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Help clients understand and break the lethal [wounds + unawareness] cycle |
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Requisites for Effective
Clinical Service
2)
Experiential Knowledge
By
Peter K. Gerlach, MSW
Member NSRC experts Council |
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https://sfhelp.org/pro/req/experiential.htm
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This article is one of a series on
professional counseling, coaching, and therapy with (a) low-nurturance
(dysfunctional) families and with (b) typical
of childhood
and trauma. These articles for
professionals are under construction.
This series assumes you're familiar with:
Before continuing, pause and reflect - why are you reading this article?
What do you
+ + +
Requisite
Experiential Knowledge
Do you agree that empathy is
a basic
requisite for effective human service (and any relationship)? True empathy
comes from having experienced what another person is living. Typical divorcing families and stepfamilies are specially complex human
systems, with unique structures, roles, development phases, adjustment tasks, and
stressors. So novice and veteran human-service professionals need
some key life experiences to really
empathize with these clients. Exception: a gifted
minority of inexperienced professionals intuitively offer empathic client
interventions.
After
77 years on Earth and
36 years' clinical training and
working with these clients, I propose that the more of the experiences below that a
clinician has, the more likely that s/he'll be motivated
to (a) develop these
and to
(b) apply them effectively. Clinicians lacking
these personal requisites can still be effective
counselors if they have the requisite
didactic knowledge (p. 1).
Vital Personal Experiences
-
a
childhood, hitting true (vs. pseudo)
and some years of self-motivated
true (vs. pseudo)
from resulting psychological
and...
-
Genuine (vs. pseudo)
and full three-level
-
One or more primary relationships, ideally including marriage, child
conception, co-parenting; and...
-
(a) Psychological and/or legal
as a child
and a co-parent, and
(b) some years of single non/custodial co-parenting; and...
-
Years of meditation and an evolving
spiritual reverence, awareness,
and maturity; and...
-
Hitting bottom, relapsing, and growing self-motivated recovery
("sobriety") from one or more harmful compulsive behaviors
(e.g.
including significant experience with 12-step groups; and...
-
Stepfamily experience:
-
courtship involving one or more living children of divorced parents,
-
re/marriage,
-
living with custodial and visiting stepchildren, and...
-
some years' experience negotiating conflicts about stepfamily
and
(priorities); and relationship
involving all
members. And...
-
Effective
personal, marital,
and family therapy for some or all of these.
|
Clients and professionals are
confronted with this inevitable question: "Can a clinician who lacks some or
most of these personal experiences (and learnings) achieve
with average divorced-family and stepfamily clients?" A related
question: "Can a supervisor or case manager who lacks some or
most of these life experiences provide fully-effective guidance
to clinicians working with these complex clients?"
|
In addition to these personal experiential requisites, effective clinicians
also need to accumulate a range of...
Key Clinical Experiences
With
qualified training and supervision, typical clinicians need to experience working as
a trainee-co-therapist or alone with several...
-
Individuals recovering from psychological wounds (intrapsychic
work); and several...
-
Troubled committed adult partners - ideally with one or more kids
(marital work); and
several...
-
(a)
conflicted separated or divorced co-parents, including several
(b) who were or are involved in family litigation; and several ...
-
(a)
Troubled (low nurturance) intact biofamilies with children,
including several (b) struggling with one or more adult or child
addictions.
And ideally, effective clinicians need well-supervised
experience working with several...
-
Separated biofamilies with one or more children, and several...
-
Pre-legal (courting or co-habiting) unmarried
stepfamilies; and
several...
-
Re/married (legal) simple stepfamilies (only one mate has
prior children); and several...
-
Re/married complex stepfamilies (both mates have prior
children), and several...
-
His-hers-and-ours stepfamilies (with one or more half-siblings);
and several...
-
Re/divorcing stepfamilies of any type.
-
Useful variations include clinical
experience with (a) same-gender, (b) bi-racial, and (c)
religiously-conflicted (e.g. Baptist-Jewish, or Christian-Muslim) couples
and families.
Option: use your version of
these factors as a crude checklist for assessing the non-didactic
half of a clinician's knowledge-competence to work effectively with
these client families. Ideally, clinical trainees lacking these experiences
will work with a co-therapist, supervisor, or consultant who has the
requisites.
