Counselling for Death and Dying

Person-Centred Dialogues

Richard Bryant-Jefferies

• Publisher: CRC Press
• Year: 2017
• ISBN:
  9781315347363
• Edition: 1
• Topic: Medicina
• Subtopic: Teoria, pratica e riferimenti medici

This book contains forewords by Sheila Haugh and Grace H Chickadonz respectively - Senior Lecturer Psychotherapy, Centre for Psychological Therapies, Leeds Metropolitan University; Center for Human Encouragement, Rochester, New York, USA. What happens to a person emotionally, psychologically and spiritually when confronted by the reality of the death of a loved one, the impending death of someone close to them, or their own death? As with the other volumes of the "Living Therapy" series, "Counselling for Death and Dying" is composed of fictitious dialogues between clients and their counsellors, and between the counsellors and their supervisors. Within the dialogues are woven the reflective thoughts and feelings of the clients, the counsellors and the supervisors, along with boxed comments on the process and references to person-centred theory. It is intended as much for experienced counsellors as it is for trainees and provides real insight into what can occur during counselling sessions. The book will also be of great value to the many health and social care professionals who, whilst they may specialise in other areas, will find that the issues dealt with in this volume have impact on the work they are doing. For them, the text demystifies what can occur in therapy, and provides useful ways of working that may be used by professionals other than counsellors. 'Richard has a deep understanding of theory and practice and has brought this understanding to this greatly neglected area in person-centred literature. [He] has the talent as a writer to honour the client, the counsellor/therapist, the supervisor and the process in all its intricacies. Richard has produced a book that, to my mind, captures the pain, the joy, the challenge of being with someone bereaved and someone facing death. The book also captures the pain and hurt and confusion of being that person who is bereaved or facing death.' - Sheila Haugh, in her Foreword. 'What is most striking about the dialogues is the realness of the feelings present in this all too human experience as lived by the clients. What is most beautiful is the relationship of acceptance shared in being in this most intimate place together as client and therapist. The healing that occurs is understandable in the strength of their connectedness.' - Grace H Chickadonz, in her Foreword.

Part 1

CHAPTER 1

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Counselling session 1: Silences and emerging emotions

Billy sat staring ahead of him. He was feeling numb. Sometimes that was how it was. At other times he felt surging sensations of sadness and grief that tore through him like a highly charged emotional wave, leaving him burning and aching inside. But today, in this moment, he was feeling numb. He was grateful for that.

He sat in his car; the rain was falling, he could see the droplets running down the windscreen. It was dark beyond. He was tight-lipped, his head shaking slightly from side to side. He wasn’t aware of the movement. He did feel himself take a deep breath, and then his breathing returned to its shallow rhythm. He still couldn’t believe it. He took another deep breath, but this time consciously, and moved his shoulders back a little. They had become stiff. He stretched his back and reached for the car keys in the ignition, taking them out and noting the clunk as he did so. Somehow it seemed loud. Perhaps it was the silence. It was quiet. He felt quiet as well. Yes, sometimes that was how he felt. He welcomed those times.

He hesitated. Counselling. Not something he’d ever anticipated needing. But he needed to talk. He needed to talk to someone. Friends had been good, but he didn’t want to burden them. His partner had been supportive as well, but she’d made it clear that she felt he needed someone else to talk to. He hadn’t agreed at first, preferring to simply say nothing and just carry on. But somehow that wasn’t working. He felt low; dispirited was the word that often came to mind. It all seemed to him to be an over-reaction, somehow. Yes, he had been close to his father, and yes, it had been sudden – a heart attack. Well, yes, he’d been a smoker and hadn’t maybe had the best of diets, but it had still taken him by surprise. In fact he had taken it worse than his mother, who now seemed to be getting on with her life after a few months of struggling to make sense of what had happened. She’d been to counselling. It was her who had finally convinced him to try it where his partner had failed.

He’d phoned to make the appointment the previous week. The counsellor’s name was Chris. He’d found his name in the yellow pages.

Billy took a deep breath and opened the car door. The rain had eased a little. He got out, closed and locked the car door and made his way through the gate and up to the front door, ringing the bell and taking shelter under the canopy. The door opened after only a few seconds.

