In order to study the lived-in experience of a counsellor’s relationship with God, and how that may transfer into the therapy room, a female counsellor (Jane) was interviewed. The interview transcript was analysed using interpretive phenomenological analysis. It was disappointing that the literature on this topic was not as specific as I would have liked. However, what became apparent through my findings and use of the Transactional Analysis Functional Ego state model (Parent Adult Child/ PAC), was the cultural potency of God as an idealized Parent, alternating between positive Controlling Parent (+CP) and positive Nurturing Parent (+NP), and the out-of-awareness discounting of the Self in the relationship.
** Reflection of my own internal process is referenced in numerical order within the text, with the corresponding detail noted under the heading ‘Reflection’ in section 7 **
Contents: Page No:
- Introduction – p3
- Literature Review – p4
- Methodology – p8
- Co-researcher – p8
- Ethics – p8
- Researcher – p9
- Interview – p9
- Qualitative – p10
- Transcription – p10
- Mapping Themes – p11
- Analysis – p11
- Discussion – p14
- Conclusion – p16
- Reflection – p18
- References – p19
Appendix 1 – Project Proposal Form 1ü
Appendix 2 – Approval of Proposal 1 ü
Appendix 3 – Participant advertisement ü
Appendix 4 – Advertise Beacon ü
Appendix 5 – Advertise SMCP ü
Appendix 6 – Advertise Facebook ü
Appendix 7 – Project Proposal Form 2 ü
Appendix 8 – Approval of Proposal 2 ü
Appendix 9 – Erskine Workshop certificate – influence for 2nd project proposal ü
Appendix 10 – Co-researcher Consent Form ü
Appendix 11 – Method & Self-Care Pictorial / Value of friends and collaboration ü
Appendix 12 – TA poetry, Cath Townley ü
Appendix 13 – Transcript of Interview ü
This research was not my initial choice of topic. I had initially chosen to research the lived-in experience of a TA trainee in a short-term therapy placement. The rationale being that after having spent three years using a psychodynamic model of psychotherapy, including regression (working with the Child ego state), I experienced some apprehension prior to starting a voluntary placement with a charity whose interventions were limited to between six and eight sessions. I wanted to seek out another’s experience to see if it differed. Within only a month of having been handed the assignment, I think I was the first in my training group to have submitted my research proposal (appendix 1), and have it agreed (appendix 2). I felt motivated and full of enthusiasm. I had started to read articles and books and felt a sense of competitiveness that I would be the first to complete the project. This competitive thought overshadowed any rational thoughts about the importance of the quality of my work. By June 2017 (three months later), and despite advertising at two charitable counselling organisations, on a counselling website, via social media, and via word of mouth (appendices 3,4,5,6), I had failed to find a co-researcher. I felt forced to change my research topic. By this time, I had met with two MIP colleagues and assisted them with their own research proposals when they told me they felt ‘stuck’. I felt frustrated at having to consider a new research project, and I noticed a sense of resentment that by helping my colleagues with their proposals, they were now ‘ahead of me’ and I was angry with myself for having helped them. This anger was immediately followed by a deep sense of guilt and shame for having these thoughts and feelings about my colleagues, with whom I had developed close relationships. (Reflection 1).
Following a personal experience in June 2017 which affected me both personally and professionally, I changed direction and decided to research the lived-in experience of a counsellor’s relationship with God and how that relationship is experienced in the therapy room when working with clients, and I submitted a further research proposal (appendix 7), which was approved (appendix 8). I hope what follows will enable the reader to understand this change of direction.
In June 2017 I was a participant with seventeen others on a five-day workshop delivered by Richard Erskine, Ph.D., American Integrative Psychotherapist, (Erskine, 2017) (appendix 9). Erskine had split the participants into small groups, inviting one group at a time to sit on the floor looking into the eyes of each group member in turn, and talking about the felt experience. It seemed such a simple activity, yet I felt tears stinging my eyes and sobs deep in my core, which I only just managed to supress (Reflection 2). The lady sitting next to me (referred to in this paper as Jane), discreetly held out her hand to me palm upwards, and looked into my eyes, smiling. The impact of the gesture, the invite to take her hand, resulted in a feeling of safety and security, and my fear immediately subsided, and I felt calm. When I thanked Jane for ‘saving me’ from my perceived humiliation, she said that God had told her to reach out to me. She said she was a counsellor and a practicing Christian (not a Christian counsellor, she hastened to add), and she explained that God was always with her and helped her both in her personal life and in her professional life as a counsellor, in the therapy room.
In that moment I had a sense of intrigue about the impact I perceived of how it would feel to have ‘someone’ watching over me, guiding me, loving me (Reflection 3). The aim of this research, therefore, is to determine how a counsellor’s sense of self may be impacted upon by their relationship with God, the presence of God in the therapy room, and how that might impact on the client.
