CONTENTS
I Introduction
II Empathy
III Skills in Building Relationship
IV Use of Relationship in Helping Process
V Transference
VI Counter Transference
VII References
RELATIONSHIP
Value of relationship can be gauged from the facet that no help can be administered to a client of casework services without positive relationship. In face, society is society because of relationship. Society is said to be the totality in which human being engage in social relationship, or in other words, it is a network of relationships. Every human action contains an element of relationship. This relationship in turn affects one’s thinking, feelings and action. When we think of something sitting all alone in our room it is in terms of our relationship with people, may be friends, family members, relatives, co-workers, or public in general. Our very existence is in terms of our relationship with people around us. Lives cannot be lived without relationship to other people. All institutions are built around relationship. Institutions minus relationship have no existence. Help or troubles emanate from our relationship with the fellow human beings. Whether one is troubled or helped by someone, relationship does exist between them.
Thus , relationship is an emotional bond between people who interact with each other . Our interaction is initially determined by the bond we have with the person concerned and in turn this interaction either strengthens or weakens this bond. It may, in other words, make us friendly or hostile to each other. It can be said to be a transmission belt of communication, a set of attitudes and responses between the interacting units. According to Northern (1969), relationship consists” primarily of emotional responses which ebb and flow from person to person as human behavior evokes different affective reactions”. According to Perlman (1957), it is a condition in which two persons with some common interest between them, long term or temporary, interact with feelings. Relationship leaps from on e person to the other at the moment when some kind of emotion moves between them. They may both express or invest the same kind of emotion: they may express or invest different or even opposing emotions or… one may express or invest emotion and the other will receive it and be responsive to it. In any case, a charge or current of feeling must be experienced between two persons. Whether this interaction creates a sense of union or of antagonism, the two persons are for the time being connected or related to each other. “ The essence of the relationship has been called an inter play, a mutual emotional exchange, an attitude, a dynamic interaction, a medium, a connection between two persons, a professional meetings, and a mutual process. The purpose of the professional relationship is described as creating an atmosphere, the development of personality, a better solution of the client’s problem, the means for carrying out function, stating and focusing reality and emotional problems, and helping the client make a more acceptable adjustment to a personal problem (Biestek, 1957)
Coyle (1948) considers relationship as “ a discernible process by which people are connected to each other and around which the group takes its shape and form” While Biestek (1957) considers it as “the dynamic interactions of attitudes and emotions”. Thus, relationship is a natural phenomenon occurring between persons interacting with each other singly or in groups. Relationship can be, then, shaped, manipulated or developed as we intend it to be.
EMPATHY
Perlman (1979) explains this as “feeling with and into another person, being able to get into his shoes”. Thus, one tries to know what the client feels and experience without getting lost in the process. Rogers (1966) explains empathy as “the perceiving of the internal frame of reference of another with pertain thereto, as if one were the other person but without ever losing the ‘as if’ condition”. Empathy communicates that the worker understands the depth of the feeling of the client and that he is with him. It requires an imaginative capacity. Comments like the following communicate empathy: “I understand that you are upset”. “I can understand how perturbed you are because of…”, “It must be difficult for you to…” Empathy does not mean the loss of objectivity. It can be learned and developed so that the therapist can understand the world of the client “as he sees it”.
Definitions of Empathy
Heinz Kohut: Empathy is the capacity to think and feel oneself into the inner life of another person.
Roy Schafer: Empathy involves the inner experience of sharing in and comprehending the momentary psychological state of another person.
D.M. Berger: The capacity to know emotionally what another is experiencing from within the frame of reference of that the person, the capacity to sample the feelings of another or to put oneself in another’s shoes.
Jean Decety: A sense of similarity in feelings experience by the self and the other, without confusion between the two individuals.
Basic empathy is the ability to be in touch with and communicate one’s understanding or the contents of the client’s experience. Accurate empathy refers to the precise identification of what the client means and feels from moment to moment. Advanced empathy is the skill of perceiving and communicating one’s understanding of what the client intends but does not say; the ability to sense half-hidden meanings and to voice them for the client, thus moving counseling forward. Empathy has been called vicarious introspection (kohut). It is recognized as core condition in counseling, philosophical empathy is the counsellor’s act of understanding the client’s core belief systems and helping him to bring these into explicit awareness for evaluation. Empathic symmetry is the balance of empathy necessary in the arena of couple counseling.