‘Hello, I’m Billy, we spoke on the phone.’

‘Yes, yes, we did, please, come in. It’s horrible out there.’

‘Thanks.’ Billy came in. The hallway was warm.

‘The counselling room is here, on the left, please come in.’

Billy went in.

‘So, have a seat, whichever you prefer.’ Billy chose the seat facing him as he came through the door into the counselling room. Chris sat down in the chair opposite him.

‘So, we talked about counselling on the phone and, well, have you any questions?’

Billy shook his head. He suddenly felt unsure of himself, unclear as to what he was doing there. He felt anxious.

‘Well, I want to give you a place here to talk about whatever you feel you want to talk about. And I hope that listening to you, responding to you, will help you.’

Billy nodded. ‘Hard to know where to start, really. It’s not something I’m used to, you know, talking like this.’

‘No, it often isn’t. Take your time.’

Billy sat staring down, wondering quite what to say next. Here he was, 42 years old, no reason to feel like he did, not really, and yet somehow . . . somehow things just didn’t feel right.

‘Well, like I said on the phone, things were OK until recently and, I don’t know, it’s like everything feels like an effort. Just feels like, well, what’s the point?’

‘Mhmm, what’s the point?’ Chris responded simply and directly to what Billy had said, and waited for Billy to continue.

‘I mean, I don’t know. I suppose it does sort of relate to Dad dying.’ Billy took a deep breath and pushed the emotions aside. They were often close but he wasn’t going to show them, not now.

‘Mhmm, your dad dying seems linked to how you’re feeling.’ Again Chris sought to be clear and straight in his response. He wanted Billy to feel heard. He wanted him to find his own way, realise that he could decide what he wanted to say and how he wanted to say it. Chris recognised that counselling was often an unusual experience for people. Talking and being listened to, really listened to, wasn’t what happened in everyday life. Usually one person talked, and while the other listened often they were simply waiting to say what they wanted to say. But counselling was different. And counselling was not about being friends. Yet it was about forming a person-to-person relationship. Not everyone understood the difference.

In a friendship, while one person may be talking and in need of being listened to, the other person may not want simply to listen. They may have thoughts, feelings, experiences that they also want to share with their friend. Friendship is a mutual relationship. However, the therapeutic relationship requires the therapist to be a disciplined listener, responsive to the client, offering the therapeutic conditions and putting aside personal thoughts and feelings that have nothing to do with what emerges within the therapeutic process. Friends can be good listeners, and often that is enough. But there are also times when someone needs somebody outside of their circle of friends to talk to, to take their inner world to, someone who can give them the time and space to be themselves, to explore, to express themselves freely in the knowledge that what emerges and is expressed in the room, stays in the room.

‘We were sort of close, I mean not really close, but, well, we got on well.’ Billy lapsed into silence; a number of memories seemed to come flooding into his mind. His dad had been a great woodworker, built most of his own furniture, and he’d learned a lot from him. They’d built a few things together over the years. He had a lot of his dad’s tools now. His mother wasn’t going to have a use for them. Some of them he’d brought back to his own shed, the rest were still in his dad’s shed. Somehow, though, he didn’t really feel like going over there and using them. Wasn’t the same, somehow.

‘Got on well together.’ Chris nodded and smiled. He felt a sense of warm compassion arise within him. Something about the way that Billy had spoken. His voice had gone soft. He added, ‘Sounds like he was important.’ The words simply formed and he felt he wanted to express the impression that he had been left with. In a way he knew that might have sounded a bit obvious, but it felt right somehow given the way Billy had spoken.

‘Guess he was, well, yes, I know he was. I mean, he was sort of easy-going, you know? Can’t remember him shouting at us as kids. My sister and I, in a way she was probably closer to him, fathers and daughters. I suppose I was closer to my mum in some ways, and yet, I don’t know, seems to have hit me harder somehow.’

‘Mhmm, his death has hit you harder than your sister?’

Billy nodded. ‘Strange that, but, yes.’ He took a deep breath. ‘But umm, well, now I’ve got to get on, you know?’