Many people have a relationship with God, and different religions have differing beliefs about who God is. This research paper is not concerned with God based on any particular religion, rather the experience or awareness of one’s relationship with God in the therapy room. It is not my intention therefore to delve into any particular religious belief, but rather to consider God in general terms, i.e. the ‘idea’ of God; the creator of the Earth and everything natural which exists, and an immortal ‘being’. However, within the following pages, I do refer to ‘Christian’ or ‘Christianity’, because a) Jane is a Christian and, b) because I recognised in Jane’s narrative that it was important to her that I understood the difference between a practicing Christian who works as a counsellor (as Jane does), and a Christian counsellor (which Jane is not).
- Literature review
A brief history of religion in psychotherapy
Sigmund Freud, the father of psychotherapy, wrote about religion that it was, “comparable to a childhood neurosis” (Freud, 1927), “infantile” and “humiliating” (Freud, 1930), and he said “…it is painful to think that the great majority of mortals will never be able to rise above this view of life” (Freud, 1963:11).
Carl Jung, a Swiss analytical psychologist and psychiatrist, and an early supporter of Freud because of their shared interest in the unconscious, said “Among my patients in the second half of life – that is over 35 years of age – there has not been a single one whose problem has not been in the last resort that of finding a religious outlook on life” (Jung, 1933: 164).
In 1964, Humanist psychologist Abraham Maslow published Religions, Values, and Peak-Experiences, in which he argued that spirituality was “well within the jurisdiction of a suitably enlarged science,” and thus fair game for psychologists (Maslow, 1964).
By 1980, Carl Rogers, arguably one of the most influential humanistic psychologists of the 20th century said “Our experiences in therapy and in groups, it is clear, involve the transcendent the indescribable, the spiritual. I am compelled to believe that I, like many others, have underestimated the importance of this mystical, spiritual dimension” (Rogers, 1980).
I wanted to find out what had been written before about how a relationship with God might influence a counsellor in the therapy room and how this in turn could impact the client. In order to do that I firstly wanted to understand how the counsellor’s relationship with God affected their sense of self. If I could do that from a Transactional Analysis (TA) perspective, so much the better, as this would fit with my psychotherapy training. I know the reader will understand my utter frustration when, as I started my literature review, I found that the Transactional Analysis Journal theme issue for May 2018 (the month after my research deadline) was to be entitled: “Transactional Analysis and Existential Perspectives: Religion, Faith, Spirituality, and Beyond”! Oh, to have had an extension of one month for my research but I did not feel this warranted a ‘mitigating circumstance’ – I digress:
From the writings of Eric Berne, seminal author and founder of Transactional Analysis (Berne, 1961), it is widely understood by those familiar with TA that people are psychologically structured according to three distinct ego states; Parent, Adult, and Child, (known as the PAC model), and that a whole healthy personality, is attained through good integration of each of the ego states, giving us our sense of self.
According to Murphree (1976), many Christians have been impressed with TA, yet when trying to apply its principles they have noticed something missing from Berne’s PAC model. Murphree therefore adds a fourth dimension, which involves a personal relationship with God chosen by the Adult. Murphree’s work is biased because he is a clergyman, theology educator, and ordained to the ministry Methodist Church, and the book is written with the Inter-varsity Christian Fellowship of the USA. I was unable to establish if Murphree is or was a counsellor. However, the book does demonstrate the teaching that without God, one is not OK, referencing scriptures in the bible. This mirrors Jane’s narrative. The reference to OK in this context is taken from I’m OK – You’re OK (Harris, 1969), and is one of the fundamental philosophical assumptions of TA. ‘People are Okay’ is a statement of essence rather than behaviour. It means that each of us has worth, value, and dignity as human beings and deserves to be treated accordingly. Murphree believes that an individual cannot obtain a harmonious whole personality by integrating Parent Adult and Child without God. He reinforces this belief with the following opinions:
- The Child will either ‘sell out’ to the Parent. This may bring some peace, however Murphree suggests it is the peace of surrender rather than that of victory, leaving the Child “smothered in guilt”, and “strait-jacketed”
- The Adult will surrender to the Child, who without God is not-OK. With a not-OK Child, the Adult will search for peace, using power and superiority to obtain OKness. Any adult relationship will then be contaminated by one-upmanship, i.e. I’m Ok – You’re not Ok.
- The Adult will bring both the Parent and Child into harmony with Adult decisions. Murphree’s criticism of this solution is that “the Adult is not equipped to preside over Parent and Child without a relationship with God”.
