3 Multiple choice in Drug and Alcohol Treatment Specialist DUE IN 12 HOURS

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IV Preparing to Counsel Others

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

The Pieces of the Puzzle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

CHAPTER 1: The Foundations of Human Behavior . . . . . . . . . . . . . . . 9

Nature Versus Nurture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Emotions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Motives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Defense Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

CHAPTER 2: The Process of Socialization . . . . . . . . . . . . . . . . . . . . 27

Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Social Institutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Social Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Social Maladjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

CHAPTER 3: Social Issues in General . . . . . . . . . . . . . . . . . . . . . . . . 37

Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Alcoholism and Drug Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Domestic Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Racism and Discrimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

V

CHAPTER 4: Social Issues in the Workplace . . . . . . . . . . . . . . . . . . 49 Absenteeism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Sexual Harassment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Stress in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

CHAPTER 5: A Recipe for Psychological and Social Wellness . . . . . . 65 Goal Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Self Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Positive Thinking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

CHAPTER 6: Counseling Tasks and Competencies . . . . . . . . . . . . . . 77 Attributes of an Effective Counseling Relationship . . . . . . . . . . . . . . 78

Acknowledging and Working with the Individuality of the Client . . 79

Counseling Precepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

CHAPTER 7: Recognizing Ambiguity and Complexity . . . . . . . . . . . . 85 Hidden Dependency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Abuse and Victimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

The Dual-Diagnosis Client . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Enabling and Codependency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

Responses to Receiving Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

VI Preparing to Counsel Others

I NTRODUCTIONI NTRODUCTION

This book is intended to provide initial training and awareness to people who plan to become counselors in the areas of substance abuse, sexual dysfunction and other psychosocial problems. Each of those fields requires significant technical and clinical knowledge. However, before that knowledge can be received, absorbed, and implemented effectively, there is some basic initial information needed by the would-be counselor.

One of the most famous quotations from the Bible that has been used in so many other contexts that many people do not realize its origin. The phrase is “Physician, heal thyself.” Perhaps a companion quotation, one also widely exported to other fields, comes from the ancient Greek physician Hippocrates. That phrase is “At least do no harm.” At the outset of training to serve in any helping profession, it is of great potential benefit for the student to contemplate the meaning and significance of these phrases.

Introduction 1

There is tremendous responsibility assumed when one sets about to help a human being try to become whole again, at whatever level of participation. To begin with, as Hippocrates warned, there is always the very real risk of not only failing to help, but of actually doing further damage. In counseling, this is most likely to happen not only if the helper lacks sufficient technical training, but if he or she brings to the table his or her own unresolved problems, deficiencies, and biases. Perhaps the single most fundamental element for success as a counselor is a well-grounded and unencumbered view of one’s own self, one’s role, and one’s limitations.

The human mind is a wonderful thing, arguably the most complex ever created. The sciences of psychology and sociology have emerged in the last century or so. They has explored how the mind forms and develops, what challenges or threatens it, and how it behaves to form families, peer groups, and communities. All human achievements, and most human failings, have their roots in the workings of this vital organ. This is not to suggest that to be effective a counselor must become a chemist, biologist, physician, or psychiatrist. We can borrow from the work of such professionals and take away a distilled, simplified version of how we all think, behave, and interact.

Without such awareness, a counselor is working in the dark, and unlikely to achieve desirable results.

You will be studying the basic issues involved in helping, as well as the impediments to helping. No one textbook, and certainly not one of an introductory nature, can take you very far down that road. You will be provided with an introduction and the framework upon which you can build.

Another expression worth a quick mention here at the outset (and one not as easily attributed to its original source as the other two, but believed to be derived from a Native American saying) is the need to “walk a mile in my shoes.” The core skill of the effective counselor is often the ability to understand what life is like and how things appear from the viewpoint of the

2 Preparing to Counsel Others

client. This ability to shift perspective with insight and empathy is cultivated through basic knowledge of human nature and human relations. That is our mission here. We will start with some relevant general information about human psychology and social problems. Then, in the later stages of the text, we will turn more specifically to the topic of counseling.

THE PIECES OF THE PUZZLE

The field of Human Relations is vast and complex. There are many different viewpoints from which to study it. It is useful to take a moment to look at the disciplines involved, and who the professionals are who practice in these areas.

Psychology is the study of human development and behavior. It is classified as a social science. There is a scientific component involving testing and field studies, but also a theoretical

element which interprets the science and is open to debate and discussion. Psychology looks at human development from infancy through all phases of life. It examines fears, feelings, behaviors and motivations. It describes what is needed for normal and successful human development, and what elements can interfere in this process and create problems.

A person with a graduate degree in psychology is called a psychologist. Some psychologists teach or conduct clinical research on the scientific aspects of behavior. However, many psychologists act as counselors and work with clients who are experiencing developmental problems or behavior- related difficulties.

Many people confuse psychologists and psychiatrists. Psychiatry is the study of abnormal mental or emotional conditions and disorders. Unlike a psychologist, a psychiatrist is a medical doctor. This means that he or she has completed medical school before obtaining specialized training in psychiatry. Because a psychiatrist is a medical doctor, he or she can prescribe drugs and medical treatments for which a psychologist has no license or training. Many psychiatrists provide therapy and counseling to patients, therefore some aspects of their work overlap with that of psychologists. A person with no specific disorder

Introduction 3

requiring medical treatment might receive help from either a psychologist or a psychiatrist. Patients exhibiting serious mental or emotional problems are treated by a psychiatrist.

This distinction is important because many mental disorders or problems can be triggered or aggravated by chemical or hormonal imbalances in the brain. It has recently been learned that some forms of depression, as well as attention deficit problems in children, fall into this category. A person suffering from such a condition may need medical treatment in order to have the best chance of recovery. Counseling alone may not be sufficient.

Sociology is the study of how people behave in social settings. It focuses more on trends in group behavior than on individual development. Because it is also a social science, it has developed objective research methods. Sociologists examine issues such as urbanization, changes to population groups, causes and patterns of poverty or crime, and government responses to social problems.

The role of a social worker is to assist individuals who are experiencing social problems. Social workers intervene in cases where people are suffering from social injustice or abuse. They arrange for needy persons to

4 Preparing to Counsel Others

receive social assistance and to participate in government sponsored programs. Social workers often have a background in sociology. Many also have a post-graduate degree from a school of social work.

The word “counselor” is a non- specific term. It may refer to any of the professionals we have just mentioned, or to others who have received training to provide assistance in some specific area. For example, “peer counselors” are people who have undergone some problem or crisis in their own lives, recovered from it, and then taken some training to enable them to help others who are facing the same situation. Semi-professional or non-professional counselors usually work under the supervision of a professional, and they refer cases that go beyond their area of expertise to appropriate medical professionals or agencies.

We have drawn together ideas, information and examples from all of these areas. Human behavior has been closely and systematically studied by the social sciences over the last 100 years. We have gained a good understanding of what makes most people succeed or fail in social situations in general, and in the workplace in particular. Psychologists can predict behavior and its outcomes in a wide range of situations.

There are always exceptions to every rule. As human beings, we are not all identical and totally predictable. Free will and individual choice are important parts of our human constitution. However, we are all influenced by predisposing factors far more than most of us realize. Without an understanding of these factors we may not be as free and as self-directed as we think we are.

When we use the terms “success” or “well being” we are describing someone whose life is “working well” from his or her point of view and that of most of the people around them. A person’s life can be going well without that person making a great deal of money, and even in spite of some physical impediments

Introduction 5

or medical problems. In general, it can be said that peoples’ lives are going well if they possess most or all of the following qualities:

• Physically they have a good level of health and fitness, or they are successfully coping with any illness or disability.

• Economically they have the basic comforts and feel reasonably secure, whatever their standard of living.

• They are employed in some line of work that makes them feel productive and competent, even if that work is not high paying, technically complex or wildly exciting — or, in lieu of employment, they find a satisfactory level of meaning and purpose via their family lives or in some other area of activity.

• They have stable and satisfying personal relations with parents, siblings, spouses, lovers, or close friends.

• They participate in society in a way that is acceptable to society itself; in other words they are not in conflict with the world around them and do not face arrests, evictions, dismissals, nor are they the victims of or perpetrators of violent acts or serious antisocial behaviors.

• They do not display health problems that are caused or aggravated by stress, conflict, depression, anxiety or confusion, dysfunction*, dependency**, or psychosis***.

*Dysfunction may be defined as a troubling inability to perform some normal and important human activity due to a medical and/or psychological problem.

**Dependency may be defined as an abnormal and unhealthy compulsive need for some chemical, substance, or activity. The related term “addiction” has a more limited and precise medical meaning.

***Psychosis is a specific, identifiable, and significant mental/emotional disorder that threatens a person’s well being and requires medical intervention.

• They are not happy all of the time but, when they are not experiencing a moment of specific illness or crisis they are fundamentally content with who they are and with life itself; they have a strong will to live and hope for the future.

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Fulfilling everything on the above list is a tall order, and learning how to become a successful and contented human being is a lifelong process. However, there are several fundamental

attitudes and awarenesses that help most people get started in the right direction and make certain and steady progress.

Introduction 7

8 Preparing to Counsel Others

NATURE VERSUS NURTURE

Since the dawn of mankind the human race has been asking the following big questions: Who are we? How did we get here? What is our purpose in being here? Many of us as individuals ask ourselves a parallel set of questions about our own unique lives and identities: Who are we? What are we like? How did we get to be this way? Is there anything we can do to improve our situation?

On an individual basis, just as on the level of the human species, these

questions cannot be answered only through intuition and opinion. Just as there is a scientific element to biological man, there is a scientific element to the social process that has produced you and I and brought us to the present point in our lives. In order to understand ourselves completely, we must begin by looking at our lives.