Empathy involves two specific skills:
1. Perspective
2. Communication.
Perspective: When seeking to communicate with another, it may be helpful to demonstrate empathy with other, to open-up the channel of communication with the other.
Either simulate ‘pretend’ versions of the beliefs, desires, character traits and context of the other and see what emotional feelings this leads to.
Or simulate the emotional feelings and then look around for a suitable reason for this to fit.
Communication: The caseworker can be effective in communicating empathic understanding when he: -
Concentrates with intensity upon the helpee’s expressions, both verbal and non-verbal;
Concentrates on responses that are interchangeable with the helper;
Formulates his responses in language that is most attuned to the helpee;
Responds in a feeling tone similar to that communicated by the helpee;
Is most responsive (interacts with the helpee);
Having established an interchangeable base of communication, moves tentatively towards expanding and clarifying the helpee;’s experiences at higher levels;
Concentrates upon what is not being expressed by the helpee (the deepest level of empathy involves filling in what is missing rather than simply dealing with what is present); and
Employs the helpee’s behaviour is the best guideline to assess the effectiveness of his response.
Limitations
It should be noted that the extent to which a person’s emotions are publicly observable, or mutually recognized as such has significant social consequences. Empathic recognition may or may not be welcomed or socially desirable. This is particularly the case where we recognize the emotions that someone has towards ourselves during real time interactions. The appropriate role of empathy in our dealings with others is highly dependent on the circumstances. For instance, it is claimed that clinicians or caseworkers must take care not to be too sensitive to the emotions of others, to over-invest their own emotions, at the risk of draining away their own resource fullness.
Empathy may be painful to oneself: seeing the pain of others, especially as broadcasted by mass media, can cause one temporary or permanent clinical depression; a phenomenon which is sometimes called weltschmerz.
There are also concerns that the empathiser’s own emotional background may affect or distort what emotions they perceive in others. Empathy is not a process that is likely to deliver certain judgments about the emotional states of others. It is a skill that is gradually developed throughout life, and which improves the more contact we have with the person with whom we empathise. Accordingly, any knowledge we gain of the emotions of the other must be revisable in light of further informat. Thus awareness of these limitations is prudent in a clinical or caseworker’s situation.
Contrasting empathy to other phenomena.
One must be careful and not to confuse empathy with either sympathy, pity emotional contagion or telepathy.
Sympathy is the feeling of compassion for another. The wish to see them better off or happier, often described as “feeling sorry” for someone. Pity is feeling that another is in trouble and in need of help, as they cannot fix their problems themselves. Emotional contagion is when a person (especially an infant or a member of a mob) imitatinely ‘catches’ the emotions that others are showing without necessarily recognizing this is happening. Telepathy is a controversial paranormal phenomenon, whereby emotions or other mental states can be read directly, without needing to infer, or perceive expressive clues about the other person.
Counseling Relationships
Clients and counselors sometimes have different perceptions about the purpose and nature of counseling. Clients often do not know what to expect from the process or how to act. Seeing a counselor is a last resort for many individuals. They are likely to have already sought help from more familiar sources, friends, family members, ministers, or teachers. Therefore many clients enter counseling reluctantly or hesitantly. This uncertainty can inhibit the counseling process unless some structure is provided. Structures help clarify the counselor-client relationship and give it direction; protect the rights, roles and obligations of both counselors and clients; and ensure the success of counseling.
Structure promotes the development of counseling by providing a framework in which the process can take place. “it is therapeutic in and of itself”.
To help client’s new directions in their lives, counselors provide constructive guidelines. Their decisions on how to establish this structure are based on their theoretical orientation to counseling; their personalities of their clients, and the major problem arise with which they will deal.