Murphree’s alternative suggestion is to obtain harmony in an integrated self by developing a personal relationship with God, resulting in a “new truth data for conscience content” in the Parent; “security of importance in the universe” (e.g. OKness), for the Child, and “a freedom from contamination by the Parent and Child” for the Adult.
In Jane’s narrative, she emphasised that she was a counsellor who was a Christian and not a Christian counsellor, and she described her training as secular (CR33). I needed therefore to understand the difference. According to the English Oxford Living Dictionaries (accessed online, March 2018), the definition of ‘Secular’, is: “Not connected with religious or spiritual matters”.
In her article ‘Biblical Counseling vs. Secular Counseling’ (Jones, 2006), Patricia Jones, American pastoral counsellor and psychotherapist, criticizes secular psychotherapy as being based on man solving his own problems without considering any external resources and without addressing the spirituality of humans. She compares this with authentic biblical counselling which she says is based on the teachings of the bible and a belief in God as our creator; believing that God can ‘fix’ all man’s problems. She further suggests that all dysfunctional problems faced by individuals or families are related to someone’s sin, and that trying to solve issues without including God will result in failure. Finally, Jones talks about integrated Christian counselling as being somewhere between the biblical and the secular, describing such counsellors as “good Christian people who have taken their secular degrees and training and “integrated” them with scripture and prayer as they apply them to counseling”. Jones criticizes the integrated model as she believes these counsellors have a limited knowledge of scripture, and she suggests “most of their counselling is secular… with an occasional bible verse thrown in for good measure”.
Contrary to Jones’s claims about secular therapists, many mainstream counsellors are now more than ready to work with the spiritual dimension of clients by integrating spiritual resources, e.g. prayer (Pargament, 2007; [i]West, 2004, 2000), although it is argued by many others that use of prayer in counselling can interrupt the counselling process and cause tensions and ethical issues (Gubi, 2004, 2007, 2008; Magaletta & Brawer,1998; Rose, 2002; Tan, 1996; Ten Eyck, 1993; Webster, 1992; Weld & Eriksen 2007). This was cited in a research article by Peter Gubi (2009) entitled: ‘A qualitative exploration into how the use of prayer in counselling and psychotherapy might be ethically problematic’. Gubi’s research was undertaken by interviewing 19 BACP (British Association of Counselling and Psychotherapy) accredited counsellors who were identified as using overt and covert prayer in their counselling work from a survey or 578 BACP accredited counsellors and 122 CMCS (Churches Ministerial Counselling Service) approved counsellors. Ethical issues raised included: a power-dynamic change in the client-therapist relationship, imposing one’s views onto the client, and unrealistically praying for miracles. Conversely there were reports of clients feeling they had got more for their money and counsellors reporting a greater mutuality and intimacy with clients.
One particular participant had a complaint lodged against them to their professional body for suggesting prayer to a client. The professional body upheld the complaint and deemed the practice as ‘unacceptable and unethical’. This could leave therapists drawing the conclusion that it is safer not to explore religion or spirituality with their clients, rather than risk ‘getting it wrong’, particularly as Gubi recognised a risk of unhealthy transference or insecure religious attachment. Although Gubi’s research suggested that there was evidence to suggest that prayer has no place in ethical practice, he also acknowledged that the research was based on the experience of counsellors and that without the voice of the client, the value of prayer in the therapy room could not be truly determined.
In her article ‘Psychotherapy and Spirituality’ American psychotherapist Rebecca Trautmann (2003), expressed that many people (both therapists and clients) find it difficult to talk about their spirituality, each perhaps waiting for the other to bring it up in the therapy room, rather than being the one to initiate; or, that at best the therapist might address it only if its relevance becomes apparent to the clients overall psychological and social functioning. However, she went on to reinforce the essence of counselling – that the best therapeutic relationship is the one in which people bring every dimension of their whole selves to the relationship, expecting they will be understood, and that through the process of therapy will undergo some ‘healing’. Trautmann also gave examples of clients she had worked with who had undergone transformational change due to being able to heal from experiences related to their religious backgrounds, and she also pointed out that a psychotherapist might be the first (or only) person to ever hear or respond to the clients religious or spiritual needs.
My research was based on the lived-in experience of one person, and there was no data set in regards to age or gender. However, due to the nature of the study, the subject needed to have emotional and social maturity, to be a counsellor, and to have experienced a relationship with God.
Whilst I appreciate my co-researcher was not selected at random, (albeit from a random meeting as noted in the introduction), our contact was minimal and we did not have any relationship either prior to or following this research. My co-researcher was a female in her mid-fifties and married with no children. I invited her to use a pseudonym during the interview and I will at no time refer to her other than with that pseudonym (Jane), to protect her identity.
