What can a counsellor help with?

It can be very difficult to decide how to take the first step in getting some help for issues that you are currently facing. It may be that we are not getting on with our partners, and finding it difficult to talk to them; it may be that we have lost somebody dear to us; it may be that we are struggling with our mental health, or just that we are at a stage in our life when things seem to be changing and we are not quite sure what we want.

Is it best to talk to a friend or a family member? Well, many people have tried that, and found that they could not be honest, or at least as honest as they needed to be, and friends and families opinions tend to be very biased towards them, which we really like, but it lacks the objectivity that may be needed.

What does a counsellor do differently?

People come to counselling for many different reasons. Rather than trying to outline what the counsellor does, this article is going to use a few examples of what might make someone go to a counsellor and their stories (anonymised to protect them).

The things that people want to talk about include;

• communication problems – including escalating arguments and just not listening to each other
• relationship issues
• separation/divorce issues for young people, families, and couples
• sex issues
• trouble with first families (mums and dads, brothers and sisters, and others)
• clients dealing with issues from their (often turbulent) past

What follows are different stories which show why people may come to see a counsellor, a very brief overview of what they have come for, and, in some cases, what might be worked on together. As with any work a counsellor does, confidentiality is an overarching promise that is made to clients, so any case studies that are mentioned will be based on clients but any names or details will be changed to protect their anonymity.

First, what happens if you are a couple and you find that you are not getting on as well as you used to, or your lives have changed? This may be because of having children; it may be because you don’t get on with your in-laws, or your first families have a larger impact on your life than you are comfortable with, and you feel there is no time for you two. It may also be that something in your life has changed, e.g. one of you has retired, a close family member has died, a child has left home, etc. Or it might be that one of you has had an affair which you are both finding it difficult to get over. These are just a few examples of what a counsellor may encounter during couple counselling.

So, here is the first story. A couple went to therapy a few years ago after Jane had admitted to John that she'd had an 'inappropriate relationship' with someone that she originally knew from work. The couple had two children aged seven and five, and they were in their early 30s. The man worked full-time as a builder and the woman worked in an office three days a week. John found emails and texts from another man who Jane had worked with in her office. The texts seemed to be of a sexual nature and arranged meetings with Jane outside working hours. Jane stated initially that there was nothing in it - that it was just 'banter'. John was angry and upset, and wanted to discuss the situation further. Jane was very reluctant to do this and felt as though she was being attacked.

The couple was then seen separately; Jane spoke about the relationship with the other man, stating that she did not think that John cared for her at all anymore, and it had all had changed since the birth of their children. He never paid her any attention or complimented her in any way. She admitted that she focused very much on the children and their well-being.

John said, similarly, that things had changed since the birth of the children. He felt that their marriage had no fun in it, and felt very isolated within the family. He added that he didn’t feel his wife cared for him, and felt that he was an outsider in his own family.

The counsellor spent four sessions working with the couple on their relationship. The first thing that happened was Jane agreed to stop her relationship with the other man. She found it easy to do this, as all she was getting from him was the attention that she craved from John. The couple agreed to spend time together, one evening a week, but also to spend time as a family. As the work together continued, the couple started to talk to each other without interventions from the counsellor.

By the seventh session, the couple decided that they had enough strategies to continue to work on by themselves and so reviewed with the counsellor what had been talked about, and both parties stated separately that they felt they did not want to give up their sessions, as talking about their lives together had really helped them. It was suggested to them that they had a session in about three months which they viewed as an MOT for their relationship. They were comforted by this, as they felt that it was something that they could both use, and that any issues that they faced would not be buried under the carpet but would be talked about at that session.

There is no stigma attached to clients coming back to review what has been discussed, being able to share what is happening in a safe space that suspends judgement, so that at the end of these top-up sessions a couple and indeed individuals can feel that they are again able to move on, noting how important it has been to talk to each other and spend time together.

The second story centres around a family. The parents (who had been married for a few years but known each other considerably longer) had one child living at home but three who had access visits only (they were children of the woman only). The child at home (a boy aged four) was a child of both, and on the at-risk register.

The family consisted of parents Pam and Bill, who were in their late 30s, two boys aged 14 and 16 (Jack and Dean - who lived with Pam’s ex-husband’s mother), a 12 year old girl (Jodie who lived with Pam’s mother), and a four year old boy (little Bill, who lives with the couple and attended the local primary school). The couple have known each other for most of their lives.

The children who were not resident with the couple visited regularly; the relationships seemed to be healthy, and there was affection displayed between them all. Pam had severe anger issues which had caused her to develop stress-related epilepsy. This was managed by antidepressants, and she visited her GP regularly.

The couple visited a counsellor and presented with Bill accusing Pam of having a lesbian relationship with a close friend of the couple. Bill had admitted two homosexual relationships with male relatives since the couple married. Pam felt that this was why Bill could not let go of this issue, which she strenuously denied. This issue caused much bad feeling between the couple, and by the third session, Pam had asked Bill to go and live with his mother for a short time to try and get his head around letting go of this issue. Even in the sessions, he kept bringing up the alleged affair, and Pam became increasingly angry.

This family worked with a counsellor for six sessions and looked at what would allow the family to move on, and how they could let go of some of the anger and bad feeling that had developed. The work done together looked at present and future-oriented systems, acknowledging the difficulties but allowing them to stay where they felt safe. This troubled family benefitted from having an open and safe place to discuss their issues, and as they stated several times, it was rare for them to attend meetings where they could decide what happens rather than have the agenda set for them.

This felt like a very positive piece of work. The benefits for the family were for them to work together to set up a safety plan for them, whereby one of the couple would walk away from a situation if they felt it was getting out of control. Hidden benefits were that they saw more of their older children, and the bond between the three older children and little Bill became a really positive thing for the couple to talk about. They discussed how much they all looked forward to their time together. By the end of the sessions, Bill had moved back into the family home and there seemed to be a better understanding between them.

