Redefining Counseling

by Jonathan Pishner

Everyone knows the image. The counselor strokes their chin thoughtfully and says, “So, how does that make you feel?” Almost everyone seems to carry some sort of image about what the counseling process is (or isn’t).

Anger management counseling where you practice breathing deeply and counting to ten.

Couples counseling where the wife is always right and the husband is always wrong.

Deep and revealing conversations with your inner child.

Lying on a couch and endlessly complaining about your life.

And on, and on.

At some point, these images may have been accurate. By now, they should be mostly myths.

Counseling has evolved a great deal since the practice began to be formalized in the days of Freud. We almost never break out the ink blots, have anyone lie down on the couch, or just encourage clients to ramble about the pain and problems in their life.

And of course, one of the most popular and damaging myths about counseling is that only people who are damaged, crazy, weak, or abnormal seek out counseling.

I’d like to propose a new way of viewing the counseling process. One that gets rid of the silly myths and takes into account the way a REAL counseling session looks.

 

Counseling is really just a specialized type of consulting

Think about it. If you want to get in shape, but you don’t know how, you hire a specialized consultant with that knowledge. We call them personal trainers.

If you get sick, you might just wait to get over it yourself, or maybe try some home remedies you know about. But, if it isn’t gone in a certain amount of time, most of us will go to a different special consultant who knows about infections: a doctor.

And yet, so many people hesitate to hire the most ideal consultant to assist them with anxiety, depression, trauma, or relationships. Mostly because we attach a lot of extra meaning to going to a counselor.

Counselors are really just highly trained consultants. We consult with people on emotional issues, relationship issues, grief and trauma, habit change, life direction and satisfaction, and above all, getting the life you want.

Because we’re really just fancy consultants, much of what we do is teach skills.*  Communication skills, emotion control skills, frameworks and models for making positive changes, almost all of it is meant to be applied and practiced outside of sessions. And those examples at the top? Sure, those are things that might happen. Sometimes. But they’re probably only for a session or two, and then we move past them.

 

How should we think about counseling?

Counseling should be a goal oriented process. A person comes in with a specific complaint or problem. The counselor uses their specialized knowledge to design a way for the client to resolve the problem, and helps them through the process. Once a person has learned what they need and they have become stable in the new way of thinking or behaving, sessions are reduced or ended.

Imagine a scenario: your friend starts getting unexplained headaches that don’t go away. They’ve tried a number of things, but nothing seems to work. Rather than go to the doctor, they insist they can fix it themselves. To most of us, that decision will start to look like a poor choice after a while. Given time, we would usually insist that they seek out a doctor’s specialized knowledge.

And yet, if that same friend struggled with unexplained anxiety, would everyone suggest that they seek out the specialized knowledge of a counselor?

Would YOU seek it out if it were you?

For many people the answer is “no”. And the reason it’s “no”, is usually because there is some kind of extra meaning attached to seeking counseling. So many people view themselves as “weak”, “stupid”, “whining”, etc when they are thinking of seeking out a counselor.  And of course, there are the labels.

 

The Labels

Part of the reason we have this fear is because of the labels used in counseling. To bill counseling to an insurance, someone has to meet the criteria for a “mental health disorder”.

Mental Health Disorder.  Scary wording. So what is an actual “disorder”?

It’s not nearly as scary or awful as it sounds. Basically, any of these “disorders” are just a list of symptoms. If you meet enough of the symptoms, you have the disorder. If you meet 5 out of 9 symptoms for Generalized Anxiety Disorder, you have it. If you meet 4 out of 9 symptoms, you don’t.

So why is there a difference? Why do I have a disorder if I’m a little more anxious?

Basically, there just had to be some kind of cutoff. A panel of experts came together to write the book of mental disorders, and they had to decide when someone had a problem severe enough to consider it a medical issue, and thus allow it to be a medical condition covered by insurance.

(Massively simplified explanation, but good enough for our discussion. You can click here or here if you really want the full story)

Creating the labels had some good benefits. It allows for streamlined communication between professionals, and it allows us to treat more people through insurance billing.

The downside is that the labels sound WAY more awful. Saying “I am being treated for Post-traumatic Stress Disorder” sounds much more severe than “I’m getting help because I had a bad event a while back and I’m having trouble moving on”.

It’s really easy to get caught up in the labels: Attention Deficit Hyperactivity Disorder. Major Depressive Disorder. Acute Stress Disorder. Oppositional Defiant Disorder.

Here’s the thing: if you click the links above, I’ll bet you’ve met the criteria for at least one of those at some point in your life.

If you haven’t met the criteria for at least one disorder in your life, you’re the odd one.

 

Can you get better on your own?

Maybe.  Here is the common question:

“But why do I need extra help?  My friend didn’t.”

It’s kind of like getting sick.  Some people get better on their own.  Some have to visit the doctor.

The same applies in counseling.  Some people struggle for a while, then get lucky enough to figure out what they need with no help. But if you can’t figure it out on your own, you don’t get a trophy for continuing to suffer.

 

The Reality

There’s no negative meaning to seeking counseling. We live in a dizzying, fast-paced, highly stressful world that our brains were not designed for. We were not built for a world powered by instant access to information, a 24 hour fear-based news-cycle, or tweets and notifications at all hours of the day and night.

Seeking counseling only means one thing. It means you need specialized knowledge and guidance that you don’t currently have.

Most people who seek counseling are not in any way abnormal. They’re just regular people who don’t yet know how to design their lives in a way that’s going to help them cope with the ever-changing world we live in.

So, I propose that counseling doesn’t have to be this mysterious, shameful thing. Good counseling is mostly just highly specialized consulting. You can learn the skills you need to continue aiming high and getting the life you want, while having less stress and conflict along the way.

 

If you want to see a few of the ideas, frameworks, or skills that you might come across in a counseling session with us, click these links and read more.

The Life You Want: It’s Too Perfect

You Don’t Have to Fight Back

Interrupting Anger – How Tricking Your Body Can Make You Calm

Can I Help When My Child is Struggling at College?

 

*- One exception to the skills concept is trauma. Trauma work is almost always best done in the office with a trained counselor specialized in trauma treatment. Even if you’ve been through the process before, trying to treat your traumas by yourself can carry some risks. We don’t recommend trying this unless specifically encouraged to do so by your own counselor.