I asked Jane if she would assist me with my research project, and she was eager to do so, stating it would be a privilege to tell me about her experience of the impact of her relationship with God in her role as a therapeutic counsellor.
I prepared her for the role of co-researcher by providing brief information about the research before the interview. I advised her that by the nature of phenomenological enquiry, feelings might be evoked which she could find uncomfortable, or which she may want to discuss with me post-interview.
I obtained Jane’s written consent for the interview, its transcript and data to be used and shared with Manchester Institute for Psychotherapy (MIP), my clinical supervisor and marking tutor (appendix 9). I also provided her with an opportunity to withdraw her consent up to a month before the research submission should she wish to do so. I aligned my research to the UKCP Ethical Principles and Code of Professional Conduct (2009), and on the day of the interview I provided Jane with assurance of confidentiality. I advised that the recording of the interview would be safely stored and would be erased following the marking of the research paper. Jane was invited to see a copy of the completed work should she wish to do so.
There are similarities between me and the co-researcher. I am female in my 50’s and a counsellor. To ensure no personal bias, it was important that I reflected on my own childhood experience of God (Reflection 4). In my adult life I have worked as a Nurse and have been present in the last hours/days of hundreds of people, with many dying whilst I have been holding their hand. I have always been struck by the reaction of those who had a relationship with God, which has hovered between fear and peace at the end of their lives. I interpret this contrast as the difference between parental and cultural introjects i.e. ‘the Fear of God’ or ‘the Love of God’. I do not currently have any conscious relationship with God and I do not have any judgement of those that do, so far as I am aware.
The interview with my co-researcher was not as easy as I anticipated. I chose to conduct it at MIP, however the room I was allocated was the one I normally worked in with my low-cost clients, so I opted to use another room for reasons of neutrality. It was the hottest day of the year thus far (30 degrees Celsius) and both the co-researcher and I were uncomfortable and perspiring throughout the interview. I opened a window but the traffic noise was overpowering so this was not an option. I had to stop the tape at one point, as we were interrupted by someone who didn’t know we were in the room (I had forgotten to inform the administration staff that I had moved rooms). I asked open non-directive questions as much as possible (Reflection 5).
I recorded the interview on a small handheld Dictaphone which, by mutual agreement, I put out of sight so Jane could speak without the visual reminder that she was being recorded. I didn’t want her to feel she needed to regulate what she said and my concern was that the sight of the Dictaphone might illicit this adaptive behaviour.
Immediately after the interview I offered Jane a de-brief which she declined. As we knew we were unlikely to meet again (living at opposite ends of the country), we went out for a short lunch together. This provided an opportunity for me to satisfy myself that Jane was not ‘triggered’ by the interview and she seemed well-grounded. I did however, offer a one-off welfare telephone call three weeks later to provide a further opportunity to discuss any impact the interview might have had on her. Jane thanked me, but again declined, stating that if she needed to discuss anything, she would do so with God.
I analysed the data using a phenomenological approach to qualitative analysis which puts the individual’s experience first, seeking to understand the data from the perspective of the individual (Finlay, 2011). This also mirrors the way I work in my psychotherapy practice. The data can be viewed as co-created because the co-researcher shares personal experience in response to the researchers prompts, questions and reflection. Where possible, I have kept the research clear and jargon-free, as suggested by Finlay and Evans, (2009) to ensure it is accessible to a wide reader audience.
For the interview, it was important to me to use a relational approach rather than relying on facts and figures, in order to gain a deeper understanding, and identify meaningful interpretation of how a person feels, thinks, and behaves as a therapist when they take their relationship with God into the therapy room with them. For this reason, I chose not to structure the interview, nor to provide Jane with a set of pre-prepared questions, to ensure her experience was not directed by me. However, I did have an overarching idea of what I hoped to find out from the interview. This was:
- Whether God affected the counsellor’s belief of Self in the therapy room
- What effect God’s omnipotence had on the counsellor’s ego states (using the PAC Model)
I did have five further questions prepared in case the interview “dried up”. However, I did not require these as Jane was very talkative.
I started transcribing the interview with headphones plugged into the Dictaphone, stopping and starting the recorder, whilst typing the transcript on to my laptop. Often, when I pressed play after a brief pause to type, the tape went back to the beginning and I found it difficult to find the place to resume the tape, so would listen to the whole thing again before picking up where I had left off. I found the process extremely frustrating and time-consuming as it took me over an hour to transcribe just the first nine minutes of the tape (Reflection 6).
Eventually, one of my MIP colleagues recommended a transcription service at a cost of £1 per minute. I sent my recording via an encrypted and confidential external mailbox. The following day it was returned, neatly typed up with an invoice for £50. However, I had lost the benefit of the disfluencies (uhm’s and ah’s). I listened to the tape numerous times to rectify this and to recognise the silences, tone of voice, and complementary and crossed transactions, making notes as I went along (Reflection 7).