‘Mhmm, get on with your life, yes?’

‘Mum’s doing well. She seems to have come to terms with it, I don’t know how. I mean, she’s got good friends, and that’s helped, and she had counselling, saw a bereavement counsellor for a while. That seemed to help her. She was the one that persuaded me to come along.’

‘So she found counselling helpful and suggested you come?’

‘Yes.’ He thought back. Yes, it had been tough for his mum to start with. She had been totally shocked by what had happened. But now, a year on, just over, she was getting herself organised. She spent a lot of time with his sister, they seemed closer now, somehow. He felt sort of, he wasn’t sure, like he didn’t know who he was. That was a bit heavy, bit extreme, he thought to himself, but it was something like that. ‘So, well, here I am.’

‘Well, it’s a difficult time and I’m glad you’re here, and I really hope that counselling is helpful for you, I really do.’ Chris felt wholly genuine in what he was saying. He felt connected to Billy, listening to what he was saying and the way he as speaking, and he still felt that warmth for him, a man in his middle years suddenly losing his father – he recalled the phone call with Billy when he had said that it had been the sudden death of his father that seemed to have affected him.

Billy looked up and looked into Chris’s eyes. He only held the eye contact for a short period, feeling he needed to look away. It didn’t feel right to be looking into the eyes of another man, and yet.... Somehow he did feel that Chris was genuine, he couldn’t quite put his finger on why, he just seemed, well, seemed to care somehow.

‘Not sure what to say now.’

‘Sometimes it can seem like you don’t have anything to say, or know where to begin.’ Chris wondered whether that had been a very helpful response. He hadn’t really empathised with Billy, hadn’t really just let him know what he had heard. Rather he’d made an assumption about what Billy might be struggling with. No, he wasn’t sure that it had been helpful.

Chris may be avoiding sitting in a silence with Billy. He’s offering him options to encourage him to speak. This is not a person-centred response. It might be facilitative, but it could be emerging from the counsellor’s discomfort and, if he is unaware of this, or unaware of the cause of it, then he is being incongruent and is therefore being therapeutically unhelpful.

Not knowing what to say seemed true enough, although, well, he had lots of things he could say, but he didn’t actually know what to say. What were you supposed to say? ‘I feel sort of, I don’t know, sort of ‘‘what’s the point?’’.’

‘What’s the point?’ Chris let his tone of voice allow his empathic response to have a questioning tone.

‘It’s like, I mean, he hadn’t been retired that long. Sort of makes you think, you know?’

‘Makes you think.’

‘It does. I mean, you work all your life and finally get some time for yourself and, well, that happens.’ He shook his head. His thoughts went back to his mother. ‘She’s doing great, my mother, that is. She seems to be getting on now. Yes, she misses him, we all do. The first Christmas was difficult, and his birthday, and hers as well. We haven’t had a second of anything yet. I don’t know, maybe it’s because she’s sort of more religious than I am, says it’s her faith that has helped. I can’t really accept that. I mean, I do accept that it’s helping her, but I don’t know. I don’t think I ever really believed in anything much, you know? Never really felt I needed to think about it. But I don’t really think ..., well, when you die, that’s it. That’s how I see it, anyway.’

Chris nodded. It wasn’t his belief, but he wasn’t there to express his beliefs. ‘So it feels as though her faith is helping her, but you can’t, don’t see things the way that she does. For you when you die, that’s it.’

Billy nodded. ‘Mhmm. Just seems a waste. I don’t know, I mean it helps her, but ...’. He shook his head. ‘Not how I see things. I just see someone who worked all his life and finally gets time to relax, and that’s it. Certainly doesn’t make me believe in a God or anything.’

‘Not how you see it, and it doesn’t encourage you to believe in a God.’

‘No. Just..., I don’t know, maybe if..., no, no, can’t see it. This is it, this is me.’ Billy opened his hands out and looked down at his body. ‘And when I’ve gone, that’s it, you know?’

