“The unbalanced woman” – Annie gets feedback from an ‘expert by experience’
As Annie refl ects on her fi rst few months in private practice, she remembers a particular case that reminded her
about the client being an ‘expert by experience’. This case is also notable for the way Annie received feedback about her treatment of the client. In independent practice, it’s not common to get feedback such as she received here. This experience also raises questions about feedback for independent practitioners such as whether to incorporate formal or informal feedback into their practices, how independent therapists obtain feedback and how feedback might challenge an independent practitioner. Our reporter had the unique opportunity to talk to both Annie and her client, Jackie (not her real name) to get each of their perspectives on the experience of therapy for both of them.
Reporter’s interview with Annie
Reporter: Annie – it’s been a few months since you started in private practice and I wondered if you could tell me about a case that’s impacted you and taught you something about being a therapist in private practice? Annie: Well, yes, I’ve been thinking about a particular case that taught me a lot and helped me to see that out of a struggle can come some great therapy. My client, Jackie, came to me via an employee assistance programme. We were allocated fi ve sessions, so it was short term. Of course, this put some pressure on me from the start.
Reporter: Of course! Tell me a lit le about the case. Annie: Well, Jackie came to me feeling angry and frustrated. She had been diagnosed with a neurological illness that caused a lack of balance and nausea and had changed the way she had to live her life. It meant she was not able to do some of the things she had been used to doing. She was a professional woman with a family and was frustrated at the position she was now in. Interestingly, during her treatment, she’d been seen by a lot of ‘experts’ – neurologists, neuro- psychologists etc. As a new therapist, I wasn’t entirely sure what she wanted or needed from me. It seemed like she’d already had so many experts working on her.
Reporter: Tell me about the fi rst couple of sessions Annie: For the fi rst couple of sessions, Jackie ‘protested’. She’d been told she might only achieve 80% of normality, now. I remember saying to her, “It’s almost like having one fi ſt h of your body, like a whole leg, missing. If you had a leg missing, you’d expect to be gentler with yourself, and people would be compassionate. It must be hard because people can’t see the part that’s missing for you”. T is seemed to bring a new perspective to her which she hadn’t thought of before.
Reporter: Seems like this intervention helped. What else do you remember that seemed helpful? Annie: Well, I wasn’t sure this was helpful at the time, but she talked about going to ride the rollercoaster at Disneyworld. I think I underestimated the power of this ambition. I became anxious about her doing this and suff ering for days aſt erwards because the rollercoaster would aff ect her balance – headaches, nausea and lack of energy – and she would withdraw and feel alone. I started to ask her, “How safe is this?” In hindsight, I think I was appealing to the intelligent voice. She talked about her “emotional rebellion with intelligent planning”
Context 155, February 2018 Reporter’s interview with Annie’s client, Jackie
Reporter: Hi Jackie! T ank you so much for agreeing to be interviewed about your therapy with Annie. Can you tell me something about going to therapy with her? Jackie: T ank you for inviting me! I’m happy to talk about it because it was a good experience for me. I really appreciated working with Annie. I was a year into my illness before I sought out counselling support. I’d been coping OK, then took a backward step and had become frightened.
Reporter: T at must have been very diffi cult Jackie: Yes. When I was fi rst diagnosed, I heard a lot of horror stories about my illness but had no advice. However, I got on with it and seemed to be coping OK and actually got a bit smug, thinking I was get ing bet er. T en, I had a setback and it hit me hard. I thought to myself “I’ll be one of those people in the horror stories! I might always be like this”. I was fi nding it hard to cope. T at’s when I found Annie and started working with her. I was feeling like I was on an emotional rollercoaster and it was very diffi cult for me to cope.
Reporter: Tell me about the fi rst couple of sessions Jackie: Annie asked me to write a diary. As I did this, I realised I had been tracking how I felt physically but not emotionally. At Annie’s prompting, I started to track both. I began to realise my emotional state was linked to my physical state. At fi rst, I didn’t think I could control either of those states! Also, I wasn’t happy to be limited – my life before had been so full. I would push myself and see what happened. Sometimes, I felt completely out of control. When I shared this with Annie, she was able to help me see I had an intelligent voice as well as the one that felt out of control. T is helped me feel safer. Made me feel that I can have control.
Reporter: T at’s great that writing it down helped so much. What else seemed to help? Jackie: Well, I think it was about the third session; I told Annie that I had always had an ambition to go to Disneyworld and ride the rollercoaster with my son. We discussed ways I could do that and use my ‘intelligent’ voice (honouring both my need to be ‘normal’ but keeping myself safe). I remember her saying to me, “T at is very clever of you to do that”. T is was a turning point for me! I realised I could do anything but I couldn’t do everything, and I could use both my rebellious and intelligent voices!
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“The unbalanced woman” – Annie gets feedback from an ‘expert by experience’
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