When counselors meet clients who seem to lack initiative, they often do not know what to do with them, much less how to go about doing it. Therefore, some counselors are impatient, irritated and insensitive and ultimately give up trying to work with such persons. The result is not only termination of the relationship but also scapegoating- blaming a person when the problem is not entirely not his or her fault. A role- reversal exercise call promotes counselor empathy in dealing with reluctant and resistant clients. Many reluctant clients terminate counseling prematurely and report dissatisfaction with the process. A resistant client is a person in counseling who is unwilling or opposed to change. There are several ways in which counselors can help clients win the battle for initiative and achieve success in counseling. One-way is to anticipate the anger, frustration and defensiveness that some clients display. A second way to deal with a lack of initiative is to show acceptance, patience and understanding as well as a nonjudgmental attitude. This stance promotes trust. Nonjudgmental behaviors also help clients better understand their thoughts and feelings about counseling. It opens then up to themselves and the counseling process. A third way to win the battle for initiative is for counselors to use persuasion. All counselors have some influence on clients, and vice versa. How a counselor respond to the client, directly or indirectly, can make a significant difference in whether the client takes the initiative in working to produce change. Roll off and miller mention two direct persuasion techniques employed in counseling: the “the foot in the door” and “the door in the face”. In the first technique, the counselor asks the client to comply with a minor request and then later follows with a larger request. In the second technique, the counselor asks the client to do a seemingly impossible task and then follows by requesting the client to do a more reasonable task. A fourth way a counselor can assist clients in gaining initiative is through confrontation, in this procedure the counselor simply points out the client exactly what the client is doing, such as being inconsistent. The client then takes responsibility for responding to the confrontation. The three primary way of responding are: denial, accepting all or part of the confrontation as true, or developing a middle position that synthesizes the first two. Doing something differently or gaining a new perception or a problem can be a beneficial result of confrontation, especially if what has previously been tried has not worked. Finally, sack recommends the use of pragmatic techniques, such as silence (or pause), reflection (or empathy), questioning, describing, assessing, pretending, and sharing the counselor’s perspective, as way to overcome client’s resistance. These techniques are especially helpful with individuals who respond to the counselor’s initiatives with “I don’t know “
Counseling can occur almost anywhere, but some physical setting promotes the process better the others. Among the most important factors that help or hurt the process is the place where the counseling occurs. There are certain features of a counseling office that will prove its general appearance and probably facilitate counseling by not distracting the client. The distance between counselor and client can also affect the relationship. Individuals differ about the level of comfort experienced in interaction with others. Among other things, comfort level is influenced by cultural background, gender, and the nature of the relationship.
The way that counselor and client perceive one another is vital to the establishment of a productive relationship. Warpath points out “clients come in all shapes and sizes, personality, characteristics, and degree of attractiveness. Some clients are more likely to be successful in counseling than others. The most successful candidates for traditional approaches tend to be YAVIS: Young, attractive, verbal, intelligent and successful- less successful candidates are seen as Hounds or UUDs (dumb, unintelligent and disadvantaged). These acronyms are cruel, but counselors are influenced by the appearance and sophistication of the people with whom they work. A number of stereotypes have been built around the physical attractiveness of individuals. The physically attractive are perceived as healthiest. The way in which counselors interact with clients may be influenced by physical factors. The nonverbal behaviors of the clients are also very important. Clients constantly send counselors unspoken messages about how they think or feel. Mehrabian and his associates found that expressed like and dislike between individuals could be explained as follows: a counselor must consider a client’s body gestures, eye contact, facial expression, and vocal quality to be as important as verbal communication in a verbal relationship. It is also crucial to consider the cultural background of the person whose body language is being evaluated and interpret nonverbal messages cautiously. The personal and professional qualities of a counselor are very important in facilitating any helping relationship. Counselors who continually develop their self-awareness skills are in touch with their values, thoughts and feelings. They are likely to have a clear perception of their own and their clients needs and accurately assess both. Such awareness can help them be honest with themselves and others. They are able to be more congruent and build trust simultaneously.