My
experience suggests that some of these experiential requisites are more
important than others, relative to therapeutic outcomes. Let's look a little
closer at selected personal and clinical factors...
Perspective
1)
Personal Experiential Knowledge
Recovery from psychological wounds
Premise: The single most powerful determinant of the effectiveness of your professional work
(and the other parts of your life) is
whether you have experienced what it feels like to...
-
admit that you were raised in a significantly
(vs.family,
-
and admit (a) any resulting false-self
and
(b) their
and...
-
feel the
process and
benefits of
self-motivated, true (vs. pseudo) personal
My experience suggests that
unseen "false-self" wounds are one
of the most powerful and widespread causes of personal and relationship
including ineffective communication, neglect, abuse, and divorce. Without this
keystone experiential learning and related didactic
knowledge,
clinicians are far less likely to (a) really accept this premise in
working with clients, and (b) solidly believe that wound-reduction and
is crucial and possible. These
lacks will relentlessly
cripple all your professional and personal relationships and
outcomes.
If
you (your ruling subselves) feel significant
about this keystone premise, please...
-
read this three-page
letter to you with an open mind,
-
try this safe
exercise with one of your talented subselves,
and...
-
review
this, this and
this when you're not distracted.
Then...
-
see if your attitude
about these client
this requisite, and the concepts in
here become more credible.
If you choose to ignore these four steps or
you remain skeptical, you're
probably controlled by a protective
which finds this experiential requisite too threatening. Similar doubt and
pessimism
blocks many client adults from (a) admitting and reducing their wounds, and
(b) protecting vulnerable kids from inheriting similar wounds.
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Notice what your ruling subselves are
now. Is your Self (capital "S")
your other personality subselves now? Reality check:
have you read these introductory Lesson-1
articles and honestly
assessed yourself
for psychological wounds yet? If not - why? |
Marriage and Co-parenting Experience
For best outcomes, I also propose that ideally, clinicians working with
divorced and remarried families need
to gain personal experience with...
-
sanctified marriage, and...
-
a range of sensual and sexual-intercourse
experiences, and...
-
conceiving and co-parenting
one or more kids - ideally male and female.
Clinicians, supervisors, case
managers, and clinical program directors who
lack this core experience probably can't really empathize with the
multi-level complexities of their client co-parents and kids. This has special
relevance for unmarried, celibate pastoral counselors.
Clinicians who lack this relationship experience can
("How can I be qualified to advise
people on marriage and child conception issues when I never have done these myself?").
Clients are apt to sense this, and discount the clinician's credibility and
competence also. Option: if a clinician lacks this experiential
marital and co-parenting knowledge, admit that early in the work, and acknowledge
without shame or guilt that it limits full
empathy. Also acknowledge it does not mean the clinician cannot be
helpful as a counselor!
Effective human-service professionals with
also need
experience with...
Genuine Bonding, and Grieving
Significant Losses
This
clinical model proposes that an
epidemic American personal and family stressor is unawareness of healthy and
blocked
and typical
impacts
of the latter. My clinical experience is that (a) many
divorced and stepfamily adults and kids suffer from
Reactive Attachment Disorder (RAD) - an inability to bond, and (b) even
if they can bond, the majority have trouble grieving well.
To fully accept this core premise and really empathize with such clients,
clinicians need to experience (a) ) true
- vs. pseudo -
(b) major
(broken psycho-spiritual
bonds), and (c) full three-level grief. Clinicians
who
significant
- and/or who lack effective training in grief basics, dynamics, and
facilitation - may believe
"I can bond (attach) and grieve
well" when they really can't do one or both (reality distortion).
Such wounded clinicians (and supervisors) are likely to discount the
relevance or impact of this core client stressor, and provide ineffective
service. Professionals also need didactic knowledge of (a) the bonding >
loss > mourning process, (b)
for effective grief, (c) how to
for blocked grief, and (d) how to free it up.
in this site and its related
guidebook focus on
these vital topics.
Reality check: on a scale of
one (I cannot bond, and I have
nothing to grieve) to ten (I bond deeply, and know well what
full three-level grief feels like), I'm a ___. Would lay and clinical
people who know you well agree with this rating?