- Self-Care and Mapping Themes
To produce a good piece of research, keep motivated and stay focused, I recognised my own self-care was important (particularly as I had omitted self-care from my initial research proposal and had to be reminded by my tutor to include it) (Reflection 8). I invited two MIP colleagues to spend the weekend with me. We sat together in my garden, eating, drinking and swapping ideas in the sunshine, based on our individual strengths and weaknesses. This collaborative relational approach to the planning stage provided me with a positive image to visualise whenever my motivation was waning, as it did from time to time and particularly during the literature review section. Twice, my colleagues and I abandoned our work to take long beach walks to clear our heads and re-focus. I found these distractions to be most welcome, and also noticed that when I stepped away from the project, my ‘back burner’ switched on, and I could think more clearly. A couple of times, I felt my internal saboteur so strongly that I found myself doing all the jobs I had been putting off for ages, in preference to completing my research, so great was my fear of failure. In fact, during this period I accessed my creative brain more than I have done in my recent history, painting pebbles I had collected from the beach, writing a 6 minute a day gratitude diary, and even putting time and effort into writing three psychotherapy poems (appendices 11 & 12). All these distractions were more appealing to my inner child than concentrating on the one thing that was most important to me! One of my colleagues bought me a beautiful scrapbook for Christmas, and I bought myself some nice coloured pens. I then highlighted texts within my transcript where I recognised recurring themes, cut them out and stuck them in my scrap book. I noticed two recurring themes from the interview transcript which I decided to concentrate my findings on.
The two recurring themes which occurred to me from Jane’s narrative were:
- God’s influence on Ego State
- Discount of Self
- God’s influence on Ego State
This paper is written on the assumption that the reader is familiar with ego states and ego-state diagnosis (Berne, 1961). To diagnose the ego states of the co-researcher, I used identifying clues from the four elements of ego state diagnosis: Behavioural, Social, Historical, and Phenomenological Diagnoses, and matched these to functional rather than structural analysis, in order to understand the impact on Jane.
Thinking of God as a cultural parent, I recognised that Jane spoke of God sometimes in a way which indicated him as a critical controlling Parent and sometimes as a nurturing Parent, for example:
Critical Controlling Parent (functional PAC model)
CR18 – I was kicked by God
CR19 – He said I’m fed up with you faffing about
CR21 – He kicked me into being a Christian
When I asked Jane if God could sometimes be experienced as a controlling Parent, she said ‘He is the most AMAZING, loving person ever’. Jane closed her eyes and in a childlike voice, clearly emotional, said ‘Jesus is THE counsellor and THE teacher (CR63). Thinking of ego state diagnosis, I interpreted this as Jane being in a Child ego state (adapted Child), with God as the idealised Parent. She also indicated how she perceived God as a positive nurturing Parent:
Positive Nurturing Parent
CR2 – God is my biggest support
CR26 – God has enabled me
CR28 – Just knowing he is there
Adult Ego State
Throughout the interview, Jane referenced her theoretical training at various points, both in terms of her biblical training (with references from the bible), and her psychotherapy training as she talked about her own personal therapy, her clinical supervision, and workshops she had attended with well-reputed psychotherapists. I noted when listening back to her narrative, that most of these offerings of theoretical knowledge appeared to be made when I asked Jane how she felt about something. I did question whether this was indicative of a defence mechanism, a distraction from her feelings, her way of ‘keeping me out’, in which case I have to question whether it was indeed her Adult ego state engaged, or a ‘Be Strong’ driver in her P1 (the little professor part of her Child ego state; i.e. the Parent in the Child).
When Jane talked about having her supervisor in her head (C58), I was keen to understand whether she perceived the supervisor as God or her own clinical supervisor (R60, R61). She said she had never thought about that – then after a short pause, she said it was a combination of God and her learning.
There was better evidence of her Adult ego state when she talked about ethical boundaries and disclosure (CR93-CR99), and she confirmed that she uses clients curiosity (for example about her wearing a cross around her neck) to explore the reason for their question and what that might mean to them, evidencing that her counselling work is based on a relational approach, using the co-created relationship of therapist and client to help the client understand their unconscious processes.
Child Ego State
When Jane talked about a time when she felt stuck with a client, she explained how she had turned to God for help in the therapy room. As she recalled the event, her speech got faster and faster and there was a sound of urgency and desperation in her voice, almost fearful like a child pleading with a parent, as she recounted:
CR58 – IN MY HEAD, I’m going “come Holy Spirit, come Holy Spirit, Jesus help me, for goodness sake, Jesus help me. I need you here right now, fill this space, Holy Spirit”
There was other evidence of Jane’s Child ego state, in the following elements of her narrative:
Adapted Child (functional)
CR30 – I would go where God took me
CR32 – What does God actually want?