We now know a great deal about human development and how the human mind works. We cannot hope to take control of the factors that have assembled themselves in our lives unless we understand some essential realities about how we work. Unfortunately, as human beings we don’t come into this world with an

The Foundations of Human Behavior 9

CHAPTE R 1

THE FOUNDATIONS OF HUMAN BEHAVIORTHE FOUNDATIONS OF HUMAN BEHAVIOR

instruction manual. The challenge for us is to try to develop ourselves by studying people and society as a whole. We can discover what works and what doesn’t work for others, and why. There is a good chance that much of what applies to others will also apply to us.

“Nature versus Nurture” is a well- known phrase in the field of psychology and refers to a long-standing discussion and debate between two schools of thought. On the one hand, there are those people who believe that human beings are fundamentally created to be the way they are by nature. On the other hand, there are those who believe that our development in a specific situation or environment, especially during early childhood, is the main factor that determines the type of personality, social skills and social problems that we will exhibit throughout our lives.

If you think about it for a moment you can see that it makes quite a difference which side is right on this issue. If who we are is determined mainly or entirely by nature, then it probably doesn’t matter a great deal how or where we grow up or what our experiences may be. We should easily be able to overcome unfortunate experiences if our fundamental nature and constitution give us the ability to do so.

By “nature,” in today’s view, we refer mainly to genetics. You may be familiar with the notion that all living things, including human beings, contain a complete set of genes within the nucleus of each of their living cells. Individual genes are arranged on 46 strands called chromosomes. The process is incredibly complex and scientists are a long way from fully understanding and identifying how chromosomes control the growth and development of an organism. However, it is known that genes control many aspects of individual traits and features. They determine our overall

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size and shape, our sex, race, physical features and many aspects about development of the brain and its capabilities.

We receive our genes from the sperm and egg cells of our parents at the time we are conceived. We receive half of our genetic material from each parent, but they merge to form a new combination that is unique to each one of us. This is why children within the same family resemble their parents and one another to some extent, but are also different in many ways. Only identical twins share an exact duplicate of genetic material with one another.

Scientists have come to appreciate the importance of genetics, especially when we study other creatures. Consider the behavior of bees and other insects that work together in colonies. There is no evidence that these creatures have a training period or a learning process. They seem to be born somehow “knowing” what they must do throughout their lives and how to do it. This innate, inborn knowledge is referred to as instinct. Instinct is the driving force in most forms of animal behavior.

We do not understand precisely how instinct is related to genetics, but it is clear that there is some connection. Although it is not known how instincts

are stored in the brain, it is evident that the information is available at birth to all normally developed members of the species.

At first glance, human beings appear to be radically different from other animals in this regard. Human infants are born without knowing very much about their environment or about their roles and tasks as adults. Most of this has to be learned through a long educational process that extends into adult life.

On the other hand, it is not entirely true that infants are born without instincts. Newborn babies display various types of defense mechanisms and reflex actions. They also develop according to predictable patterns, even in the first few months when their development cannot possibly be controlled by a conscious thought process or things that they have observed and learned from others.

The Foundations of Human Behavior 11

Thus, it becomes clear that even human beings are born with certain instincts that guide their early development and behavior.

However, the vast amount of information that must be learned by each human being provides the framework for the “nurture” side of the debate. Through careful study of large numbers of children and adults of all ages and situations, it has become clear to psychologists that there is a pattern and a process to human development. Certain conditions are necessary in order for children to develop normally, to become well adjusted to society, and to avoid psychological and social problems. It has also been shown that when some of these basic requirements are lacking,

specific problems and abnormal behaviors can be predicted. In short, psychological studies have virtually proven the significance of our external environment and upbringing to some of the traits that we develop, the skills that we attain, or the problems that may confront us both during childhood and later in life.

Which side is right? Is the geneticist or the psychologist better equipped to explain to us how we became who we are? Most experts today would agree that both factors are important in determining who we are. When we try to determine the origins of a specific problem or trait it is important to consider the influence of both genetics and upbringing.

It is also important to understand and accept that neither nature nor

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Emotional development is greatly influenced by environmental and conditional responses.

nurture determines what is totally beyond our ability to control or change. If this were the case, there would be little point in making an effort to improve ourselves. It would be a no-win situation. If we spot weaknesses or deficiencies in ourselves, we would have to conclude that we are what we are because of genetics, or we were not nurtured properly. Either way, there would be nothing we could do about it now.

Very few experts in the field would support this line of thinking. We need to be aware that there are factors that work within us that we do not entirely understand and that may be difficult to control. At the same time, there are countless examples of people who have successfully taken charge of their lives and made significant and lasting changes in who they are and what they decide to do. It is not easy to take charge of who we are and what we become, but it is certainly possible and well worth the effort. Were this not true, there would be little role for psychologists or counselors.

EMOTIONS

Before we can understand how to change ourselves, better our lives, or help others to do so, we need to continue the fundamental exploration of who we are and exactly how we decide just how well we are doing. This issue is directly

involved with what we commonly refer to as “feelings” or “emotions”.

In the animal kingdom, success appears to be measured purely in physical terms. If the animal is alive and well, free of serious injuries or illnesses, it can generally be termed successful. If it has successfully reproduced, it seems to have achieved the ultimate level of success of which it is capable.

With human beings it is obviously far more complicated. Simple health and reproduction do not define success in our eyes nor in the eyes of those around us. How then do we know if we are doing well, or if we need to make some change in our situations?

Like other animals we are born with various ways of sensing the world around us. Without senses we would not know that the world outside our bodies ever existed, nor would we have

The Foundations of Human Behavior 13

come to the conclusion that we exist as a separate entity in a larger world. Babies are born without a clear understanding of these things and must discover them as they develop.

In probing our world and discovering what it is all about, we employ various physical senses, such as sight, touch, taste, hearing and smell. We also have the ability to experience pain. Pain provides powerful information about how our bodies are doing and when they are in physical danger.

Emotions are extensions of our physical senses. They are more complex, for they involve the ability of our brains to process information and form conclusions.

We can learn a great deal about the nature of emotions by studying the emotional level of infants. Many psychologists believe that newborns experience emotional states only in a very general way. They may experience general excitability, or general distress, in response to physical sensations such as hunger, pain, and warmth.

However, newborns do not experience emotions in the same way as adults. Often, parents and casual observers tend to “overestimate” the emotional responses of infants. For example, an infant who is crying may appear to be severely distraught and

experiencing extreme fear or rage. We come to this conclusion largely because we realize that if an adult were behaving in this manner such conclusions would be warranted. An adult crying hysterically is a person experiencing considerable distress. However, the crying reaction in infants is much simpler and usually not as emotionally traumatic as it may appear.

Young infants have relatively little capacity for any of the strong emotions that we experience as adults. They experience relatively little fear. It is unclear whether or not they experience love, even though they have an instinctive attraction to their primary caregiver. It is unlikely that they experience anger or rage even when they are emitting shrill cries of protest from their cribs.

All of these stronger emotions we now believe are learned during the

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earliest phases of our social development. Fear in particular is a learned response. If you were to be so reckless as to put a rattlesnake into the crib with a young infant, you would find that few if any of the infants would display any fear. Infants do not know very much about what is dangerous to them. In the beginning they may have no clear notion of danger or harm at all. As a result, they can observe things that are quite terrifying to many adults and experience no emotional reaction at all.

This seems to reinforce the notion that strong emotions come as a result of our learning process. They are tied in with our memories of good and bad experiences and our desire to repeat the former and avoid the latter in the future. Eventually we become aware of the possibility of being harmed not only by our environment but also by others around us. We become aware of the need to compete with others for the

things that seem essential to us. As a result of this entire process of growth and development, we become increasingly capable of feeling anger, disappointment, jealousy, fear and frustration.

Many of these emotions may be described as sensory indicators for our mental states. Just as loud noises or sharp pains may warn us about dangers in our physical environment, emotions provide us with another level by which we view and learn about our situations and our relations with others around us. Thus, emotions convey important information to us and it is important that we deal with this information.

The Foundations of Human Behavior 15

Understanding our own inner needs leads to better relationships with others.

Sigmund Freud, the father of modern psychoanalysis, long ago pointed out the harm that can result from ignoring strong emotions. If you feel a sharp pain when you put your hand on a stove burner, you need to take your hand away immediately or your skin and underlying tissue are going to be damaged. If you feel strong emotions, chances are you need to respond to them in some way or you may experience a similar type of internal harm.

The problem is that instinct tells us what to do with the hand on the hot stove. The correct and appropriate response to strong emotions does not appear to be anywhere nearly as instinctive or automatic. We know we have to do something, but there is a danger that what we do may be the wrong thing and may actually make the

situation worse. This is why the causes of our feelings and emotions need to be explored in detail before they can be understood and acted upon appropriately.

MOTIVES

Before we can hope to change our behavior to patterns that can be more effective in getting what we want in life, it is important for us to know why we do the things we do and, just as importantly, why other people do what they do. Sometimes the actions of others seem totally illogical or irrational to us. However, upon closer examination, we may discover that their view of the world is significantly different from ours, and that within their view what they attempt to do may make considerably more sense. Their view may seem distorted and inaccurate to us, but they must still respond to it, since it is the only view they have to work with.

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Psychologists have determined that there are a wide variety of factors that motivate human behavior and a hierarchy to these factors. In other words, some basic needs and motives are more important to us than others. Until these fundamental needs are satisfied, we tend to direct most of our energy in their direction. It is only once the basics have been met that we turn our attention to satisfying needs that are higher up on the ladder.

