THE COUNTER TRANSFERENCE OF RISK WORKING THROUGH ANXIETIES

THE COUNTER TRANSFERENCE OF RISK: WORKING THROUGH ANXIETIES Bridget Mc. Connell (MBACP)

WHO AM I? Bridget Mc. Connell, BA (HONS), (MBACP). School counsellor in an independent boarding school (ages 11 -18) Worked a variety of youth counselling settings Adult and youth counsellor in private practice Lecturer in counselling Mother to 2 teenage boys From a holistic health background

RISK AND YOUNG PEOPLE Working with young people: Spontaneous, exciting, varied and rewarding. . . also, scary, disempowering and alarming! • Risk taking in is part of growing up – moving towards unfamiliar (dopamine) • This age can be evocative of own histories – our own inner teen.

AIMS FOR TODAY Interactive Personal and Professional Development Workshop Key aim: To feel grounded and calm in response to risk scenarios with young people - more able to maintain relational depth and provide containment. 1. Explore risk in various different contexts, identify specific pressures 2. Gain awareness of countertransference and impact on the relationship 3. Learn techniques to help process this

SAFE SPACE BOUNDARIES • Confidentiality (case work) • Only participate if comfortable to • Experience pool • Bring what you can manage in this setting

DEFINING COUNTER TRANSFERENCE “Awesomely complex……our unconscious reactions to another person’s unconscious reactions. ” (Norcross, 2011) Defensive, reactive and embodied countertransference (Clarkson, Rowan) Today’s workshop focuses on any ‘felt sense’ arising from work with risk.

WHAT IS RISK? Risk is integral to life – can you name a risk free situation? Think of a risk situation in your work with young people - talk with your neighbor about it briefly. • What was the risk? • How did you manage it? My varied risk tolerances in different settings….

Write down an intention for yourself…

MULTI-DIMENSIONAL RISK Many factors influence our responses to risk… Personal (practitioner) Professional relationship Culture/gender difference (adapted from Reeves, 2015) Contextual/ organizational Behavioral/ situational (young person) These factors either support or put pressure on therapeutic relationship

GROUP WORK (PART 1) Personal/ Practitioner Self as resource Own histories Support network Self care Values and beliefs Vicarious trauma Young Person Situation/ Behaviors At risk or risk taking Abusive Academic risk Drugs/alcohol Self harm or suicidal Sexual risk Social media Context/ Organization Policies/ procedures Private practice Counselling organization School/college Supportive? (adapted from Reeves, 2015) Professional Training/ CPD Reputation Experience Supervision Ethics Culture/ Difference Gender Age client ~ counsellor Ethnicity Class In groups discuss risk case example What pressures or support were present?

RISKS OF HIGH PRESSURE/ LOW SUPPORT • Risk assessing or absolving practitioner anxiety? • Well being/ safe plan or “over to you…” • ‘Hot potato’ effect of referral • Schools and institutions may see counselling as ‘tick box’ (and – and, not and - or) Blame Culture Can be fear inducing or even shaming for therapist Causes a disconnect in the relationship

VICARIOUS TRAUMA AND BURN OUT Therapists’ at risk… • Empathising with traumatic material impacts our ANS • Too many pressures and insufficient support exacerbate this risk • The self as a resource is depleted – compassion fatigue • The client is at risk through disconnection

POSITIVE RISK – REMAINING RELATIONAL Young peoples’ behaviors asks… “Can you connect with me, even when I present a risk…? ” “Staying vulnerable is a risk we have to take if we want to experience connection. ” (Brene Brown) When asked, “what facilitates relational depth? ” therapists respond… “. . . the act of taking a risk with their clients” (Cooper, 2004)

RELATIONAL RISK ASSESSMENT • Connects through distress • Engages client autonomy wherever possible • Gives opportunities to learn self-care (comfort list) • Puts them in touch with resilience factors and support network • Therapist responsible to, not for clients’ wellbeing

GROUP WORK (PART 2) Case example: What were you feeling, thinking or doing – identifying counter transference? • Feelings and emotions • Beliefs and attitudes • Motives and drivers • Patterns of relating, ‘knee jerk’ reactions

EMBODIED COUNTER-TRANSFERENCE • Kinesthetic responses to client material • Counter-transference experienced physically in the body through atmospheres and contextual cues (Samuels) • ”An internal aura that encompasses everything you feel and know…” (Gendlin) • The Body Keeps the Score (Van Der Kolk)

EMBODIED COUNTERTRANSFERENCE INDIVIDUAL EXERCISE Notice: • Sensations you feel in your body (hot, cold, achy, stiff, tingles etc. ) • Visual or auditory images that arise (pictures, colours, sounds, music) • Movement or muscular impulses in your body (head turning, legs tense, hands, heavy chest etc. ) • How you feel emotionally (sad, irritated, happy, angry, anxious, scared, disgusted etc. ) • Any thoughts that occur (Rothschild, 2006)

COUNTER TRANSFERENCE REACTIONS AND RELATIONSHIPS Co-created relationship Flowing dialogic relationship

INTERPERSONAL NEURO-BIOLOGY • Mirror neurons convey unconscious messages via somatic empathy • ‘Contagious laughter and yawning’ cited as an examples of this (Platek, 2003) • Naming feelings is intellectual, emotional affect is a physical phenomenon – somatic markers (Damsio, 1994) • Subtle observable characteristics of feeling states are unconsciously mirrored via inter- subjective dialogue.

CONSCIOUS POSTURAL MIRRORING EXERCISE Pair work – A & B (choose low key feeling, not highly emotive) • Sit opposite each other at a comfortable angle – adopt neutral body language • A - bring your scenario to mind and slowly adopt body, breathing and posture accordingly • B – notice and gently mirror the posture, eye contact and breathing • A & B silently notice what arises in you for a minute or so • A & B Consciously de-mirror by changing your posture breathing back to neutral/ relaxed • Share feedback sensitively – SWAP (Rothschild, 2006)

MANAGING COUNTER-TRANSFERENCE • Self-insight, self-integration, empathy, anxiety management… (Van. Wagoner, et al) • Awareness of feelings, ability to make sense of them with empathy (Reich) • Menatlization and practitioner affect regulation (Watkins, Fongay)

TOOLS AND TECHNIQUES Practical exercises… • Energy in Motion (Hartman) • Anchors and safe places • Befriending emotion (Skaakvitne and Pearlman, 1996)

CHECK BACK WITH YOUR INTENTION… WRITE A LETTER TO YOURSELF • How are you feeling now? • What have you gained awareness of? • How do you see the risk scenario now compared to earlier? • Make some pledges to yourself (self-care or conversations to have) You may wish to post this letter to yourself, process notes, burn or bury it

ENERGY AND BODY PSYCHOTHERAPY FURTHER READING • Focusing (Gendlin) • Hakomi method (Kurtz) • Emotional freedom technique (EFT) (Craig) • Energy Psychotherapy (Mollon) • Mindfulness and meditation • Somatic trauma therapies (Ogden) • The Body Keeps the Score (Van de Kolk)

Thank you for your participation Plenary Q&A