Counselors who possess this type of knowledge are most likely to communicate clearly and more accurately. Three other characteristics that make counselors initially more influential are: perceived expertness, attractiveness and trustworthiness. Counselors who use nonverbal cues in responding to clients, such as head nodding and eye contact, are seen as more attractive than those who do not. Trustworthiness is related to the sincerity and consistency of the counselor. The counselor is genuinely concerned about the client and shows it over time by establishing a close relationship with the client. It is essential, therefore, that the counselor respond to the question of trust rather that the verbal content of the client in order to facilitate the counseling relationship.
The goals of counseling change over time and change according to the intimacy and effectiveness of the counseling relationship. In the first session, both counselors and clients work to decide if they want to or can continue the relationship. Counselors should quickly assess whether they are capable of handling and managing clients problems through being honest, open and appropriately concretive. On the other hand, clients must ask themselves if they feel comfortable with and trust the counselor before they can enter the relationship wholeheartedly.
Patterson and Eisenberg think that all clients enter counseling with some anxiety and resistance regardless of prior preparation. Uncertain feelings in both clients and counselors may result in behaviors such as seduction or aggression. Counselors can prevent such occurrences by exchanging information with clients. Manthei advocates that counselor’s presentations about themselves and their functioning is multimode: visual, auditory, written, spoken and descriptive. While such presentations may be difficult, they pay off by creating good counselor-client relationships.
Interviews that focus on feelings or relationship dynamics differ markedly from information - oriented first sessions. They concentrate more on the client’s attitudes and emotions. Counselors should set aside their own agendas and focus on the person of the client. Shertzer and stone call this type of behavior rapport. Rapport is established and maintained by counselors who are genuinely interested in and accepting of their clients. Ivey states that the two most important micro skills for rapport building are basic attending behavior and client-observation skills. A counselor needs to tune in to what the client is thinking and feeling and how he or she is behaving. Establishing and maintaining rapport is vital for the disclosure of information and the ultimate success of counseling. One way in which counselors initiate rapport is by inviting clients to focus on reasons for seeking help. Such no corrosive invitations to talk are called door openers and door closers. The amount of talking the client engage in and the insight and benefits derived from the initial interview can be enhanced by the counselor who appropriately conveys empathy, encouragement, support, caring, attentiveness, acceptance and genuineness.
RELATIONSHIP IN HELPING PROCESS
How relationship can and should be used to help persons with problem has been a serious concern of not only social work but of other professions too like that of psychiatry, psychology etc. Social work always recognized the importance of human interaction and attempted to use relationship in a conscious and deliberate manner to benefit the people it worked with. Social work literature is full of description of relationship from various angles only because of its great importance in a helping process.
Richmond (1917), in her earliest work, has pleaded for an intensive study and use of social relationship in social casework. Social caseworker’s focus should be on “skill in discovering the social relationships by which a given personality has been defined: an ability to get at the central core of the difficulty in these relationships: and power to utilize the direct action of mind up on mind in their adjustment”.
None can deny the utility and importance of human relationship in promoting change and development. When relationship is established and used by a social worker consciously, purposely fully and deliberately to help client(s), it is called a professional relationship. It is characterized by “conscious purposive ness group out of the knowledge of what must go into achieving its goal” (Perlman, 1957). In face, relationship is the channel of entire casework process. It is the medium through which knowledge of human nature and social interaction are used, and through which, they are given the opportunity to make choices, both about receiving and using the help. Thus, one finds that relationship is the basis of all help.
TRANSFERENCE
Transference has been historically embedded in psychoanalytical theory and is considered one of Freud's most significant achievements. As Freud clearly formulated transference can be clearly formulated, transference can be seen as occurring in all human relationships. It is a natural human tendency that becomes magnified and intensified in therapeutic relationships because of the nature of such relationships. That is, because therapeutic interactions focus on help giving, with one person seeking to provide conditions for psychological growth in another, the tendency to experience and manifest transference reactions becomes heightened.
Just what is transference? Despite the great complexity of this construct, two basic conceptions may be educed. The first is the Classical Freudian view. In that view, transference is seen as the reliving of Oedipal issues in therapy relationship. The therapist is reacted to as if he or she were any or all of the participants in the client’s early oedipal situation; most often the clients mother and/ or father. Because of the exclusive focus on the oedipal context, this definition is quite narrow n restrictive and of course requires that the therapist share the psychoanalytic view of the critical importance of the Oedipus complex in human development.