CR50 – It’s God working through me
CR52 – The more experience I get, the more comfortable I am in the space – that’s who God makes me (discounts self)
- Discount of Self
Jane said on a number of occasions that if she had not had a relationship with God, she was certain she would not be a counsellor, even going as far as saying her training was more or less a tick box exercise, so strong was her trust in God to guide her the right way. Using the analogy of a boat on the sea (God being the sea and Jane being the boat), she said she would let God guide her in the therapy room, and she would go where he wanted her to go. Prayer before each session was clearly important to her, to ask God to bring love to her and her client. She also referenced a time when she had forgotten to pray before a session, resulting in an internal dialogue with God in the therapy room, in which she apologised to him and asked him to be there for her (CR129).
Although Jane described her training as secular, she also implied in her narrative that the Holy Spirit works through her (CR58); a statement more fitting to Christian counselling. According to the Mimosa Christian Counselling Centre (2018), secular counselling believes that the client is self-empowered and responsible for the changes they need to make, whereas Christian counselling believes that the Holy Spirit works through the counsellor, to facilitate changes which will be more pervasive as a result. I interpret this as a discount of the counsellor, which Jane confirms in her narrative when she appears to not take responsibility for some of the things she says in the therapy room, for example:
CR39-CR41 – things come out of my mouth … ‘that’s not me’. It didn’t come from me… CR41 – and I know it’s come from God.
CR42 – I will prepare and pray
CR44 – I will ask the Holy Spirit to come because I am his vessel
Jane went on and sounded excited as she continued…
CR45 – There’s a part of me that thinks I don’t do anything. I just go into the room and I’m his vessel and it’s nothing to do with me.
I noticed that I felt a little uncomfortable at that statement (reflection 9) and at that precise moment we were interrupted by voices outside the interview room which disturbed the flow of Jane’s narrative, so I asked her to carry on where she had left off. She continued (confirming the reason for my discomfort), as she said that some people might think it’s dangerous. She argued that she herself didn’t think it was so because, as she said, she had the theory behind her (CR49).
Further discounting of her own counselling ability continued:
CR50 – But it’s not me. I think it’s God working through me
CR53 – Before each session I ask for God’s support to help me and guide me, to keep us safe, to guide my client.
CR59 – Something will come out of my mouth and I will think ‘where’s that come from’?
Jane wore a sizable cross on a chain around her neck. She stroked it as she told me that her clients sometimes notice she wears it and might comment on it. She said “they do notice I wear a cross and sometimes they will…” then immediately Jane appeared to retract the statement and contradict herself, by saying “they’ve never actually asked me”, almost as if she regretted the previous statement. I wondered if Jane was questioning her ethics. I had given this some thought myself, as I was aware, when reading the interview notes, of my own inner critic questioning the ethics of overtly wearing a cross on a chain in the therapy room. After all, I could not imagine a therapist wearing a Manchester United shirt or a tee shirt with “I voted Brexit” on the front, and I wondered if this was really any different. I was surprised that I was unable to find anything in the ethical code about dress code in the therapy room. Certainly, when I was a student nurse in the early 1990’s it had been part of my code of conduct that in order to be an exemplary role model in society, I must always be seen as non-judgemental and with no personal bias, and for that reason should not wear clothing with any political or religious slogans, and nor must I publicly declare any particular persuasion. I was surprised that the same did not appear to extend to counsellors and psychotherapists. I note in regards to projection, the UKCP code of professional conduct
acknowledges in the therapist that: “their professional and personal conduct may have both positive and negative effects on the way they are experienced by a client and that the psychotherapist undertakes, in a continuing process, to critically examine the impact these effects may have on the psychotherapeutic relationship with any client, placing a priority on preserving the client’s psychotherapeutic best interests”.
I was pleased to see that when Jane talked about clients noticing the cross around her neck, she said she would use it to explore their curiosity. Much of the research is conflictive about whether addressing spirituality in therapy is helpful or unhelpful, and how difficult the therapist may find it to approach this subject. A 2015 study in America looked at the anonymous responses from 422 licensed clinical social workers’ (LCSWs’) in response to an online administration of a Religious/Spiritually Integrated Practice Assessment. The study found 80% believed that discussing clients’ religious and spiritual views would be valuable to the therapeutic process, yet only a minority of clinicians end up doing so in practice (Oxhandler, Parrish, Torres & Achenbaum, 2015). There were however, two variables which were identified as significant predictors toward integrating clients’ religion and spirituality in practice: practitioners’ intrinsic religiosity and prior training.