Psychologist Abraham Maslow is best known for identifying a fundamental hierarchy of human needs. The existence of a general hierarchy is widely accepted. At the bottom of the hierarchy are the most basic and fundamental needs, the ones that get our top priority if they are ever shaken. The most essential of our needs are simple physical requirements. These include food, drink, shelter and warmth. A person who is stranded in

the desert makes finding water and escaping the heat his or her top priority. In such a condition one stops worrying about things such as personal appearance, what someone else will think of them, or whether or not they are meeting their goals in life. When life itself is threatened, this becomes our number one priority.

Next up the ladder are broader safety issues. Even when we have the basics of food and shelter, if we feel we are in danger for any reason, safety becomes our next priority. During times of warfare or ethnic violence, people worry about safety. We also worry about safety in unfamiliar situations, such as when we are alone late at night, or passing through a dangerous neighborhood. Needs for safety may also apply to financial issues. A person who is afraid of losing his home because the mortgage can’t be paid may feel threatened. Thus, while safety refers mainly to physical well being, it may extend to financial security as well.

Once these two fundamental needs have been met, the next highest priority is what Maslow refers to as belongingness and love. We seek to be accepted and liked by others and to be needed and loved by them. This need is fairly self-explanatory. Given its position on the ladder, it tends to fall by the wayside when either our physical health or our safety is challenged.

The Foundations of Human Behavior 17

Once we have achieved love and belongingness, the next highest level of need involves esteem. We want not only to be loved, but we wish to be respected and admired. We seek praise, recognition and achievement. We would like to be leaders. We would like to have influence over others. We would like to feel good about ourselves and our personal accomplishments. However, once again, if anything on the ladder below is threatened, we may quickly abandon the pursuit of esteem until we have managed to look after the more fundamental issues.

At the top of Maslow’s hierarchy are self-actualization needs. We may set various intellectual or aesthetic goals for ourselves. We may wish to become more creative. We may wish to pursue a special talent. We may want to stand out as individuals and achieve a unique personal identity. We may have spiritual goals for ourselves. We may be working on self- improvement. This is the highest level at which humans are motivated to achieve their needs and wishes. People are only successful at this level if all the lower levels have been adequately fulfilled in their lives.

Consider the following practical example. You are part of a union that is voting on a new contract. The vote is likely to be very close and there is considerable disagreement among the workers about whether or not to accept

management’s latest offer. You are of the opinion that the offer is not adequate, that it is an insult to the work force. You are prepared to go on strike. You do not understand why so many of your co-workers are hesitant about doing this and seem to want to settle at any cost.

Let’s examine your situation a little closer and compare it with those of your fellow workers. Perhaps you come from a two-income family. Your spouse may have an adequate income that will help tide you over through a strike. You may have relatively few debts. There may be some of your co-workers who are considerably more worried about these things. They may fear for their basic physical or safety needs if the contract should be rejected and the workers should be forced to strike. The difference in viewpoint on this issue corresponds to how far you and your co-workers have separately climbed Maslow’s hierarchy

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Maslow’s hierarchy of needs.

of needs. With your physical and safety needs looked after, and likely those of belongingness and love, you are now concerned about self-esteem. You want to receive what you feel you deserve. You want recognition from management. You want to be treated with respect, and you feel that this offer fails to do this. Your decision to reject the contract may be logical. However, another worker’s decision to accept it may also be logical if that worker still has fundamental problems regarding well-being or basic economic security.

Another example arises when two female friends have an argument because one of them is involved in a relationship with an abusive male. The person in the abusive relationship may be reluctant to end it and may be unwilling to look at the situation objectively, naively hoping for improvement. Her friend, on the other hand, may be insistent that she herself would never tolerate a situation where someone was taking advantage of her or subjecting her to any form of abuse.

The difference in the two outlooks may once again have to do with Maslow’s hierarchy. The person who is stronger willed and more ready to step away from a bad relationship may have achieved a good level of belongingness and love in other aspects of her life. Feeling secure that she is loved, she is able to proceed to the issue of esteem and will reject any relationship that hurts her self-esteem. However, her friend may not fundamentally feel that she is loved. She may be so desperate to fulfill this need that she accepts this relationship even though it is less than satisfactory. Once again, the hierarchy of needs helps to color the two women’s viewpoints, outlooks and attitudes. Perhaps at some future stage in her development, the woman who is presently at the lower level may make progress in feeling loved to the point where she is no longer tolerant of any form of abuse and has the strength to break off the relationship, even if it means going without a partner for a time until she finds a better situation.

Another complicating factor concerning human motivations is that they often spring from parts of our mind of which we are not fully aware. One of the most important contributions that Sigmund Freud made to the field of psychology was defining different levels of the human mind. While Freud’s theories are not always accepted these days, it is nevertheless useful to

The Foundations of Human Behavior 19

examine some of his basic notions since they provide one interesting model of how the mind might work and why we may find it so difficult to understand our own thought processes.

Freud identified two basic parts of the mind that he called the conscious and the subconscious. The conscious mind involves the thoughts of which we are readily aware. When we are thinking to ourselves about what we want to do in a given situation we are using our conscious mind. However, we also have an unconscious mind that is active “behind the scenes,” and we do not always know what is going on there. Sometimes dreams can provide clues to motives or anxieties that are being dealt with by our unconscious minds. According to Freud, much motivation comes from the unconscious mind, which makes it very difficult sometimes

to be fully aware of specific motives in a given situation.

Freud gave the term ego to the conscious part of the mind. The ego is the part of the mind that makes deliberate decisions. It is aware of sensory data and our train of thought. When you make a decision about what to eat in a restaurant, or whether to make a left or right turn at a traffic light, your ego is at work.

Freud divided the unconscious mind into two elements that he called the id and the superego. The id is the part of the mind that tries to achieve pleasure in life. It is where our fundamental wants and drives originate. If we compare the ego to the driver of a car, the id is a child in the back seat screaming, “I want this,” or constantly making restless complaints or protests about being bored or hungry. In other words, the id is the part that can get us into trouble. The ego must control the id and its desires or we will tend to wander into behaviors that are not always socially acceptable.

The superego is what we often think of as “conscience.” It is the part of us that realizes that we cannot always do what we want the moment that we want to do it. It is aware that there are such things as right and wrong and that we have social obligations. We have to consider the feelings and well-being of others. The

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Sigmund Freud

superego is the part of the mind that is concerned with morals and ethics. When the ego is being driven too much by the id, the superego interjects doubts or a feeling of guilt or remorse in an attempt to steer us back onto a better path.

Some psychologists make a further distinction to what they call the preconscious mind. The preconscious mind exists just slightly below the level of the conscious mind or the ego. It holds ideas or motives that are very close to our direct thought processes. By stopping and thinking a bit, we can generally get in touch with the wishes and ideas of our preconscious mind.

However, most psychologists believe that other motives and ideas are buried much deeper in our unconscious mind, far below the level of the preconscious. One of the purposes of counseling sessions with a psychiatrist is to try to

access some of what is buried deep down in the subconscious. Sometimes, strategies such as hypnosis are used to help unlock the deeper levels of the subconscious. The assumption is that what is buried deep below the surface of our minds is of considerable importance to understanding our motives and reactions and is worth revealing and exploring.

Many psychologists think of the complete mind as being much like an iceberg floating in the sea. Only the tip of an iceberg appears above the water and the much larger piece is actually below the surface of the water. The ego is the part of our mind that is above the surface. However, the larger and more complex areas of superego and id are buried deeper down.

The Foundations of Human Behavior 21

It is little wonder we sometimes surprise and confuse ourselves with the way we react to certain situations or with strong emotional responses that catch us unprepared. This is also why the process of self-knowledge is so fundamentally important if we are to gain self-control. There is so much of our mind “under the water” that we need to do some exploration if we are truly going to know and understand ourselves and go on to counsel others.

DEFENSE MECHANISMS

Ideally, before we made any decisions in life we would take time out to study the situation and to probe our own needs, ideas and motives at every level of our mind before coming to the best possible conclusion. In the real world, however, we often have difficulty doing this. Sometimes, immediate decisions or responses are required. We are forced to take action in social situations before we have had a chance to figure out how we feel about the situation, what outcome we would like to see, or the best means to achieve that outcome.

When our mental circuits become overloaded we often resort to defense mechanisms as a way of dealing with or avoiding situations that are unpleasant or causing us stress and anxiety. Defense mechanisms can be a good thing because they can bring us

immediate and temporary relief from a stressful situation that is overpowering. However, if we rely on defense mechanisms and use them as a crutch, we never get to the root of our problems and invariably they tend to get worse. It is important to understand when we are using defense mechanisms so that we can decide to limit their use and replace them with more positive and thought-out reactions and responses. An understanding of the defense mechanisms used by clients is critical to the success of any counselor.

A basic defense mechanism is simply to ignore a situation. Procrastination can be a defense mechanism. We don’t know quite what to do, so we do nothing. A more severe

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Defense mechanismes are usually multi-layered and highly individualized. The depth of each level is based on past and present experiences.

form of this defense mechanism is repression. When we repress something we push it down into our unconscious mind where we will not have to be aware of it and will find it less painful. Feelings of hostility are often repressed.

When we repress something we are not just putting it off. We begin to deny its existence, and this is seldom a healthy thing to do. An extreme form of repression produces amnesia. When amnesia occurs we lose all memory of a situation and any of the details surrounding it. Serious traumatic incidents, as well as injuries to the brain, can bring on amnesia that may be either temporary or permanent.

Another extremely common form of defense mechanism is what is known as rationalization. Rationalization means that we cannot face the real reason for our behavior so we invent other reasons and try to convince ourselves that they are correct. A common form of rationalization is blaming others or making excuses for why we cannot or did not do something. For example, if we forget to do something important that someone in authority asked us to do, we may lie about how busy we were with other things and how impossible it was to do what was requested of us. Those other tasks may have taken only a small amount of time but we exaggerate them in order to make an excuse.

