it.
[Curiously, I hadn’t noticed till later in my own life how much and often young people had long been drawn to come and talk with my parents.]
Only within the last half century has couples or marital therapy become a distinct discipline. (Notwithstanding, some of the secrets of good marital counseling have existed for hundreds or thousands of years.)
Many therapists who do excellent individual therapy will avoid “marriage counseling.” It is a very different kind of therapy involving unique skills. Many therapists are not interested in “trying to manage couples who must argue endlessly.” It takes special skills (and patience!).
From my specific family background and a unique undergraduate program at the University of Iowa in the 1960s, I was fortunate to have implanted the ability to translate between numerous different personal and professional “languages.”; This skill is of singular value in marital counseling, where it’s as if one person speaks Greek and the other Swahili. Even the alphabet is different – and they both think they speak English! When this is not a significant handicap (though it usually is when a couple comes to see me), it can be a resource of tremendous energy and creativity – as the French say, Vive la difference!
Although most couples seek counseling initially because of a crisis in their relationship, some seek our services to enrich an already good (or at least adequate) marriage. It’s not yet that common, but time and energy (and money) are well spent.
One crucial difference in doing couple or marital counseling is that the therapy contract is with the relationship, not with each separate individual.
In a good relationship, the relationship itself nurtures the individuals within it. It’s the marriage itself that keeps and cares for the two married persons. And each party’s best care is the care given to the relationship, not just to the other person. (Here is also a secret of conflict resolution within the relationship.) I honor and reinforce this reality by making the relationship (or marriage) itself my client.
When one party leaves the relationship (i.e., by divorce, infidelity, addiction, death), the relationship itself has collapsed. When it is possible (i.e., the parties are still alive and not re-committed elsewhere), and there is some compelling mutual desire, the work of our therapy may be the decision and struggle to rebuild the relationship.
Years ago, I learned that when therapy becomes fuzzy (unfocused), it’s often because the contract is fuzzy (unclear). There are times when, after marital counseling, one or both parties may enter into individual therapy with me. (And to answer a frequently asked question: yes, I am comfortable and competent to see married (or cohabiting) persons separately with separate therapy contracts. It does involve an exceptional boundary-keeping ability on the therapist’s part.)
The process of couple or marital counseling begins by calling me for an appointment. If possible, I like to see both parties together for a first session. At that first session, I get to know both of you, and you get to know me. If I believe I can work with you effectively, I will offer my services for future work. And if you feel likewise, we then have a working therapy relationship. Next, I will often meet with each of you separately to gain further information and acquaint myself with your background and family patterns. I do this because many or most difficulties in a relationship originate from family backgrounds, and it is my art to see and disempower them for you when they “get in the way.”
The duration of the therapy varies widely, and I generally can’t offer much of an estimate at the beginning. But even a short time of counseling can benefit many couples.
persons. persons. And each party’s best care is the care given to the relationship, not just to the other person. (Here is also a secret of conflict resolution within the relationship.) I honor and reinforce this reality by making the relationship (or marriage) itself my client.
When one party leaves the relationship (i.e., by divorce, infidelity, addiction, death), the relationship itself has collapsed. When it is possible (i.e., the parties are still alive and not re-committed elsewhere), and there is some compelling mutual desire, the work of our therapy may be the decision and struggle to rebuild the relationship.
Years ago, I learned that when therapy becomes fuzzy (unfocused), it’s often because the contract is fuzzy (unclear). There are times when, after marital counseling, one or both parties may enter into individual therapy with me. (And to answer a frequently asked question: yes, I am comfortable and competent to see married (or cohabiting) persons separately with separate therapy contracts. It does involve an exceptional boundary-keeping ability on the therapist’s part.)
The process of couple or marital counseling begins by calling me for an appointment. If possible, I like to see both parties together for a first session. At that first session, I get to know both of you, and you get to know me. If I believe I can work with you effectively, I will offer my services for future work. And if you feel likewise, we then have a working therapy relationship. Next, I will often meet with each of you separately to gain further information and acquaint myself with your background and family patterns. I do this because many or most difficulties in a relationship originate from family backgrounds, and it is my art to see and disempower them for you when they “get in the way.”
The duration of the therapy varies widely, and I generally can’t offer much of an estimate at the beginning. But even a short time of counseling can benefit many couples. Also, over the years, I have found it possible to work on the marriage or relationship even when only one of the partners comes to see me.