It is my belief that by not talking about religion and spirituality, we risk sending a message to clients to whom it is deeply meaningful, that it is unwelcome or off-limits. I think that overtly engaging in an authentic dialogue about what religion and spirituality means to the client, provides a good honest base for ‘permission’ to explore, rather than running the risk of perceived ‘denial’. By wearing a cross, Jane invites a curiosity which a client may or may not choose to bring into the therapy room (either verbally or through body language – e.g. looking at the cross, and facial expression when doing so). It could be argued that this provides an opportunity for a relational approach, in which to explore what it means to the client, whilst keeping Jane’s own connected relationship with God, and working in the co-created relationship. However, this relies on the client raising the issue in response to Jane’s cross.
I am left with a discomfort about Jane’s idealisation of her omnipotent relationship with God, especially in regards to her apparent discounting of herself in the therapy room and her relationship with her clients. This discomfort is balanced in part with the knowledge that Jane’s husband is not a Christian and therefore I am aware that Jane can accept the uniqueness of her spiritual relationship, and that not everyone shares this experience. I expect therefore, that this is reflected in her client work. However, I would advocate that all therapists discuss religion and spirituality (relationship with God) with their clinical supervisors and explore what this means to each of them, to ensure that clinical supervision remains non-biased in order to protect the views of the therapist, and the safety of the client.
I am grateful for having undertaken this research because it has enabled me to reflect on my own practice and my unpreparedness for responding to issues raised about religion and spirituality in the therapy room. Here are some recent examples of how spiritual issues have arisen in my own therapy practice:
- A man in his 70’s who has suffered from long-term depression believing that God is punishing him for things he has done wrong – he remembers being told as a young boy at communion that if he was not ‘good’ he would go to Hell.
- A young lady whose husband has recently died by suicide was struggling with her Christian faith, questioning how God could let this happen.
- A young woman from a Muslim family was finding it hard to reconcile her western lifestyle with her husband’s desire to take a second wife.
This brief research has helped me to understand how spirituality and relationship with God might influence a counsellor in the therapy room. However, it also leaves me with a thirst to research what the experience is like from the client’s perspective.
Some people’s personal development (whether therapist or client) may be limited by oppressive religious beliefs. Others may find their beliefs to be a great source of comfort (as in Jane’s case). Without exploration, the therapist will not know which of these (if any) are relevant to the client. If either party (client or therapist) feel they have to leave the spiritual part of themselves outside the therapy room, this could have a negative impact on the authenticity of the therapeutic relationship.
If a therapist does have strong religious or spiritual beliefs, it is almost certain to inform the way they view the world and will therefore be taken into the therapy room as part of themselves, whether consciously or unconsciously. Therefore, to deny the client the invitation to also explore this in the co-created relationship could be viewed as creating a power-over dynamic.
What has become apparent through my research is the difficulty which both therapist and client may face in raising the issue of religion and spirituality. As if to emphasise this, I make the following observations:
- I learned only due to talking about the cases described in the ‘discussion’ section of this paper, that my own clinical supervisor of two years is the daughter of an Anglican Vicar.
- I learned only when talking about my anxiety about completing my research project, that my own personal therapist of four years is a practicing Christian.
Neither my clinical supervisor nor my personal psychotherapist had previously explored what religion or spirituality meant to me and nor had they disclosed their own faith. It is for this reason that I conclude my research by acknowledging that many guiding theories don’t incorporate religious belief, and many therapists get very little training in how to address spirituality compared with for example, anxiety, bereavement, marital conflict, etc., which leaves therapists to make their own assumptions of what is or is not acceptable, with perhaps sometimes dangerous or diminishing consequences.
This conclusion has led me to a decision that part of my rapport-building with clients going forward will include exploring faith issues with them, in the context of the therapeutic relationship. This will empower clients who have strong religious or spiritual beliefs (positive or oppressive), to feel able to bring that part of themselves into the therapy room. It will also enable clients to make an informed decision to work with me in the relationship, where they can choose to explore the meaning of their faith in relation to issues brought to therapy, or to decide that I am not the right therapist for them, and to seek therapy which fits with their faith, including for example, Christian counselling using the Bible as a tool for understanding and addressing the client’s issues or a Muslim approach counselling developed at the Markfield Institute in Leicestershire, which incorporates the values of Islam.
For my part, I intend to get to know more about myself in relation to my own spirituality through further personal reflection, therapy and clinical supervision. I will also learn more about the major religions and human spirituality so that I have a greater understanding of how these may affect a person’s life. However, I also recognise that me having more knowledge could potentially unconsciously reinforce clients’ religious scripts, (i.e. accepting my own knowledge base without exploring the client’s truth). To this end, I will also be mindful not to use my knowledge to jump to conclusions, but rather as a background base from which to use phenomenological enquiry to understand the lived-in experience of all my clients.