The problem is that we don’t always just lie to other people with rationalizations, we actually lie to ourselves. We convince ourselves that there is a good reason not to do something or a good reason not to try to achieve something simply because we do not want to face up to the task of how to go about doing it.

A more extreme form of rationalization is when we try to convince ourselves that something we failed to achieve was not worth achieving in the first place. If we tried and failed at something, we may tell ourselves that what we strived for wasn’t important or wouldn’t have been useful. If we lose an important relationship with a loved one, possibly through our own fault, we may try to convince ourselves that the other person was not suitable for us and we are better off without them.

The Foundations of Human Behavior 23

Another form of defense mechanism is known as regression. Regression tends to occur when we begin to make some improvements in our life, but then become confused or stressed, or don’t see the results we wanted immediately, and so we lapse back into our old behaviors. People who try to give up use of harmful or addictive substances experience a regression when they lapse back into bad habits. A person who goes on a diet to lose weight but gives up after a couple of weeks is regressing to former behaviors. An ex- cigarette-smoker who starts smoking again is regressing.

Sometimes we regress by resorting to behaviors that are more associated with earlier stages of our lives. Suddenly we may begin acting like teenagers or children again, throwing tantrums, demanding attention, or doing unproductive things to retaliate when we feel that someone has wronged us.

A final form of defense mechanism worth considering here is denial. In denial, we are so insecure about a situation that we simply pretend that it does not exist. This is similar to amnesia, except in this case there are no gaps in our memory. We are simply refusing to admit that “one and one is two.” For example, a woman who is frequently assaulted by her husband is clearly a victim of an abusive domestic

relationship. However, she may be so overwhelmed with confusion as to what to do about the situation that she denies to others and to herself that her husband is actually abusive. To others she may claim that her bruises are the result of accidents. To herself she may try to convince herself that she was the one who was in the wrong. She exonerates her husband’s bad behavior because she does not know what to do about it and she has resorted to the defense mechanism of denial in order to keep from being overwhelmed with fear and anxiety about the situation.

Defense mechanisms are unhealthy ways of dealing with situations. They never get to the root of our problems, so the prospect for improvement is very slim. The best way to overcome reliance on defense mechanisms is to accept the fact that we are using them and that they are not constructive elements in our lives.

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Notes

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CHAPTE R 2

THE PROCESS OF SOCIALIZATIONTHE PROCESS OF SOCIALIZATION

CULTURE

To some the word “socialization” may sound like something one does to become popular at a party. Actually that definition would not be totally off the mark. To social scientists, socialization is a general term for the process we go through in learning how to interact with others in our society.

What we need to learn in order to become socialized can loosely be defined as culture. Many people think of culture as art, music and literature. These are portions of our culture, but the term covers a much broader range. Our culture also includes radio, television, newspapers and magazines. It encompasses our political traditions, civic and religious holidays and rituals. It may include elements of how we work, how we dress, how we shop, how we drive our cars, how we spend our vacations, even how we speak and greet one another. Any knowledge or behavior that others in our society

expect from us can be considered part of our culture.

The important thing about culture is that it is linked to expectations. When it is wantonly disregarded we can anticipate consequences or penalties. Culture is part of what makes us comfortable in society, and when someone attacks or belittles it, they are apt to get a negative reaction from those around them.

There are some elements of culture that are common to all of humanity. Many cultural elements vary significantly from one part of the world to another. In some cultures a handshake is a common greeting. In others the same gesture is accomplished with a bow or a kiss on the cheek. Some cultures permit nudity on public beaches, while others would make an arrest for such behavior. Places or creatures may be sacred to one religious group yet have no meaning to another. Even minor details

The Process of Socialization 27

tend to vary significantly, such as on which side of the road you drive your car.

As we study how human beings adapt and relate to the people around them, the importance of culture cannot be overlooked. Culture is more than an accumulation of habits. It reflects the goals, values, and beliefs of a people. This is why it is taken seriously in a society. Most people do not regard their culture as a “bunch of dumb rules.” They see it as a tradition that links them to their ancestors and that preserves and protects the quality of their lives.

As human beings develop, there is inevitably some clash between the dictates of the culture and a person’s desire to assert an individual identity. Some cultures are very rigid and permit little individual expression. Most of us consider ourselves fortunate to be living in North America where individual freedom is actually seen as an important part of our culture, rather than as a challenge to it. In a relatively liberal and permissive society, most people feel the need for the secure boundaries that a culture provides, and there are limits to the tolerance for unusual behaviors, especially ones that appear to threaten cultural values. Whatever opinion one may have of this reaction in people, it is important to accept that it is logical and predictable. If the staunch individualist is ignorant about the culture and its significance to others, he or she is likely to encounter opposition and even hostility. How many Hollywood movies have been made over the years in which a person from a western culture visits a primitive tribe, carelessly touches or damages some sacred object, and soon finds himself in deep trouble? In real life, people often find themselves in a less literal form of “hot water” when they deliberately or accidentally violate some element of culture.

One interesting point about culture is that it exists not only on the level of races or nations, but within much

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smaller groups and organizations. For example, a specific company will have a distinct culture. The culture may include things such as a formal or informal dress code, habits about how and where breaks or meals are taken, or the use of parking spaces. There may even be unwritten guidelines about behaviors such as whether it is appropriating to greet another employee when passing in the office or the shop.

A person who is unfamiliar with the culture may end up violating it in a way that makes him or her stand out, and that may make others feel hurt, resentful or critical of the non-standard behaviors. Whenever you enter a new social environment, it is important to become extra sensitive and observant about cultural issues. Most successful people deal with cultural uncertainty by being temporarily less assertive or outgoing, following the lead of others, and making friendly gestures that indicate their desire to “learn the rules” and fit in. Counselors must be especially sensitive to cultural differences among clients.

SOCIAL INSTITUTIONS

Institutions within society are important shapers of our culture. The main institutions are the government, organized religions, the mass media, the educational system, and large fraternal or social societies. Major

charities also play a role in shaping our culture, as do organized leagues for sporting events.

In parts of the country where there is one large and dominant employer, that corporation is also a primary cultural institution. This may apply to a mining town, a farming cooperative or a major manufacturing plant.

These institutions not only have their own internal patterns of behavior, but they shape our society as a whole. One way in which they do this is actually a deliberate process. Institutions grow in size, power and security by influencing others to join them, accept them or support them in some way. A key example involves political parties. Most parties support specific goals and ideologies that can only be achieved if they are able to

The Process of Socialization 29

Attitudes towards social institutions are closely linked to issues of conformity. Individual viewpoints towards the fixtures of society have profound effects on economic, political, and religious beliefs.

persuade a majority of citizens to vote for them. In a more indirect way, religious groups sometimes compete for public support, especially with regard to key issues that may be disputed or are of a controversial nature.

Social institutions influence our behavior and our thinking in many ways. Sometimes they do so openly though direct campaigning. However, more subtle means are sometimes employed. Advertising is a means of attempting to influence the opinions and behaviors of others. It is often used to convince consumers to buy a product. However, ads are also used to promote candidates, causes, philosophies, patriotism, or cultural events.

We have been so continuously bombarded by the influences of social institutions throughout our lives that often we do not fully appreciate how important they have been in the shaping of our habits and opinions. It is often difficult to determine which thoughts and opinions are truly our own and those that we have acquired from groups within our society.

Sometimes on the news we see people in other parts of the world behaving in ways that seem irrational, even insane, to us, whether it be acts of war, persecution, racism, or other forms of aggression or destruction. What we often fail to realize is that these people

have been brought up in a different cultural environment from us, and have been directly influenced by some very different social institutions.

Social institutions are formed in response to systems of belief. These beliefs touch upon fundamental issues such as the existence or nature of God, codes of moral conduct prescribed by God or that are considered self-evident, and views about issues such as the role of government, the need to help others, and the rights and freedoms of the individual. Because there are deep fundamental differences among human beings on these issues, religious and government institutions vary greatly not only from one nation to another, but even within a single culture.

Social institutions are not only important in originating culture and social expectations, but they are also important agents for the socialization

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process itself. Our institutions create our schools, daycare programs, cultural events, entertainment outlets, and they provide the settings for much of our social interactions.

SOCIAL DEVELOPMENT

The first and most important agent of socialization for developing human beings is the family. Family interaction is of critical importance for several key reasons. The first is that the most important and enduring aspects of our personalities develop during the early years before we are old enough to go off to school. During this period of time, our parents, siblings and extended family members ARE our society.

We learn about the world mainly by observing these individuals. If their outlooks and behaviors are typical of the rest of society, then it is relatively straightforward to make the progression from family life into the larger society as we progress through childhood. However, if family values or behaviors are radically at odds with those of society, we may have difficulty understanding, accepting, and overcoming the early influences. For example, if we are exposed to violence in the home, it may be hard to understand and adjust to the fact that the rest of society does not consider this behavior acceptable. We may become insecure, uneasy, or develop a negative self-image if we begin to believe that what we have learned through early socialization is unreliable or unacceptable.

In an earlier chapter we looked at the issue of nature versus nurture. We examined the role that instinct seems to play in the earliest stages of human development. During the first year of life, we experience rapid growth, and physical development. We develop sensory and motor skills. This part of our development is triggered by instinct and is largely independent from the observations of other persons. As such, it tends to follow a very predictable time table in most babies who are free of illnesses or other physical limitations. The vast majority of infants are capable

The Process of Socialization 31

Statistics show that since the early 1960’s the structure of the American family has changed dramatically. Approximately 48% of North American families function with one live-in adult.

of holding their head erect and steady at around the age of three months. Visual capabilities develop in a complex pattern over the first six months or so of life. Tests have shown that most two- week old babies tend to look primarily at the internal features of a face, such as the eyes, rather than responding to an overall shape. Babies’ color receptors are not fully functional until they are about two months old. It is between the ages of three and five months that babies become adept at merging the visual images of both eyes into true stereoscopic vision.