In the broader conception, transference may be defined as a repetition of past conflicts with significant others such that feelings, behaviors, and attitudes belonging rightfully to those earlier relationships are displaced onto the counselor. To the extent that the client's reaction to the counselor are transference based, the client is responding to the counselor as if the counselor represented aspects of the transference source, for example, mother, father, sibling. For example, the person in therapy may begin to look at the therapist as if the therapist were the patient's mother, transferring their feelings for the real mother to the therapist. It is important to understand that the client does not really think or believe that the therapist is the mother, father, or sibling when transference reactions are occurring. Rather, the client transfers significant aspects of the parent's reactions towards him or her from earlier times onto the therapist, such that the therapist is erroneously assumed to be exhibiting those reactions (motives, attitudes, feelings, etc.).
In transference, the client may react to the therapist as if the therapist does not like him/her, is being critical, will abandon him/her, is not trustworthy, is perfect, is wonderful and so on. In other words, an array of affects, motives, characteristics, and behaviors may be attributed to the counselor erroneously.
CASE 1
Over many sessions, this client felt sure that the therapist could give her solutions to her life problems, which in fact were profound. She felt that the therapist really knew the solutions and was withholding them. He was not giving her fair share – what she deserved to have. Because of this she experienced a chronic sense of deep anger toward the therapist. During one session in which she angrily criticized and pleaded with the therapist to "tell her", he pointed out the bitterness in her request and how her feelings must echo feelings from long ago. She responded by tearfully expressing how she never got her share from her parents, how she was never taken care of. This interaction was a critical step in the work toward her coming to understand her transference and work through the conflicts underlying them.
CASE 2
During the early weeks of a long counseling experience, the client, among other things, could never break silences by offering new material. Her mind would go blank. She feared and fully expected that the therapist would feel critical of her initiating new topics and of any material she might initiate, despite the reality of the treatment situation; that is, her initiation was welcomed. A significant portion of counseling was focused on the client's injurious relation with her mother, a deeply narcissistic woman who had few boundaries, and whose needs this client had to constantly attend to. In close relationships, this client this client consistently carried with her a sense that the only way she could be cared about was if she denied any of her needs and attended to the others. She became a stranger to her own needs, and much of the counseling aimed at helping her learn about what she wanted and needed, and psychically disengage from the often unconscious entanglement with her mother.
RULES OF THUMB
1.Transference is always an error
The perceptions that the client has of the counselor represent displacements that were appropriate (not an error) to other relationships, from another time and place. It needs to be stated here that by no means are all perceptions the client has of the counselor erroneous, nor are all emotional reactions clients have towards their counselors based on misperceptions. It is important for the counselor to understand which are realistic and which are based on transference.
2. Transference may be positive or negative
The client may project positive attitudes into the counselor, based on needs tied to past conflictual relationships, for example, because of the client's deprivations of the parent, she or he may need to see the counselor as more loving or powerful than is realistically the case positive transferences are often more difficult to appreciate than negative ones.
3. The emergence of transference in the counseling is facilitated by the therapist's neutrality and ambiguity.
The concept of neutrality is one of the most misunderstood. By neutrality one does not mean bland indifference or lack of caring. Instead we refer to the therapist's not taking sides and not imposing his or her values and beliefs on the client. Ambiguity is a similar but not identical concept. It refers to the tendency not to present a clear picture of one's feelings, life and attitudes.
In any event, it is generally agreed that counselor ambiguity and neutrality create an environment in which transference is more likely to develop and emerge fully. This is not to say that transference does not occur in active therapies, where the therapist is very open about his or her values and may take sides. It occurs there, too; but ambiguity and neutrality allow it to develop and come into the open more fully and in a way that many counselors believe to be less 'contaminated' (by the reality of the counselor.