Our next story concerns a young woman, aged 24, who was offered four counselling sessions by the company she worked for to deal with a bereavement. The young woman, Adele, was very distressed by the sudden death of her father as a result of a heart attack. Unfortunately, as the family lived 130 miles away, it had not been possible for her to get to the hospital to see her dad before he died.

"I never got to say goodbye".

The sessions were used to talk about her dad. She shared stories of her childhood, including why she had left home to get a job in London as there were no jobs where she came from. In the second week, she took to counselling a picture of her and her dad at her dad’s 60th birthday. The therapist helped her to talk about what she would like to have said to her father if she had got there in time. Adele addressed the photograph as though her dad was present. Over the course of the sessions, Adele was able to talk about loss and follow the process of her loss at various stages (see below). She took the photograph to the session every week, and she said it felt very much as though her father was there at every session. Adele was able to acknowledge the end of her father’s life; she felt that her father had abandoned her by not waiting, and this left her with a huge sense of loss with her father‘s passing.

Loss is a hard thing to process. It allows us to move on with our lives without forgetting the memory of the one who has passed on. If you briefly look at the stages of loss, they are;

• Denial - a feeling that this is not happening, hiding things from friends and family, and not dealing with reality.
• Anger - feeling out of control, overreacting and behaving in an irrational way, having a short fuse, and being overly aggressive
• Bargaining - what lies beneath this is thinking what we might change, if...
• Low mood - can’t stop crying, can’t eat, trouble sleeping.
• Acceptance - the fog starts to clear and you feel more in control; you find that you can more easily cope with what life is giving you when you find that there is hope for the future.

Adele, over the course of the four weeks, worked through these feelings, and this eased her sense of loss. Adele did not want to end the sessions so abruptly, and so it was agreed with her that she could go back to the counsellor whenever she felt the need. In this first instance, she asked if she could have a session the next month and just talk about how life was progressing. It was agreed, and Adele now phones the counsellor about every two months and arranges to go and see them, just to discuss where she is and how she’s feeling.

The final story is about young people. It relates to a 17-year-old young man called Jake, and his therapeutic journey. Jake presented with a high degree of anxiety, and was a school refuser - he had last been to school when he was 16 and had taken GCSEs, but he had not achieved sufficient grades, due to his lack of attendance, to move on to further education. Jake's story was that he had lost his father at 13. Although his mother and father were not together at the time of his Dad’s death, they did live close to each other, and Jake was co-parented by them both. Jake’s mother found it increasingly hard to work and manage her three sons, and she also suffered from severe anxiety attacks and found it difficult to leave the home. Jake’s brothers, both of whom were older than Jake and did not live at home full time, were both very successful. Jake's middle brother was at Durham University studying physics for a doctorate, and his older brother was a qualified doctor working in Wales as a GP. It seemed as though Jake had a lot to live up to.

Jake had started to manifest anxiety at a young age, and it had been recognised at primary school that Jake did not want to participate in school activities and found going to school quite difficult. When Jake moved onto senior school, things got even more difficult for him, as he felt he was never 'good enough'. This not only increased his anxiety but made it difficult for him to make the journey from home to school, especially after the death of his father which affected the whole family, particularly in terms of finances and emotional support.

Jake talked about what it was like for him to go to school, and why in the end he had stopped making the effort. He said that he felt isolated from the experience of school, and that he never wanted to talk to other people or interact in any way with his peers. He was then branded as 'weird', which he found incredibly difficult to accept. In the first session with Jake, he found it difficult and was not really able to share his feelings, or indeed voice what he wanted from counselling. He had made it very clear that he wanted to change his life. It is worth noting that at this stage Jake had been at home for nearly two years and had not really been out of the house much. Jake looked unkempt, and clearly personal hygiene was not big on his list of things that were important to him.

He continued to work with the therapist for six months, during which time they looked at what Jake needed to do to change his life. Part of the work focused on working on his memory, which he felt he had a problem with; he would go into class and not remember anything he had learnt. The first breakthrough came when Jake started talking about going back to college to complete his GCSEs. He had realised that he could not move onto further education before he had completed at least five GCSEs, and was prepared to give this a chance. The first thing he had to decide was which college did he go to, and how would he get there. Jake chose a college quite a long way away from his home, and during the summer holidays just before he enrolled, he made the bus journey with his elder brother a couple of times to familiarise himself with what it would be like and to get to college.

When Jake started at his new college, he was not sure that he would be able to maintain his attendance there, as he found it very frustrating having to talk to other people and was not able to eat at all at college, and so got home in the evening hungry and tired. He worked on going out at lunchtime and just eating a sandwich. This he was able to do but not every day. During the first month after Jake started at college, there was a marked difference in his appearance and his personal hygiene, both of which improved and immeasurably. The counsellor was uncertain as to whether Jake would be able to manage a full year at college. He had decided to study English and maths as a must, along with sociology, history, and psychology. There was no problem for him with the academic side of college; the social side however, he found much harder. Jake continued to have sessions a regular basis, and he heard recently that he had passed all five exams - four with A* grades and one with a B. Jake then had to decide whether he wanted to go on and do A levels at the same college, or onto a different college, also thinking about what courses to take. Jake has worked through some obstacles which, 12 months ago, would have been insurmountable, and although they were not easy, perseverance paid off for him. Jake continues to be seen on an ad-hoc basis, but he will only contact the counsellor if he needs to talk through something specific.

You have seen through the course of this article four very different stories from very different people. This may give you the ability to take that first step to contact a therapist or counsellor, to give you the support and strategies that will help you to move forward and also help to make your life just a little bit easier.