The importance of “nurture” can be seen in the fact that children are not quite so predictable in the development of more “social skills” such as learning to talk, toilet training, and the like. To a large extent, socialization of toddlers and young children varies in proportion to the quantity and quality of stimulation that they receive. However, this is only true to a point. The socialization process is still largely

driven from within. Even children with comparatively absent or neglectful parents make concerted and impressive efforts to learn about the world around them as quickly as they can. For example, the basic process of learning a mother tongue is accomplished with an impressive efficiency which adults find hard to replicate if they try to learn a second language later in life.

Another reason parents are so influential in the development of early social awareness is that parents make deliberate attempts to influence their child’s socialization. While children are born with certain instincts, parents develop instinctive responses towards their children as well. Human parents have a strong instinctive urge to protect their children. In our complex human lifestyles, this protection extends well beyond prevention of accidents and elimination of physical danger. Parents have learned through experience how important the socialization process is to a person’s well-being and happiness throughout life. They have observed that people experience varying rates of success within society, and that some degree of deprivation or suffering is associated with socialization failures. Therefore, they try to protect their children from this form of harm by deliberately teaching their children the values, customs and skills they will need to participate in society.

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As the child grows older, portions of this fundamental parental responsibility are delegated or passed on to various social institutions, including schools, churches, and organized groups. At some point along the way, the significance of the family as the primary agent of socialization begins to diminish. Instead, the child becomes increasingly influenced by his or her peer group and the larger society, as perceived through direct experience, and through the media. This is also a critically important part of social development, because it leads gradually towards independence that is necessary in order for a person to function in the adult world.

The transitions are gradual and often confusing. Parents are often unsure when they should back away and exert less direct control over their children. Children, in their natural drive towards independence and adulthood, may try to pull away too soon, or they may rebel against the control that both parents and social institutions feel a need to exert over them.

SOCIAL MALADJUSTMENT

When all goes well, the development process advances along a steady, if sometimes bumpy, road toward eventual independence as a reasonably happy and effective member of adult society. However, any number of factors can short circuit that process and lead to developmental problems.

Problems in social development may result from many causes, including genetic disorders, injuries or illness. They can also result from abnormalities or deficiencies in the child’s environment, especially during early childhood.

The Process of Socialization 33

Abuse, isolation, under-stimulation, inconsistency, and deprivation may all be factors. Parents may fail to be effective in helping the socialization process of their children due to the effects of poverty, physical or mental illness or gaps in their own socialization as children or adults.

Social maladjustment can lead to problems such as deviance, alienation and aggression. Deviance can be loosely defined as abnormal and unacceptable behavior that is considered harmful. Drug use in adolescents is a good example, although not all drug use is spurred specifically by maladjustment. Alienation is a process by which children become separated from the mainstream of society or from their peer group. It is often accompanied by feelings of inadequacy, frustration and/or depression. Aggression often results when fundamental needs are not adequately met, and the child blames others for this deprivation.

Social scientists are sometimes criticized for being overly concerned with the root causes of maladjustment behaviors to the point where they seem to deny or diminish the element of “free will” in human behavior and choices. Taken to extremes, the developmentalist perspective can make us all seem like puppets, doomed by deficiencies in our upbringing to act out roles over which we have little understanding or control.

Very few people today accept that restrictive view of what human beings are all about. We are influenced by both nature and nurture, but neither controls us nor dictates what we must become. These factors may create habits, tendencies, weaknesses and blind spots, but they do not reduce us to puppets. Sooner or later we all get the chance to observe and study a wide range of human behavior in the world at large beyond the narrow influences of our particular upbringing. We get the chance to make rational choices, and even to change fundamental aspects of our outlooks and personalities. Counseling works because self-directed change is possible. However, that change is not always as easy to accomplish as we might expect, and it is made more difficult when we don’t understand the influences of our past which may tend to steer us back toward some unwanted habits. An important role of the counselor is to provide an understanding of these problems.

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Notes

The Process of Socialization 35

36 Preparing to Counsel Others

CHAPTE R 3

SOCIAL ISSUES IN GENERALSOCIAL ISSUES IN GENERAL

We now turn our attention to issues that affect us on a larger scale as members of society as a whole. This is important because an individual’s problems often need to be viewed against a backdrop of societal problems. These greater social issues help to shape the world around us, and this world is the stage upon which all of our personal relationships are played out. If we do not understand these issues, we may fail to appreciate the effects they have on our lives and those of the people with whom we come into contact in helping relationships.

POVERTY

When you first hear the word poverty, the images that come to mind may involve people in distant parts of the world. We have seen people who suffer greatly from the effects of wars, natural disasters, famines, and bleak economic situations. Sometimes the extent of this suffering is almost unimaginable to

many of us in North America. We often feel compelled to do something to help, to contribute to a cause or campaign aimed at responding to a specific need or crisis.

While it is important for us to be aware of global problems and crises, many people fail to appreciate that poverty is also a problem here in North America. It has an effect upon all of us in our society, regardless of our personal situations. Here in North America poverty is sometimes hidden from view. The most serious victims tend to live in inner cities or in remote rural areas. Because we may not live or work in these areas, we may not be aware of the extent of the problem, or the degree of suffering.

Sociologists are very much aware of the existence of poverty in American and Canadian societies. Social workers and government officials create programs to help those in need. Some of these programs are more effective than others, and public understanding and

Social Issues in General 37

attitudes are often critical to the success of achieving social goals.

There are various definitions of what constitutes “living in poverty” in North America. Experts devise formulas so that they can quantify the problem and keep track of positive or negative trends. To some experts the poverty line is defined as less than 50% of the average annual income for an area. Since the cost of living varies greatly from region to region, another useful statistic can be found by examining how people spend the money that is available to them. If a family is required to spend more than 60 to 65% of their income on the basic necessities

of food, clothing and shelter, it can be regarded as living below the poverty line. These families have very limited resources to devote to such areas as health care, education and school supplies, transportation or recreation. They generally find it impossible to save any money and so they have little security for the future. This can create considerable tension and stress within the home environment and lead to a wide range of social problems.

Poverty is an issue that often tends to form a dividing line of public opinion. Some see poverty as a disgrace for which society as a whole is to blame and which society must act together to

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Percent of Persons in Poverty, 2006

Source: U.S. Census Bureau, 2006-2008 American Community Survey

7.6% - 10% 10.4% - 12.4% 12.6% - 14.6% 15.% - 21.0%

address and solve. Others see the plight of the poor as largely their own fault. They blame them for a lack of effort or initiative at solving their own problems.

Very few experts on social issues share this second point of view. They view poverty as a vicious circle from which it is very difficult to rise without outside help from society as a whole. There is a more self-serving economic reason for society to take an interest in ridding itself of poverty. Social economists are able to demonstrate that victims of poverty cost society considerably more than the money that is distributed to them directly through welfare or unemployment insurance programs. Poverty is at the core of a broad range of important social problems, from crime to drugs and prostitution. It fuels the need for expensive services such as health care expenditures, shelters, homes and orphanages, prisons, and a broad range of other government programs, all of which cost North American taxpayers billions of dollars a year. This doesn’t take into account the extra money that citizens spend privately insuring themselves, arming themselves, and trying to protect themselves from some of the negative repercussions of living in a world where a significant portion of the population suffers from serious physical, economic, social and psychological deprivation and disadvantage. Worse, much of this money is spent coping with

the problem without fixing it, so money will have to be spent over and over again.

ALCOHOLISM AND DRUG ABUSE

Like poverty, alcoholism and drug abuse are personal problems that take their toll on society as a whole. Alcoholism has been a serious problem in North America for decades. It contributes to 50% of all fatal traffic accidents, and a staggering proportion of health care costs. It motivates or contributes to many assaults, thefts and other violent crimes, and is often the key factor in chronic unemployment and domestic violence.

The related problem of drug abuse has been on the rise again through the 1990’s, especially among young people. In some cities more than half of all high school students claim that they have at least experimented with some illegal drug. The vast majority of students know someone who is a frequent drug user. Drugs are easy to obtain in most American and Canadian high schools. Law enforcement efforts to deal with the problem have thus far met with limited success.

Sooner or later alcohol and drugs touch us all, either personally or through a family member or friend. We must all decide what our own

Social Issues in General 39

philosophy and behavior will be in this area. In times of stress or personal crisis, we may face the temptation of using chemical substances as a short- term “solution” to the pain and unpleasant emotions that we may feel welling up within us.

It is ironic that many of us first become exposed to alcohol and drugs in social settings such as parties. The irony lies in the fact that the long-term effects of chemical abuse lead not only to economic and health consequences, but to antisocial behaviors that can cripple our human relations efforts. Just as there is a vicious cycle to poverty, there is a similar pattern with people who fall victim to substance abuse. It erodes resources, relation- ships, and basic self-esteem. In doing so, this abuse adds to the unpleasant awareness that propelled users to try this “escape hatch” in the first place.

It is not always easy to define when a person has a “chemical dependency problem.” It is harder still to identify such a problem in ourselves. Alcohol in particular is a legal substance that is used in moderation by many happy and successful people in our society. How do we know when a person is slipping over the imaginary line that defines that person as a problem drinker?

Many of the warning signs have to do with human relations problems that begin to creep slowly but unmistakably into problem drinkers’ lives. A drinker clearly has a problem if one or more of the following things begin to occur:

1) If drinking or drug use contributes directly or indirectly to arguments or problems with bosses, coworkers, friends, spouses, parents or family members

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2) If it causes strain in relationships, or makes people back away from the drinker

3) If it causes financial losses and/or wasted opportunities that detract from the drinker’s standard of living

4) If it is also causing accidents, injuries, illness, or trouble with the law, then the problem is even more serious.