- Project Proposal – On reflection, I recognise that at school I used to share ideas with classmates who would use my ideas in their written essays and obtain A’s in their work, whilst I was too lazy to convert my thoughts into written work and would often get marks of C’s or D’s. My anger towards my colleagues was related to jealousy. Today, I recognise that sharing ideas and asking others for help usually results in better outcomes, yet in my anxious state when I failed to identify a co-researcher, I had gone into a Child Ego state and experienced archaic feelings. As soon as I had identified a new research project, my spirits were lifted as I had a sense of being ‘back in the race’.
- Erskine Workshop – I was astonished that when I was asked to look into the eyes of individual members of a new group, I felt an overwhelming fear. Of what, I was not sure – I now think fear of intimacy. I think this was a racket feeling covering sadness, evolved from a ‘don’t be close’ injunction. I was clearly in a very early Child ego state (possibly pre-verbal).
- Jane taking my hand – I recognise on reflection, this links to my own unmet relational need for security and to be loved.
- Awareness of possible researcher bias – Prior to my birth, my parents had met at Church as they were both Sunday School teachers. I remember as a young girl feeling forced to go to church every Sunday and doing so reluctantly. As I got older (perhaps about age seven) my parents stopped going to church (I think I overheard my father stating he was Agnostic). Whatever the reason, I stopped going too. I do accept there may be a projected ‘falling out with God’ from my father but I am not consciously aware that this is the case. Later, as a young housewife and mother living in a new area, I took a few bible studies with a visiting Jehovah’s Witness which I found helpful as I was otherwise isolated. I remember feeling a sense of belonging as a result of these studies. However, I remember being told that God would not approve of me returning to work and I felt angry, perceiving criticism for putting financial gain (income) above the care of my young child. I am aware this could be perceived as a repeated pattern of me ‘falling out’ with God. Again, I am not consciously aware that this is the case.
- Interview – On replaying the tape, I was disappointed at the quality of my interviewing and I recognised that I did not use as much phenomenological enquiry as I intended to, possibly due to environmental discomfort and the fact that I was also trying to manage menopausal symptoms of hot flushes. My internal process was “I should have asked that”; “why didn’t I ask that”; “aren’t I stupid for not thinking about the other”. I recognise this as an injunction ‘Don’t be Important’, counter-balanced by ‘Try Hard’ and ‘Be Perfect’ drivers to overcome a ‘not good enough’ introject. I also recognised that I used some leading questions (e.g. R83) and some unhelpful closed questions. I found myself agreeing with some things Jane said, and reflecting that back to her, when in reality I did not feel that. I recognise this as incongruence, and on reflection I wonder if this is something to do with my own “fear of God”. I have contracted with my personal therapist to explore this further.
- Transcription 1 – My frustration and my feelings of incompetence were so bad at the length of time it took me to transcribe, that I was almost literally beating myself up! I sunk into a depression and decided that I was not good enough. I took to my bed for two days, ate what felt like the contents of my house, and considered how I should go about withdrawing from the course. One of my colleagues reached out to me during this time and my response to her asking about my well-being was “yes I’m fine”. I could not have been any less fine, and this demonstrated the power of my ‘Be strong’ driver.
- Transcription 2 – I found it uncomfortable listening to the tape and my focus was initially on my own voice (self-criticism “why didn’t I say this, do that, ask the other, etc”. It took many attempts before I was able to really involve myself in Jane’s narrative and hear her subjective experience, remembering her body language as my memory replayed the date and time of the interview.
- Self-Care – I remember laughing when my tutor returned my proposal to me reminding me to include how I would manage my self-care. This was an area I had been working on in my personal therapy sessions because in my employment history I was a workaholic, never switching off, so I had consciously contracted to consider my self-care in every project. I realized this needed my closer attention and regular reflexivity.
- Analysis (discount of self) – I recall feeling uncomfortable when Jane said she doesn’t do anything, just sits in the therapy room and lets God work through her. I remember thinking “God, that sounds dangerous”. It was interesting to me that I used the word God, as though I too was speaking directly to him. I am aware that in the past I used to use the word ‘GOD’ in my speech without being consciously aware and I had brought this to my awareness and consciously changed my language over a number of years, so it was interesting to me on this occasion that I used it. I felt that I wanted to challenge Jane and I wonder if she had picked this up through my body language, because her next sentence was as if she had read my mind, as she said “some people may think it’s dangerous”. I remember feeling judgemental and thinking, “she should not be counselling – this is unethical”. As I write this, I am also aware that if Jane chooses to see a copy of my research, that I want to have a preparative conversation with Jane beforehand, as this may have a undesirable impact on her.
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