Sometimes, my schedule and energy will not allow me to take on a new client couple right away. But call me to see what we can work out.
Call me – Bill McDonald, Phone 810 629-0760
Anger Management
Since I get many inquiries asking if I do “anger management” counseling, I want to spell out some thoughts and responses.
1: Defining the Issues
Anger Management, Domestic Violence, and Road Rage – are increasingly common terms in this age of heightened life stress.
Anger Management problems usually have to do with an inability to manage or control one’s anger responses in the face of increased frustration and stress.
Domestic Violence is much the same with the addition of coming from a (usually inherited) belief system that it is right and necessary to maintain order in a household or specific environment by any and all means available.
Road Rage often comes from a perceived violation of “my personal space” on the road – to which an equal (or greater) violation in return is deemed justified.
Our society rightly considers all three to be “offenses” where internal control is lost or inappropriate, and the intervention of external control is warranted. When someone loses it (for example, in a domestic situation), somebody else (cf police authorities) must step in to provide order and protection.
2. How to Change
The usual goal, or ideal, for each of us is to develop adequate internal controls to maintain our order, especially in the face of increased frustration and stress. And the purpose of our internal order includes protecting all others from any violation, especially by our actions. For thousands of years, the hallmark of any well-developed society is that the vulnerable within it are protected. (In the Old Testament, it is found that whenever God heard the cry of a widow or an orphan, his wrath would be kindled beyond all other situations.) And some years ago, the Vatican saw it appropriate to issue a set of Ten Commandments for drivers.
One further characteristic of the problem is that the part of the human brain that could help us think more clearly about these issues is generally overpowered by that other (much more primitive) part that locks us into “fight, flight, or freeze” responses. That’s why the most effective change with “anger issues” is challenging work. A good rule of thumb is that if a person has more than one anger episode in five years, it signifies a deep-set problem.
So, the process doesn’t involve a simple behavior shift, such as changing how the toilet paper unfolds. Instead, it involves an extensive “re- wiring” of the brain so that in times of crisis, our manner of responding will come from having formed a very different “groove.”
The optimum type of resource to help bring about change – both in behavior and thinking patterns (belief systems) is Group Therapy. So, if you want your best shot at changing, this is where to go. It’s not easy, but it’s effective.
Also, any helpful therapy must be sufficiently powerful to overcome the near-universal pattern of denial by the offender that their problem is as severe as it is. This is true even considering the considerable feeling of shame often involved.
3. Resources for Change
At this time, I don’t have much familiarity with local resources for specific “anger management” work.
You may also contact Resource Genesee at 810-232-6300 for additional assistance.
I will not provide just a quick series of sessions to satisfy the demands of a court or probation officer. In such cases, if you work with me, I may insist from the beginning on a written commitment to a lengthy program of therapeutic work.
Individual therapy can be helpful in several cases. I have had training and experience in this field and am familiar with its underlying dynamics. In some cases, individual therapy may be much more effective over a lengthy period, but taking longer and costing more than standard group work.
In any case, I am willing to provide an initial consultation to further evaluate your needs, circumstances, and options.
4. Anger is not necessarily the ‘enemy.’
Teaching people not to feel anger is rarely the answer. It’s there for an essential developmental or social reason. But if we allow only the primitive part of our brain to act it out, the larger culture of necessity must step in to protect others from damage. That’s why we have ‘sports’ or martial arts – to ‘order’ that energy. There’s a reason more folks follow football on TV than golf.
Maybe there’s a correlation between anger and toilet training. It involves almost entirely re-orientating our neurology, yet each of us has accomplished this radical shift. I heard the author Scott Peck once explain that we allow ourselves to be toilet-trained because someone we love (a parent) wants us to change. We learn to control our anger and not hurt others, even if we want to. I once had a client, a career Army Drill Sergeant, about training recruits in the critical difference between following orders and the desire to kill an enemy. He cared deeply for his recruits and the crucial difference between the two. We had many conversations about the importance of his work and his abiding care for his recruits.
We know from our current political discourse how the politics of hate can easily poison a large population and even destroy a democratic way of life.
In the meantime, my ‘anger management’ clients continue to re-wire the grooves of their brains toward a more effectively peaceful manner of living together in our world.