It is difficult for most people to deal successfully with a substance abuse problem without obtaining professional help. Trained counselors understand these problems thoroughly, and they know what help and support is available to deal with them.

DOMESTIC VIOLENCE

Domestic violence has always been an important social issue. We hear more about it today than we did in the past. This is in part due to greater public awareness and discussion of the problem.

Domestic violence includes sexual or verbal abuse of children by parents or other adults, and violence between spouses. Women and children are most often the victims, although senior citizens and even some men can suffer from such violence as well.

Abuse can be broadly classified as sexual, physical, and verbal. Sexual abuse includes rape, but also fondling and/or any unwanted touching. It also includes the use of sexually related threats or humiliation as a way of achieving dominance or control over another person.

Physical abuse includes assaults of all types. It is important to understand that, under the law, assault can be

Social Issues in General 41

physical or verbal. A threat or a gesture that causes someone to fear for his/her safety is a form of assault and is against the law.

Verbal abuse can be more subtle than a direct assault. Any attempt to break down a person’s dignity and will, humiliate them or destroy their self- confidence and self-esteem are forms of verbal abuse. For example, a parent who tells a child that he or she is evil, stupid, unlovable, or destined to failure

is committing a form of verbal abuse. Parents may verbally oppose wrong things that their children do, but when they attack the children personally they are violating their children’s human rights as defined in our society.

It is sometimes difficult to determine what forms of parental discipline may be considered abusive. Even experts are not always in agreement on this issue. Some approve of corporal punishment, such as spanking, if it is done under control and without causing excessive pain or any physical harm. However, some experts are so opposed to corporal punishment of any form that some countries are considering laws to make it a criminal act for a parent to strike a child under any circumstance.

It is important to realize that children can also be abusive to their parents, both physically and verbally. Senior citizens may also face abuse at the hands of children or adults, and this is a growing concern.

Like all other social problems, these issues become broader than the individuals who directly suffer from them. There is a larger cost to society as a whole in coping with the repercussions of abuse. These repercussions include violent crime, increased drug and alcohol abuse, unemployment, displacement,

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alienation, and problems that end up affecting the education and health care systems. It has been documented that abused children are more likely than others to become abusive parents unless something is done to understand and break the cycle. As with other social problems, professional counseling is often critical in accomplishing this.

RACISM AND DISCRIMINATION

We are all aware of the devastating effect that racial discrimination and ethnic conflicts have had on human history. We recognize and understand the meaning of racism in its most flagrant and devastating forms, such as race riots, racially motivated assaults, and civil wars or other conflicts motivated by racial, ethnic or religious differences. However, we are sometimes not as quick to see the more subtle signs of racism that exist within our own society and within the workplace.

Discrimination refers generally to unfair treatment on the basis of specific differences among people that are related to their background and not to their individual performance or personality. This may mean discrimination based on race, religion, ethnic origin, sex, age, sexual orientation, political viewpoint, physical appearance, size or other superficial traits. A related problem is discrimination based on illness or disability.

It is important to understand that when we refer to racism and similar forms of discrimination we are talking about acts that by their definition are unjust. Discrimination occurs when one reacts against persons based solely on assumptions or fears because of their characteristics. In other words, discrimination takes people with faces and makes them faceless. It ignores who they actually are, and reacts to them as two-dimensional stereotypes.

It is common sense that there are “good people” and “bad people” in all races and nations. Our society today expects us to give individuals the benefit of the doubt unless they have behaved in some objectionable manner. Racism is a denial of that opportunity, which is the right of everyone in our country. It is a prejudgment, the unjustified withdrawal of a chance to participate and to be treated fairly.

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It should be emphasized that discrimination does not only pertain to people from other races or other nationalities. Of equal importance in our society today are issues of discrimination against women in certain job settings, or unequal pay for women. Other examples include discrimination against the elderly or against older workers, discrimination against married people with children in certain apartment buildings, and numerous similar examples. The point is that everyone in society is entitled to have a fair and equal chance at basic rights and resources such as housing, medical treatment, use of public transportation, use of public areas such as malls and restaurants, and the opportunity to be employed and paid a fair wage.

With regard to employment, discrimination takes various forms. Discrimination may prevent someone from being hired in the first place, in which case it is overt and extreme.

However, there are more subtle forms of discrimination in the workplace. Discrimination, whether based on sex, race, or any other factor, may restrict a person’s opportunity for advancement. It may lead to an unjust dismissal. It may lead to a person being laid off when, based on seniority or other factors, someone else should have been laid off first. It may lead to attempts to dismiss someone or find an excuse for terminating his/her employment before he/she is able to reach retirement age. It can also lead to unfair compensation. In some parts of North America employers are notorious for hiring illegal immigrants because they can be paid less than the law provides and are not in a position to come forward and make complaints for fear that they will be sent out of the country.

There are now strict laws in place in the United States and Canada to prohibit any and all of these practices and they are increasingly being enforced. There are tribunals that hear complaints based on violations of human rights when people are refused employment or housing, unjustly dismissed from employment, or when they have suffered from some other tangible effect of discrimination.

Most major employers in North America now have official hiring policies that are designed to prevent personnel officers from making

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decisions based on racist or prejudicial attitudes. There are now a wide range of questions that are not permissible for an employer to ask during a job interview or on a job application. Some people may be unaware of the extent to which this protection extends to them. Listed below are some examples of questions that employers may not ask on a job application in most parts of North America:

• Are you married or single? • Where were you born? • What is your religion, or what

church do you attend? • Do you belong to any political

groups, parties, or societies? • How old are you? • Do you have any children? • What does your spouse do for

a living? • How much money does your

spouse earn?

In some jurisdictions, it is not even permissible to ask if a person has ever been arrested, if he or she has ever been refused credit, or to probe into a person’s past or personal background at all, other than to ask details of employment and education. As a general guideline, the only information job applicants are required or expected to provide is the names and addresses of previous employers and places where they attended school or took courses.

Discrimination is relevant to counselors because it contributes to stress and self-esteem issues, both of which may intensify substance abuse or marital problems. If a client appears to be suffering from discrimination, helping the client to redress this issue might be part of an overall plan to deal with the client’s lifestyle issues that may be impeding successful recovery.

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Notes

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Notes

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CHAPTE R 4

SOCIAL ISSUES IN THE WORKPLACESOCIAL ISSUES IN THE WORKPLACE

The social issues discussed thus far affect all of us in society as a whole. They are not specifically workplace issues, though all of them can affect performance on the job. For this reason, Employee Assistance Programs (E.A.P.s), organized by major employers, offer counseling on all these topics. Referrals from E.A.P.s are becoming an important source of new clients for some counselors dealing with alcohol and drug abuse, sexual dysfunction, or other marital/family issues.

However, there are some additional social issues that concern the workplace directly and especially. It is important to remember that the workplace is a very real and important part of the environment of any employed client. What happens there can contribute to problems such as alcohol and drug abuse, and can also serve as a generator of warning signs of their existence. We will examine some of these.

ABSENTEEISM

The term absenteeism refers to any unacceptable absence from work such as an absence not caused by illness or approved by a supervisor. Absenteeism is a problem that is often underestimated in significance by young people who first enter the workplace. One reason for this is that in the past decade many public school systems have either willingly or inadvertently softened their stance with regard to school attendance. Principals and teachers have been tolerating students being away from school without good

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excuse more than they did in the past (although recently there are signs that in some places the trend is starting to reverse itself and schools are trying to reinstate an emphasis upon mandatory attendance). In some cases the problem has been merely a lack of ability to enforce the rules.

One problem with a fairly lax standard of attendance in public schools is that it sometimes leaves young people caught by surprise when they enter the working world where the standards are not only tougher but they are both enforceable and enforced. In the public school, students tend to be part of a large crowd that must be dealt with sometimes as though it were a single entity. You can get lost within a crowd, or within a peer group, and the individual attention paid both to your achievements and your transgressions is somewhat reduced.

When entering the workplace, however, young people are entering a one-on-one world. They are not hired as a group, but rather as individuals. They will be working for one specific company, usually for one specific supervisor. The work they have been hired to do is of considerable importance to their employer or they would not be spending the money on their wages. Failure to do the work will have consequences for the employer. The employer will not be able to survive

unless he or she is in the habit of passing those consequences along to employees when it is appropriate to do so.

The problem of absenteeism in the workplace can be somewhat compared to a school of piranha attacking a large animal in a lake or river. Individually, each fish takes rather small bites. However, the cumulative effect of all of the bites taken by all of the fish can be devastating in its consequences. Absenteeism costs businesses billions of dollars a year. It is often their single most significant and definable cause of loss.

In large corporations the losses can be so significant that personnel will be hired specifically to deal with this issue and considerable time and money will be invested in training supervisors to enforce company policies and deal

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with violations. However, in small businesses, absenteeism can be even more devastating. It may not merely be a case of having to spend extra money to have the work done by other people. There could be a loss of income that may prove irreplaceable and that, if prolonged, could even threaten the livelihood of the business.

Consider the following example. If a store has three employees to serve its customers, and one of them does not show up for a shift on a busy Saturday, and cannot be replaced at the last minute, the store is left to function with only two workers. This obviously makes for an unpleasant day for the two people who will have to work extra hard that day. It has additional consequences that the person who failed to show up may not have considered. The employee who stays home may assume that the store will actually come out ahead because they may not have to pay him or her for the shift and will thus save the wages that were to be spent that day. However, in most cases, the store stands to lose far more money than they would have saved. In all likelihood the store would be so busy that the lineups would discourage people from coming in and shopping there on that particular day. Hundreds or even thousands of dollars worth of business may be lost as people walk into the store, see the lines, and walk out to shop elsewhere. Furthermore, some of the customers

who do stay and wait may become annoyed and frustrated, and this may affect their shopping decisions in the future. The next time they need something the store sells, they might remember the lineup and they may decide to go elsewhere. It is almost impossible to calculate the losses over the long term that the poor service store provided on that day may have caused.