A third type of valuable personal experience for clinicians is...
Family-court Conflicts and
Divorce
Paradox: to fully empathize with these complex client families, clinicians
need experiential and didactic knowledge of (a) legal divorce (vs.
"breakups") and (b) a flourishing, high-nurturance primary
relationship and family. Growing up with divorced parents does not provide
the same experiential knowledge as personal divorce. Wounded (distrustful,
skeptical, guarded) clients are apt to c/overtly discount the credibility and
authority of a clinician who lacks both of these requisites, even if
s/he has a reputation for professional effectiveness. Do you agree with
this?
Professionals lacking personal life experience with divorce and
successful primary relationships risk stunted empathy with, and/or
unconscious negative biases about,
divorced client adults - specially parents. This is
specially likely for clinicians with strong religious and/or ancestral
values about divorce being a "sin," a "failure," and/or a
contemptible sign of moral
weakness, immaturity, and/or lack of commitment. Such critical attitudes will
inevitably "leak" and promote divorced-clients' distrust, guilt, shame,
resentment, and
defensiveness ("resistance"). This reaction is also likely with the parents and children of divorced
adults. Corollary: clinicians who experienced parental divorce in childhood
(or never married) risk key transference
issues with divorced parents.
Another
key personal experiential requisite is...
Spiritual Awareness, Faith,
and Maturity
My 36-year
experience as a counselor and family therapist suggests that only a minority
of
American clinicians (and health professionals) include
spiritual awareness
(vs. religious faith) in their work.
As a recovering atheist, I now believe that genuine (vs.
dutiful, rote, and/or fearful) faith in, and regular communion with, a
nurturing (vs. toxic)
is
essential for...
A widespread testimony
to this is the proven theme of "turning over life-stressors to my Higher
Power as I conceive of (Him/Her/It)" in all
12-step addiction-management philosophies and programs.
Clinicians, supervisors,
consultants, and administrators who lack or minimize spiritual awareness,
faith, and
will probably achieve significantly less than they
could otherwise.
Paradox: if you lack this experiential requisite, you will not be able to
objectively assess the validity of this premise and act on it.
Premise: one symptom of co-parental wounds and unawareness and a
low-nurturance family is caregivers (a) ignoring or scorning a young child's
spiritual curiosity and growth, and/or (b) forcing
and
religious beliefs and practices on her or him. If your ruling
(a) deny or
discount the reality of subselves and psychological wounds, and/or they (b)
haven't experienced a Higher Power benignly influencing your life,
you're apt to reject or trivialize the importance of this reality. Pause and
notice how your subselves react to this proposal...
Addiction Recovery
This model proposes that each of the
of addiction is a clear symptom of false-selves trying to self-medicate
relentless
I estimate conservatively that
over 70% of the many hundreds
of my Midwestern divorced-family and stepfamily clients were active or
recovering addicts themselves, and/or had addicted relatives and/or
ancestors. Clinicians are most apt to non-judgmentally empathize with such
clients if they have experienced (a) admitting one or more addictions
(toxic compulsions) themselves, and (b) effectively managing (vs. recovering
from) them. This includes experiencing one or more inpatient and aftercare
situations + relapses + 12-step-group participation, and (ideally) competent
addiction-counseling and support.
The full benefit of these personal experiences can manifest if clinicians
and supervisors also have...
-
accurate didactic knowledge of addiction
etiology and
progression,
-
compassionate (vs. critical)
attitudes about addiction and addicts,
and...
-
informed training and experience in addiction-assessment and
management interventions.
Fortunately, we're moving beyond the misinformed
era where mental-health academics, researchers, and practitioners perceived
addiction as (a) an individual's "disease," vs. a multi-generational family-system
malfunction; and (b) a separate field from family-systems
therapy.
This knowledge-requisite suggests that employers and clients who
hire clinicians should view personal experience with effective addiction
management ("...and I've had no relapses in the last 14 years") as a
positive trait! What do your subselves
to this proposal?
________________________
Note that well-designed
in-service role-plays and discussions can
raise clinicians' experiential knowledge of each of these topics,
tho less than actual life experience. For an example, see this
four-part group role-play of a typical
stepfamily situation.