Depression and anxiety
This brief article spells out my general thinking about treating Depression and Anxiety. Treating them is more than using medication. Much research information has become available in past decades, much of it sponsored by the pharmaceutical industry, and therefore, it is very open to bias. There’s lots of money to be made designing and marketing medication to fix these problems.
Depression and anxiety are not the same thing, but more and more are considered to be in the same family of disorders, with some personalities tending more to one or the other. That’s why I’m talking about them here together.
I also consider each to exist within a spectrum of intensity, ranging from clinical to situational. The most severe level is clinical depression or anxiety – where the level of suffering and disability runs deep. This is where modern pharmaceuticals can be a godsend, often to keep a person alive and functioning. Here, we need more good psychiatrists/pharmacologists who can help guide a patient through the maze of available medication to find the right one or combination to relieve the suffering. A combination of this “chemotherapy” plus good “talk therapy” (my field) seems to yield the best results.
At the other end of the intensity spectrum is what I call the situational level of depression and anxiety – where they are more a reaction or result of life situations. These can include life disruptions such as loss, crisis, illness, aging, or boredom. My theory of operation is that in the middle and toward this end of the spectrum, anxiety, and depression can have an actual purpose for the personality. This purpose seeks the maturing of the individual.
Some persons are more depressive and anxious than others by nature. There are many ‘born with’ aspects of our personalities – rendering the childhood perception of “fairness” a moot point. But our task in life is to take what we have and wrestle out an authentic life from it. Another way of saying this is that our primary task in life is to discern and live out our life purpose. This is why, when I have a realistic option, I prefer to stay away from medication use.
In the same vein, many marriage and sexual problems in relationships carry the purpose and promise of maturing the marriage. It’s said that marriage itself is what prepares us for marriage. It is life itself (including experiences of depression and anxiety) that prepares us for life. This is why I don’t burn out in my work. I continually see a maturing process emerge from people working with me. And my work with clients’ depression and anxiety is a part of this larger process.
Life Coaching
Some persons are more depressive and anxious than others by nature. There are many ‘born with’ aspects of our personalities – rendering the childhood perception of “fairness” a moot point. But our task in life is to take what we have and wrestle out an authentic life from it. Another way of saying this is that our primary task in life is to discern and live out our life purpose. This is why, when I have a realistic option, I prefer to stay away from medication use.
In the same vein, many marriage and sexual problems in relationships carry the purpose and promise of maturing the marriage. It’s said that marriage itself is what prepares us for marriage. It is life itself (including experiences of depression and anxiety) that prepares us for life. This is why I don’t burn out in my work. I continually see a maturing process emerge from people working with me. And my work with clients’ depression and anxiety is a part of this larger process. experience – from Living.
In earlier times, knowledge was not as fragmented into various fields like psychology, sociology, theology, anthropology, biology, and numerous other ‘disciplines’ that study what it means to be human and a part of the natural world. In those times, the storyteller often carried the wisdom of the ages implicit in their story-telling – and those stories themselves were many, many generations old. My heritage and development as a storyteller often become the tool of profound change and practical wisdom for clients.
For example, one beneficial area of such ‘coaching’ is my expertise in the nature and secrets of male/female relationships. For some clients who are single or newly single, I become a ‘dating coach.’
I’ve been tempted to include an additional section about my Relationship Coach skills.
Grief Therapy
Grief is a natural process – and one of the inevitable experiences of life. However, that doesn’t mean we have to suffer it alone, nor when it seems overwhelming to deny ourselves some needed or well-deserved help. And there are times when one new grief appears to bring back an earlier one which is often called unresolved or compounded grief.
The work of a therapist here is to help, advise, and direct your grief so that it fulfills its inherent purpose of healing. Grief is itself not an “illness” – even though it can involve a great deal of emotional and physical pain. Grief, in time, is meant to bring about healing, and a good therapist understands, encourages, and facilitates that.
The solution to grief is often to go down inside ourselves – down to where it hurts, down to the places we (and often those around us) usually try to avoid – down and within to where also are the secret wells and resources of a richer life.
It’s said that in life, there is death, and in death, there is life. Deep inside us, they often intertwineTo bring us – Life lived to the fullest. In the Bible, it’s called “Eternal Life.” In every age and culture, it can be one of our greatest struggles…and blessings.
Narcissistic Victim Syndrome
April 2011, “The Narcissist and His Woman”
April 2014, “Responding to the Narcissist’ Women”
Several worthy responses accompany each. In the meantime, I’ve also worked with a handful of male ‘victims’ agonizing over this same ordeal. It’s never a quick-fix struggle.