Of course, every time one employee stays home from work, there may not be this sort of direct and measurable loss to the business. However, business owners know that over time small losses add up. This is why almost every business owner has decided that, in order to be successful, they must adopt a tough policy with regard to unjustified absenteeism. There is always the fear that if an owner becomes lax with enforcement the problem will increase. A person who is successful in skipping work one day

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will look for other opportunities to do so in the future. There is also a legitimate fear that if an employee is allowed to get away with this, other employees will be resentful, or may be motivated to skip work themselves.

There are other more subtle reasons why absenteeism angers and annoys business owners, sometimes to a greater extent than young employees are able to understand. When an employee fails to show up, or calls in sick when there is reason to suspect that they are lying, what occurs is a breach of trust, and a breach of contract. When a person accepts employment at a company, he or she is in effect signing or entering into an unwritten contract with the person or company that hires him or her. The person is guaranteeing his or her services in return for salary and other benefits. By allowing the person onto its premises the business is trusting the person with its money, its merchandise

and its good name. It is allowing the person to be a representative for the company in its dealings with customers.

When an employee is absent without excuse from work, employers often feel violated. They feel that their sense of trust has been betrayed. They may feel that they have been conned or duped by statements and behaviors that the employee showed during the job interview which are no longer evident. Right or wrong, they get the sense that the employee is trying to “pull a fast one” on them. In a sense, the employee is stealing something from them by dishonoring the agreement that has been made. There may be economic consequences for the business by the employee failing to show up, but even if there are no obvious consequences, the feeling of betrayal can still be there.

The other problem with absenteeism is that it suggests the employee is not committed to working for the company. It suggests that the employee would rather be elsewhere, that the work is of little interest, and that the employee feels no sense of duty to perform it. The larger problem with this is that it leads the manager to wonder if the employee will be performing well even if he or she does show up the next time. Persons who have tipped their hand that they don’t want to be present are people who need to be watched closely, even when they do finally come back to work.

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A startling amount of workplace absenteeism is fueled by alcohol/drug problems and/or marital difficulties. However, since employers are often unaware of these underlying problems, they often take absenteeism more “personally”, viewing it merely as unprovoked dishonesty and insubordination. It is only recently, and still mainly in large corporations, that employers have recognized the degree to which problems in the home fuel problems in the workplace, and have established E.A.P.s. as a means of helping employees receive assistance. In the past, an employee with a drinking problem that was affecting his or her work was often summarily fired. Today, it is increasingly more likely that the first response will be to offer the employee help.

The other problem with absenteeism is that it is subtly addictive in itself. The employee who stays home from work one day to engage in a recreational activity or recover from a hangover may be sorely tempted to do it again. While some employees stay home to engage in recreational activities with their friends, others stay home out of laziness, because they want to sleep in, or because they have been out late the night before. Some are genuinely too sick to work, but the sickness may be caused by substance abuse rather than a virus. Sometimes employees simply stay home out of depression or frustration with their job and dissatisfaction with their work situation or with life in general. Sometimes they stay home because their personal problems are draining them of the energy they need to focus on work.

SEXUAL HARASSMENT

Sexual harassment has become an important issue in the workplace. It is one that many young people entering the workplace may not fully understand. Sometimes people accused of sexual harassment defend themselves, believing that the rules have gone too far or are excessively strict. They do not believe that they have assaulted anyone or violated any legal or moral code, and they don’t understand why they are being reprimanded.

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The fact of the matter is that sexual harassment laws and guidelines are not merely designed to protect employees. It has always been against the law to force oneself upon another person sexually, or to use threats to force a person to perform some sexual activity.

These things are forbidden and have always been so. However, sexual harassment, as it is defined today, goes much farther than this. The intent is not just to prevent assaults, but to prevent sex from becoming an issue and a problem, to prevent a person’s sexuality from interfering with his or her ability to do the job, and insure employees to feel comfortable and secure in their work setting. The intent is not just to prevent assaults, but to prevent sex from becoming an issue and a problem.

Most employees prefer to be able to concentrate on the job for which they have been hired. While they are doing their jobs, employees do not want to be constantly compared to one another on a sexual basis. They do not want to be the butt of sexual jokes, and they do not want to be ostracized or treated unfairly because they do not wish to flirt or engage in jokes or discussions that are of a suggestive nature.

Sexual harassment can be extremely stressful. It is analogous to the problem of bullying in the public school system, a problem that has been receiving increased media attention.

For all these reasons, modern sexual harassment guidelines are considerably tougher than they were just a decade ago. They now include such factors as off-color jokes and cartoons, unwanted teasing, unwanted mention about the size or shape of a person’s body: in short, anything that causes sexual tension or distraction.

Sexual harassment runs a gamut in severity, from incidents that are mildly annoying or distracting to those which are so upsetting and stressful that they can force a person from the workplace. Sometimes a situation progresses from milder incidents to more flagrant ones. This is why, particularly in large companies, supervisors are now receiving extensive training on the

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topic of sexual harassment and how it must be managed and controlled. Like absenteeism, it is a serious problem that cannot be dismissed lightly. There is no such thing as being only a little bit sexually harassed, or putting up with sexual harassment once in a while. The problem cannot be dealt with unless the standard is applied uniformly at all times and to all individuals.

In its most flagrant and serious form, acts of sexual harassment are designed to force employees into participating in sexual acts. A boss may

overtly request that a coworker have a sexual relationship with him, or may simply perform a series of gestures that are intended to convey a strong suggestion of sexual interest. If the harasser is rebuffed at first, the tactics may change somewhat. The harasser may be tempted to use his position of authority within the company to retaliate against someone who has rejected sexual overtures, threatening the person with dismissal, lack of promotion or simply saddling him or her with an unfair number of undesirable assignments as a “punishment.” It frequently happens that such retaliatory action causes so much distress that an employee is forced to leave a job that they otherwise would have been happy to continue. It even propels some people into alcohol or drug abuse, and it has been implicated in some cases of sexual dysfunction.

Laws are now in place to provide harassed employees with alternatives to quitting. Many companies have implemented a “sexual harassment policy” where a person who feels victimized can report the alleged abuser to a designated person within the company. A series of confrontations then takes place, with the victim always protected from being identified. This may include a verbal or written warning or even dismissal, depending upon the evidence available and the severity of the complaint. A person who

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Although most states have strong laws in place pertaining to sexual harassment, many victims have found that reporting an incident is a difficult experience.

has been dismissed as a result of retaliationfor refusing sexual advances may seek outside assistance and win compensation.

After all, a person who is on the job is somewhat of a captive audience or a fixed target. Someone on the street who does not wish a person’s advances could simply walk away from them, avoid them, or refuse to take his or her phone calls. However, if two people work for the same company, there may be very little that a person can do to physically remove oneself from another employee’s unwanted advances short of quitting and plunging personal and family lives into chaos. This is why a stricter guideline must be applied to protect workers, since they are in a situation where they are vulnerable, and where they have a lot to lose if a situation becomes intolerable for them.

STRESS IN THE WORKPLACE

Stress has become a popular topic in recent years. Not only professional counselors, but also people in general are more aware of its impact. We are beginning to appreciate better how stress can rob us not only of our health, but also of success in our human relations endeavors.

Stress takes many forms and different people express and react to it

in different ways. There are a variety of causes, and a variety of symptoms. In general, stress is an accumulated psychological distress that manifests itself in physical responses and in emotional and behavioral changes. Stress may include any or all of the negative emotions of fear, anxiety, depression, boredom, frustration, intimidation, hostility and similar emotions. However, the key word is “cumulative.” Stress is often created by a large number of minor problems and events that begin to pile up. There may be one overriding factor such as a personal relationship that is not going well, or it may simply be the pressure of day-to-day events.

Some jobs are more stressful than others by their nature. If a person’s work involves more than the typical

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amount of pressure, danger, responsibility, or the need for attentiveness, then stress will be a factor even in a job that is going reasonably well. Domestic situations also cause stress, especially when they are unstable or involve an element of hardship, abuse or violence.

Some people experience more stress than others in the same circumstances. The amount of stress that we experience is related to our sense of ourselves, our confidence in our ability to deal with situations, and to the mechanisms that we have developed to relieve ourselves of the stress that builds up within us.

It has been well documented how stress contributes to health problems such as headaches, stomach disorders and even the development of chronic illnesses. It is important to realize that stress can have an equally devastating effect on the success of a person’s human relations and social interactions.

When stress builds up to intolerable levels, it often tends to erupt in ways that can damage relationships with others. These eruptions may be out of proportion, inappropriate, and misunderstood. It is not just that there is a chance that a stressed person will say or do something that will offend or anger someone else. Some ramifications are

subtler. For example, any public display of succumbing to stress, or less-than-ideal ability to cope with it, may be viewed as a blemish on a person’s character.

People don’t want to associate with, let alone have as employees, people who are emotionally erratic, calm one minute, flying off the handle the next. Unpredictability and uncertainty are not things that are valued or even well tolerated in our society. Most employers would rather put up with someone who is somewhat of an underachiever, if moods are consistent and predictable, than deal with someone who is full of surprises in terms of moods and emotions, regardless of his/her performance in better moments.