2) Clinical Experiential
Knowledge
Clinical outcomes with these multi-problem clients are most apt to be
satisfying
when professionals have (a) direct
experience with - say - 20 or more divorced-family
and stepfamily clients, and (b) being
supervised by a veteran professional who has
most or all of the special
you're
studying here.
This implies that assigning or accepting case responsibility to
clinicians lacking these requisites and a qualified supervisor or consultant is unethical, because it
significantly risks inadvertently harming client families, and/or providing
ineffective service to them and their insurance carriers.
Key aspects of
this clinical experiential learning include
validating that typical divorced and stepfami-ly
clients...
-
require different assessments and
interventions at each of these five developmental
-
are unusually complex
multi-problem,
family systems with many structural differences,
and extra developmental stages and adjustment tasks, compared to average intact
biofamilies;
-
(a) really are stressed by these four
or
- specially false-self
-
and (b) don't know it, what it
or what to
about it; and...
-
are often unaware of using inappropriate
biofamily norms to form unrealistic family role and relation-ship
expectations; and...
-
usually can't
their surface
needs from the
that cause them; and...
-
don't know communication
basics or how to
effectively as co-parenting
and...
-
don't know healthy-grieving
basics,
blocked-grief symptoms and impacts, and how to evolve and implement a
meaningful family grieving policy;
and these families typically...
-
don't understand values, role, and loyalty
(priority) conflicts, and associated relationship triangles - and have
no viable strategy for identifying and resolving them as teammates; and...
-
experience years of anguish and stress
because unresolved
between wounded ex mates cause significant co-parenting and
legal conflicts; and typical
divorced and stepfamily co-parents...
-
don't know how to pick qualified
advisors
and
to
help them build stable,
relationships and families.
|
Perhaps the most important learning from working with these complex, challenging clients comes from
experiencing the profound
satisfaction years later of client co-parents saying "Thank you
so much for what you gave us. Our family couldn't have made
it without you!"
|
Self Check
Recall: this two-page article summarizes the first of seven requisites
for providing effective clinical service to divorced-family and stepfamily
clients - special didactic and experiential knowledge. Breathe well, sit back, and recall the specific needs you wanted to
fill by reading this article. Then reflect on your
to
what you've read here.
On a scale of one (low) to 10 (high)...
My present didactic knowledge of
topics on page 1 is a ___ Option:
take these four
thotfully, and see what you learn.
My motivation to invest time in
studying the didactic topics on page 1 now is a ___
My present experiential
knowledge of the topics above is a ___
For more perspective
on what you know (or need to learn), review these questions and answers. As you do, imagine what it would be like for
a typical unaware co-parent to do review these related
lay
questions and answers...
Implications
The
scope of these four knowledge domains has major implications for you
personally and professionally. See how you feel about these ideas:
Personal Implications
If
you back away from the detail of these four requisite knowledge domains, I
suspect you'd agree that this is a
lot to learn, validate, and integrate - yes? I also suspect that
your formal education to date has not covered most of these topics in any
depth. If so, you're confronted with a practical and ethical question, if
you serve these complex clients in/directly:
should you proactively invest time
to upgrade your knowledge now?
Your
answer will depend on who currently
your personality subselves + your age + your current workload and
professional goals + the
of your professional environment. If you were a typical divorced or
stepfamily client, how would you want your counselor or therapist to answer
this question?
Consider:
-
Learning more conceptual (didactic)
knowledge about...
-
systems,
-
harmonizing personality subselves,
-
effective communication, and...
-
healthy three-level grieving
will
benefit you personally and with all your clients and coworkers -
win-win-win. Ethical implication: if you elect not to study these
topics, you're neglecting your self, and choosing to provide less than
your best service to your clients, co-workers, employer/s, and society.
That will probably violate your integrity, raise your guilts, and
degrade your self-respect.
-
Designing and acting on a plan to increase
your experiential
knowledge of some or all of the topics above will benefit you personally
and all your clients.
-
Deciding to (a) upgrade your knowledge of
these topics and use your knowledge to upgrade your professional
behavior will require you (your subselves) to make one or more
(core attitude) changes.