One of the joys of this work for me begins to emerge in the middle of my clients’ struggles, where they start to (slowly) realize how much the narcissistic relationship had stolen from them over time. One particular client, whom I now see bi-weekly, emerges from long-buried or never-revealed parts of her original self over three years now after she ended the 27-year narcissistic relationship. “Slow and steady wins the race.” (Aesop)
Here’s a list of common responses.
“So many things are so different.” “Like a whole different world.” “I’m so different.”
“I was afraid to leave for so long.” “It’s no big deal, It’s totally fine.”
“I’ve made some serious progress – to undo all the crazy in there.” “All those pieces at once now come together.”
It’s like being slowly released from a deep spell you couldn’t even realize, except for a subtle awareness something is missing. And, of course, you were trained to believe it’s your own fault.
Sexual Counseling
First, a few clarifications: Sexual counseling itself is considered by many to be a specific branch of the larger field of the psychotherapeutic arts. And because of that, it can involve some specialized certifications and credentialing. I need to state here that I have not gathered those specific credentials.
Secondly, I’m not your best resource for the type of information best found in the hundreds (thousands?) of sex manuals on the market. For that information, go to Barnes & Noble, Borders, Amazon, your neighborhood bookseller, or ask a public librarian (they know much more than you might think!). If you need good how-to information, find a good book (or a good friend).
What I do know a lot about are the sexual problems that show up in relationships. For me, sex and relationships are tightly interwoven, and to consider them in isolation from each other is, at the least, naïve.
I subscribe to the belief that the most essential sex organ of the body is the brain. When I was a younger man, I thought that was a strange idea, but as I get older, it makes more and more sense.
What I want for my clients in their committed relationships is that they know (experience) passion. The foundation for this is that commitment is what best makes for good sex, not vice versa. When we first marry, our hormones can do that work for us, but that will diminish. Then come the “problems.”
In my experience, those very “problems” (within a committed relationship) become the key to growing that lively love and intimacy, which is one of the purposes and gifts of a long-term relationship. David Schnarch claims that a sexually active young adult cannot even begin to comprehend the nature and intensity of that sexual passion experienced by a vital couple in their sixties or older. The purpose of my sexual counseling is to help my clients get there.
Paradoxically, the best sex (and the best key to intimacy at all levels) comes from each person becoming strong in their self (Schnarch uses the family systems term “differentiation” – standing on one’s own two feet).
The best teacher for marriage is marriage – nobody is ‘ready’ for marriage before the wedding. And the best resource for sexual intimacy and passion is to grow within a committed relationship (marriage, etc.). So you can begin to see that for me, my couple counseling and my sexual counseling are enriching aspects of the same process.
When I work with sexual (or dating or relationship) issues with individuals, I work from the same framework. Most (perhaps all) sexual “issues” stem from earlier (or current) relationship issues – often from within one’s family of origin. Here, too, my goal is to help my client to a new freedom to become and enjoy being a vital, healthy sexual person, to the end that the freedom and possibility of love and intimacy in a relationship becomes possible.
Being a sexual person is our birthright. What we do with that birthright as an adult, I want to be a free choice.* David Schnarch, Ph.D., Passionate Marriage – Keeping Love & Intimacy Alive in Committed Relationships. (New York, Owl Books, 1997)
Changing Bad Habits Effortlessly
People will often ask, “Why do I do things that aren’t good for me?”
As therapists, we will often answer the question obliquely with some explanation, not of why we do these things in the first place, but rather how to undertake the often difficult process of changing or stopping a particular behavior or habit. We can be good at understanding and guiding one through such a difficult undertaking.
I had a client many years ago, a career engineer, working for General Motors, who in the past had been a severe alcoholic. But he told me he had quit alcohol – one day some years before he had just quit, and never touched a drop since. Ever since I’ve wished I’d taken time to ask him specifically how he did that. But since his purpose for being with me was seemingly unrelated, I didn’t pursue that question. However, it has stuck in the back of my brain ever since.
More recently, I’ve revisited this question of how some people can and do change bad habits effortlessly – and have collected several clues to the process. I don’t attach a guarantee of this work for everybody, but it is emerging as a process I trust can be done. And that’s the mark of a good therapist.
Bill McDonald – 810-730-9454