Autonomy - what does it mean and what does it mean to you?

An ethical definition of autonomy is "Most basically, respect for autonomy requires giving persons independence in their decisions and actions to the extent to which they do not harm others or do not violate others' rights. Thus, it translates into a negative obligation not to subject autonomous persons' decisions and actions to controlling influences".

Interestingly my attention is drawn to the word "giving" in the definition. If something is given surely it can be given, or taken, away?

In common parlance, you have the right to choose and I am obliged to respect that. Autonomy can be given away and also taken away. For instance a sentence to prison, an obligation to pay a charge, or conversely, being so unsure and anxious that we give another the ability to make our decisions for us. And this is where, in my experience as a counsellor, I encounter autonomy in the counselling session.

On one hand, there is the client who has arrived at a place where their self-image is so small they have allowed others to make the decisions for them, either wittingly or more commonly not having sufficient self-worth to maintain their choices/decisions as being valid, worthy and being heard. Respected.

Conversely, there is the client who is domineering, controlling and "wearing the trousers". Perhaps this comes from not being secure or able to trust another. Autonomy is the right to choose but is not restricted to making good choices, neither does it imply making "bad" choices should not be allowed.

As parents, teachers, managers, and supervisors, we are allowed to curb others' bad choices and to try to stop them from being made. Does that apply in counselling though?

As a person-centred counsellor, I am obliged to always hold a client in unconditional positive regard (UPR). This is something I am able to do but it is not always easy. When a client wants to stay with an abusive partner, when a client wants to continue with maladaptive behaviours (drugs, drinks, violence, criminality) it is not easy. When a client has such low self-esteem and drive that they feel unable to challenge a manipulative partner, boss or family member, UPR means I have to accept and consciously not challenge that.

So how is that different from blithely and passively accepting the way the client is?

It may sound counterintuitive, but, if the urge to offer advice, to collude and to be critical is held at bay, then significant change can take place. How so, you may ask? 
As I have been taught and have also seen, the change toward a positive choice/s, autonomy, can and does take place. An axiom I attribute to Carl Rogers i.e. "the organism will always do what is the best for the survival of the organism" I find really useful. When I do not step in and thus take away from the client's autonomy, when a client feels UPR from me, when a client feels safe and "held" then an amazing thing takes place. The previously unheard client whose self-image is so low they feel unable to try and change their lot in life does something incredible. The same happens with the client who is so insecure and unchallenged that they dominate and rule the other party. 

Both sorts of clients can discover and listen to their feelings. They feel able to be comfortable with being vulnerable, not being in control, and expecting not to be heard. They find they can accept others' will/decisions as well as their own. This allows them to look to the causes of the way they behave.

So far so good. What occurs next is a privilege to see. These clients then come up with ideas about how they want to be and how to achieve a different way of being.

In the counselling session, at first, they feel able to think about what the supposed changes might be like in life outside of the counselling sessions. The session is experienced as a safe place to try out solutions. It is OK if they do not serve the client as hoped. Failing is OK - it is a sign that the client is trying. When an idea serves the client then the client begins to grow. They realise it is alright to succeed and that they are worthy of success. The client usually then begins to try out different ways of being, outside of the counselling session. When a client tells of a different way of being, maybe eating every day or telling another person their feelings about the other, then I am confident change – therapeutic change – is happening.

With the domineering client, they can feel that different views are not a direct challenge to them personally. That their views are not threatened by others' views. That it is more a case of both views being valid and that there is enough room for both views to exist – exist without the need to come into conflict, to establish superiority. Perhaps haltingly these clients begin to feel comfortable with difference. They feel the pleasure of being wanted versus being in control. 

With both types of clients, their autonomy was always present. When they are able to put in the work in counselling sessions, the autonomy re-emerges as an autonomy that is different but that serves them better.