Second-order changes occur
when your
persuades active
and
subselves to want to change their values,
perceptions, and behaviors. Restated:
if a false self
often controls your personality, studying the topics
above will probably not significantly improve your professional
outcomes. Your ruling subselves will also probably discount, reject, fog, or
"forget" what you just read.
-
These four knowledge domains confront you with a decision: should you
focus your work on (a) reducing existing client problems, or
(b) helping to prevent such
problems long-range. Where do you stand on this now?
Pause, breathe well, and notice what your
subselves are
now ..
|
Low to no interest in,
ambivalence about, or deferring meaningful study of these
domains and topics suggest that you're probably
ruled by a protective
For
perspective and options, see this. |
Two Professional Implications
The Value of
Unrestricted Multi-modal Therapy
Premise: typical clients need at least three of these knowledge
domains to effectively fill their current and long-range needs. Clinicians
are ethically responsible for assessing clients' knowledge, motivating them
to learn, and helping to teach them what they need to know. This usually
required many contact hours over many weeks.
Because of the scope of
these domains and topics, clinicians and
organizations (e.g. HMOs) who provide (a) time-limited service
(e.g. "10 hours or sessions max") and/or (b)
only one primary modality (intrapsychic, couple, family, or group therapy)
can't provide fully-effective
service. Urging clients to
self-educate can be a partial offset, but my experience is that typical
U.S. co-parents can't
learn or apply new knowledge effectively without empathic,
knowledgeable coaching and encouragement along the way.
This is specially true of
admitting and reducing false-self
communication-
upgrades, and
learning how to grow
attitudes, relationships, and families.
Clinicians and organizations who
focus on reducing clients'
presenting secondary problems and
ignoring these vital primary
are
their clients - a violation of implicit professional ethics. Notice
how your subselves are reacting to these ideas now...
Accepting vs. Changing Your
Environments
You may (a) learn new knowledge and (b) adjust your client-service paradigm, attitudes, and
behaviors, to gain better outcomes. If you do this, you confront several
ethical questions: "Am I now responsible for motivating...
-
my
co-workers and administrators to learn, integrate, teach, and apply
these topics?" A practical way to do this is via appropriate
in-service seminars.
-
the schools which teach people in my
profession to include this knowledge in their curricula?"
-
the professional
associations I belong to
(e.g. AMA, APA, ABA, NASW,...) to learn and integrate these topics into
their training and evaluation criteria?"
-
departments in my state government that (a)
accredit organizations like mine, and (b) license and (c) regulate the
ethical conduct of clinicians; to learn, integrate, teach, and apply
these topics?"
-
the local and general public to learn about
some or all of these topics?"
Your personality and life and work situation may prevent you from "going the
extra mile" and helping people in these areas upgrade their knowledge of
these core topics even tho no one expects you to. Option: discuss the
pros and cons of working to improve your professional environment with your
wise Future Self, and see what you
experience...
Is there anyone you want to make aware of this article, what it links
to, and these related guidebooks? If so, get
clear on your motives (needs) and which subselves cause them, and
copy or email this. Then notice how you feel If you're in an
organization or consulting group. Effective people to alert are (a) your
clinical director, and (b) the person/s
in charge of professional staff development and/or
in-service training.
Recap
Typical human-service consumers (clients) don't know what they need to
know about the topics summarized in this article. This ignorance (lack
of knowledge) is one reason clients hire human-service
professionals to help them reduce the personal and family "problems." This is specially true with adults leading
low-nurturance, multi-problem biofamilies, divorcing families, and
stepfamilies. To state the obvious, clinicians can't help their clients
learn what they need to know unless they have the knowledge themselves. From
36 years'
clinical research and experience, this article proposes topics in three
domains that any professional (like you?) can benefit by studying -
including human-service organization and program
managers, administrators, funders, and evaluators. The article invites
you to (a) honestly assess your existing knowledge level, and (b) decide
if you want to upgrade it now.
Gaining fluency at applying this didactic and experiential knowledge is one
of
typical
clinicians need in order to provide consistently-effective service to
complex, multi-problem client families. Gaining this knowledge also yields
major benefits for all human-service professionals in their personal
lives!
 Next,
review requisite clinician self-awareness
(knowledge), or return to the requisite "menu."
+ + +
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Updated
September 30, 2015
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