4. Transference is not conscious.
Although the client's feelings toward the counselor maybe fully conscious, the fact that they are displacements from other, earlier relationships is not. The caseworker seeks to make them conscious, with the aim of resolving or correcting transference distortions.
5. Transferences are most likely to occur in areas of greatest unresolved conflict with significant others earlier in one's life.
The final rule of thumb implies that humans are more likely to misperceive the present based on the past in areas in which there were significantly unresolved conflicts in past important relationships. Thus, for example, if a central area of unresolved conflict in one's childhood had to do with dependency, issues around are likely to be evidenced in the transference relationship with the therapist.
To conclude it must be said that the concept of transference (and counter transference) is one of the most complex in psychology today, and it has been extremely difficult to develop methods of studying it scientifically.
COUNTERTRANSFERANCE
Given that the counselor-client relationship is a two way street, involving contributions from both participants, it is important to look at the counselor's contribution to the transference configuration. As transference, counter transference is also seen as universal. No matter how emotionally mature the caseworker, and how effectively he or she has overcome inevitable conflicts, the caseworker is a human being, and as such will have areas of unresolved conflict. These sore spots contain the issues that are likely to develop into counter transference reactions. This occurs when material presented by the client touches areas of unresolved conflict in the counselor. For example, a therapist might have a strong desire for a client to get all 'A's' in university because the client reminds her of her children at that stage in life, and the anxieties that the therapist experienced during that time.
A wide array of definitions can be found. The totalistic definition views this phenomenon as including virtually all of the counselor's emotional reactions to the client. Thus, realistic reactions, not based on particular conflicts within the counselor, will be seen as counter transference, just as will conflict-based reactions. The classical definition is the "counselor's transference to the client's transference". This is very narrow in that only client transference reactions, and not reactions that are non transferential, can be the trigger for counter transference. An intermediate definition may be the most useful one – the counselor's transference to the client's material---to the transference and non-transference communications presented by the client.
Does counter transference hinder or help progress in counseling? This depends on whether it is considered an over behavior or an internal experience in the counselor. As an external behavior, it is something to be controlled and ideally to be worked through, because it is important that therapists don't act out their own conflicts with and on their clients.
In recent times, counter transference has more often been viewed as an internal experience of the counselor. When seen in this way, if properly handled it can be extremely helpful to counseling. It can allow the caseworker to gain insight into the kinds of emotions and reactions the client often tends to induce in others. For example, in one instance in an interview, a counselor felt quite irritated with the his client's sullen withdrawal and near-monosyllabic utterances, and an image came to his mind of him shaking the client into life. As he reflected on this he could see how he had been unconsciously 'shaped' by the client's material into feelings and reactions that were typical of the client's description of his relationship with his abusive father. These counter tranferences were not so much a manifestation of his own emotional life, but rather originated in the client's unconscious need to structure the world in familiar ways. Here, counter transference is used in the service of deeper understanding of the client. Nevertheless, this requires that the caseworker, in fact, be willing to focus on his/her feelings toward the client when these are experienced as conflictual. Also, it requires that the counselor is willing and able to understand where these feelings come from in his or her own life, a task that can be anxiety provoking but extremely important.
Unfortunately, also just as with transference, empirical research on counter transference has been spare.
Lastly, to conclude, one can say that transference and counter transference will be a hindrance to social casework only when the caseworker does not have adequate knowledge and sensitivity to recognize and deal with these phenomena. Dealt with sensitively, these phenomena are a welcome entity that aid in the wholesome growth and development of the individual.
REFERENCES
1. Gelso, C.J. , Fretz, B.R.; 'Counseling Psychology'; 1995; Prism Books PVT LTD, Bangalore, India.
2. Feltham, C; 'Understanding The Counseling Relationship'; 1999; Sage Publications, New Delhi.
3. Internet- http://www.contactpoint.ca/bulletins/v6-n3/v6-n3y.html
4. Upadhaya – Social Casework
5. John S Koshy – Guidance and Counseling, Dictionary of Counseling
6. Gibson and Mitchel – Introduction to Counseling and Guidance
MSW's Students (2007-2009), Christ College, Bangalore, India
Saturday, August 4, 2007
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