‘When you’ve gone ..., that’s it.’ Chris kept with what Billy was saying, seeking to empathise with his words while also matching his tone of voice, which seemed to Chris to be conveying a kind of resignation, as if he was resigned to his fate in some way. That was how it was, and you had to get on with it, and it didn’t make sense, it didn’t seem fair, but...

‘Makes you kind of wonder, though ...’.

‘Wonder?’

‘Whether it’s all worth it, I mean, you know, you sort of plan ahead, work for the future, but, well, what’s the point. I kind of wonder. Is it all worth it?’

‘Is it really all worth it.’ Chris spoke slowly, holding the focus on what Billy had said.

‘And it is, of course it is.’ Billy was thinking of his children, Sarah and Tara. And yet he knew as well that sometimes he wondered, even when he thought about them. Billy lapsed back into silence. He felt strangely detached once again. Yes, it did give him things to think about and he was tired of thinking about them as well. He felt that familiar numbness creeping up on him. That question still went through his head, ‘what was the point?’. He had no answer, in fact he wasn’t really trying to find an answer. Sometimes he did, but at other times it was all too much. There was no answer. It didn’t make sense. The only sense to be made of it was that life could be bloody unfair. He felt angry. He took a deep breath, the anger passed, the numbness became more present. He’d never felt like this before his dad had died, well, you didn’t think about death and dying. At least he hadn’t, not like it was going to happen to someone close to you. Not yet. Now, well, now he didn’t know what to think. Truth was he didn’t really want to think. Stay numb, that was the best way. A few whiskies of an evening, that helped. Clare didn’t like it, but she didn’t understand. It wasn’t her dad. Her parents were alive. She didn’t understand. It felt like no one understood, not really, what it was like, what he felt.

He thought about Chris, the thought just appeared in his mind. Would he understand? Could he? He was a counsellor. That’s what counsellors were good at, weren’t they? But how could he know? It all felt too much, too overwhelming. He was looking down and thought about looking up, to check what Chris was doing, but he didn’t want to, he’d rather stay in himself, in his own world. Not that he was thinking of it quite like that. He just kept his head down, his eyes on the carpet, not that he was seeing the patterns, they were there, but in a way he wasn’t. It sort of felt safe to stay in his own head, his own world. It was out there that troubled him. Yes, he was safe in his own head somehow. The numbness had returned. He was thinking, but somehow not thinking. Thoughts, but he didn’t feel like he was thinking them, like they were being projected into his head somehow. They weren’t his, and yet...

Chris sat in the silence, feeling a degree of intensity. The atmosphere felt, well, it wasn’t so much tense in an uncomfortable kind of way. It didn’t feel awkward or strained. It didn’t feel like Billy was trying to find something to say; maybe it had been like that, maybe earlier, but now it felt different. Often, in his experience, you could sense a change during a silence. The sense of awkwardness could pass and often such shifts were indicative that the client was thinking or feeling in a way that was absorbing them. That they were engaging with their own inner world, as it were, being what was present, focusing on what was emerging. The awkwardness was often associated with not knowing what to say, feeling embarrassed, being uncomfortable with silence or being with a stranger, all quite reasonable reactions.

Chris believed that during silences, as a person-centred therapist it was important for him to maintain his therapeutic attitude. Just because the client wasn’t outwardly communicating didn’t mean that he could let his attention wander. It was part of the discipline of being a therapist. And it was a discipline, a self-discipline. Not everyone appreciated this. He was contracting with a client to offer his availability for the therapeutic hour, to provide for that relational therapeutic climate that he knew was facilitative of constructive personality change.

He also believed that somehow his interior attitude made an impact, even during silence. He believed that somehow it made an impact on the client – was impact too harsh a word, maybe impression was better, softer – even though there was no visible or verbal form of communication occurring. He felt genuinely accepting of Billy’s need to be outwardly silent, and he was grateful for feeling that way. He believed that his warm acceptance of his clients had to be felt, that it wasn’t something you thought about feeling towards your client, it had to present ...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Foreword
• Foreword
• Preface
• About the author
• Acknowledgements
• Introduction
• Part 1
• Part 2
• Author’s epilogue
• References
• Contacts
• Index