This points out the importance of doing what we can to handle stress in our lives, and as counselors, helping clients to handle it in their own lives. Some people believe that the way to handle stress is to eliminate all of

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the things that tend to cause it. Unfortunately this is seldom practical. Life is often by its very nature stressful. If you don’t feel at least some stress driving a car across the city during rush hour, you are probably not sufficiently aware of the real dangers that demand your attention. Sometimes we may also have serious health problems that require hospitalization, surgery, or some extended and possibly unpleasant treatment. We experience sickness and eventually death of the other members of our family and other people we care about. Our jobs don’t always go smoothly. Our personal relationships are not always easy. In other words, at least every once in a while something is going to happen, something that is partly beyond our control that is going to cause us to experience more stress than we are comfortable handling. For people in chronically difficult situations, or with inadequate coping skills, this will happen to them more frequently and more intensely.

Ignoring the situation does not often work. The only way to handle stress is to accept the fact that it is real and develop a strategy for relief before it becomes overwhelming.

There are various things we all can do to reduce the stress we feel in our lives, and these strategies need to be communicated to clients. Some of them

involve trying to improve the situations that cause the stress, if there are realistic ways of doing this. However, others involve simply taking time out. We all need to have outlets, little escapes once we are home and on our own and have free time at our disposal. We need to have hobbies and interests, things that intrigue and excite us, things that we look forward to doing. Preferably, some of these should be physical activities, outdoor experiences or athletic events.

Athletic activities provide several benefits, both physically and psychologically. They tone our muscles, increase our circulation, and improve our respiratory and circulatory systems. This allows us to sleep better and induces every system in our body to function with greater efficiency. That in itself helps us to cope. If we have health problems on top of personal problems, then we are double-dipping in the stress department. However, if our

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health is good this gives us one main advantage in coping with difficult human relations situations.

There are often subtle and simple ways of relieving stress in our day-to- day lives. Simple things such as taking a hot bath, lighting a pleasantly scented candle, listening to music, and brightening up your room with eye pleasing colors can have surprisingly positive effects. Like stress itself, the positive things we do to cope with it are also cumulative. A lot of very little things can add up to a big difference.

Particularly during times that are very stressful, we need to treat ourselves. There is the old analogy about the horse who pulls the cart because the owner hangs a carrot on a stick in front of its nose. The point of the

carrot idea is that we need to have something out in front of us, something we can see, something we can obtain in the near future that motivates us to keep going during tough times.

In other words, be good to yourself. If it seems like a battle out there, treat yourself like the wounded warrior you may be feeling you are. Give yourself a break, a chance to rest and recover. In doing so, you will find that your problems will seem less intense and overwhelming. You will have more self- control in your dealings with others and you will be able to project a positive disposition when doing so. Whatever difficulties life throws at you, you will avoid adding to the list yourself and becoming your own worst enemy.

Offering this type of advice to a client is pointless if the client’s life situation is such that there are no healthy outlets and no chance for a reasonable balance. For example, a hard core drug addict spends almost all spare time either taking drugs or engaging in a complicated cycle of events to secure and pay for them. There is no “leisure time” in the sense that we might perceive it. Furthermore, persons who are trapped in abusive relationships are often deprived of normal and healthy outlets or alternative activities. The abuser calls the shots, and often deliberately isolates the victim from contact with

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the outside world as much as possible. However, not all of a counselor’s clients are living in such desperate circumstances. For example, many teenaged substance abusers may appear to have a normal life full of opportunities of which, for one reason or another, they are failing to take advantage.

One factor that is often under- estimated in causing stress and frustration is the deceptively simple topic of boredom. As compared with fear, acute anxiety, or pain, boredom can seem like a relatively mild form of discomfort. However, if persistent, it can have an unexpected degree of influence over our moods and actions. Many clients, teenagers in particular, complain to counselors that they suffer from an incapacitating level of boredom with their lives.

Boredom can be viewed as a form of self-evaluation about our lives. We are telling ourselves that we are not sufficiently satisfied with what we are

doing with our life. Something is missing. We are under-stimulated, under-motivated, and distinctly under- enthusiastic about ourselves and how we are living.

We all get bored on occasion. We all have to do work we find tedious. The problem arises if, when we get home and finally have the free time we were looking forward to, we still find ourselves bored. If this consistently happens to a person, it is a sign that some time-out is needed to rethink and restructure some important aspects of life.

People tend to be bored when they do not have sufficient understanding of themselves. They have not set goals for themselves. They do not know what they want, and consequently they have difficulty figuring out how well they are doing and how happy they are or ought to feel about their lives. The simple act of setting and pursuing goals is one good way to alleviate boredom. It helps to develop a sense that life is valuable, and time is limited, and we must make the best possible use of the free time that is available.

One problem with boredom is that, like so many other situations, it is frequently misunderstood. When people don’t take responsibility for their own boredom, they tend to blame others. I am bored because my job is pointless. I am bored because my life partner

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isn’t satisfying me. I am bored because I don’t have the opportunities or attributes I see in someone else.

As long as a person continues to blame someone else for his/her boredom it will be expressed in frustration and resentment. The person will fail to take the internal steps necessary to discover the root of the problem and do something about it. The best way to view boredom is to see it as your own problem. It is not something the world is doing to you; it is something you are doing to yourself.

If a person is laid up with a cast in a hospital bed, boredom may be inevitable because there are limited resources to change the situation and engage in other activities. Under most other circumstances, however, people

do have the ability to change their situations, and it is their responsibility, not the responsibility of other people, to do so.

This doesn’t mean there is no role for a counselor, but the counselor cannot solve the problem for the client. The counselor can only help the client to understand the problem and become aware of options for solving it. The two main assets the counselor provides are emotional detachment and the perspective that comes from training and experience. Professional counselors see hundreds of people in similar situations and have learned to identify the problem and create practical solutions.

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Notes

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Notes

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CHAPTE R 5

A RECIPE FOR PSYCHOLOGICAL AND SOCIAL WELLNESS

A RECIPE FOR PSYCHOLOGICAL AND SOCIAL WELLNESS

GOAL SETTING

Each problem that a client brings to a counselor will have specific causes, symptoms, and solutions. However, there are some general attributes and activities that are necessary for all of us in order to keep our lives balanced and focused, and to avoid some of the tensions or dissatisfactions that are often the triggers for unhealthy emotional states, and unhealthy physical or chemical

outlets. We will discuss some of these prerequisites for wellness.

The first of these is goal setting. Goal setting is important not only with regard to career or employment ambitions, but in our personal lives as well. Unless we set goals for ourselves, not only are we less likely to live up to our potential, but we will have trouble figuring out how well we are doing. We need standards against which to measure ourselves, and goals provide them for us.

In order for goals to be helpful, they must be positive and realistic. We need to set goals over various time frames. We may have long-term goals, such as to own our own home within the next five years. There may be medium-range goals concerning where we would like to be in the coming year.

However, it is also important that we set short-term goals, even daily goals. When we wake up in the

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morning, it is helpful to have some sense of what we would like to have accomplished by the end of that day. Such daily goals, again provided they are realistic, help to give us a sense of satisfaction with our day. When we have accomplished our goal, we have a good feeling, we feel successful, and at the end of the day we are able to unwind and relax without feeling frustrated or dissatisfied. When clients are trying to recover from difficult problems, it is often the daily, one- step-at-a-time goals that are most important, particularly in the early stages of the counseling process.

Goal setting is also a way of taking larger tasks and dividing them up into manageable parts. If a person has a large task that must be completed during the coming week, such as packing all belongings in preparation for moving, this may seem overwhelming and the person may have a tendency to put it off until there is no alternative but to scramble to get it finished. By

dividing the task into daily goals, each of which will handle a portion of the total workload, it becomes more manageable and the person can avoid feeling stressed out, frustrated or overwhelmed. This principle can be applied to most of life’s tasks and problems, even those that are less tangible. The principle is to decide where you need to go, then identify the steps that will take you progressively toward that destination.

SELF EVALUATION

People have trouble comprehending their problems, even with outside help, unless they have at least a threshold level of self-knowledge. In order to gain this knowledge in a meaningful way, there must be some level of reflection and self evaluation. This is not a process that comes naturally to everyone, and an important role of a counselor is often to help a client engage in this process.

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Some people are so insecure and defensive that they are almost never willing to admit they are wrong about anything. The fact of the matter is that we are all wrong some of the time, and we can all improve as human beings. Furthermore, people who are fundamentally secure, happy and successful tend to be the most self- critical because they do not see criticism as a threat. They are not afraid to look in the mirror, and as a result they are more likely to notice things about themselves that can be improved.

Objective self evaluation is never an easy process. Many people find the key to successful self evaluation is to be attuned to how other people see them and react to what they do. An opinion that someone else has about a person is not necessarily a correct one, but it is certainly something that is worth taking a good close look at. If a person finds that several people react to him or her in the same way or seem to share the same opinion of his or her work, then there is good chance that there is something to what they are saying. They may not understand the person completely. There may be factors of which they are unaware. However, if they have a problem with the person, then the person must accept that a problem exists and needs to be addressed. Denying that the problem exists is not going to enable the person to solve it.

It is particularly useful to listen and consider the opinions of those who are somewhat detached or objective, people one does not have a close relationship with and therefore do not have an emotional involvement that may cloud their view. This is one of the important reasons that many people turn to professional counselors at critical moments in their lives when they feel the need to make a change or when they are experiencing a particularly stressful or difficult situation.

A client must take the feedback from a counselor and/or others and sift through it and consider it carefully. What ultimately matters is the client’s

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own assessment. An assessment cannot simply be handed to them by others. They can only contribute bits and pieces. The client must be the one to put the puzzle together. Otherwise, the client will merely be trying to execute someone else’s game plan, without fully understanding its relevance and validity, and without being fully committed to it.

For self evaluation to be effective, it must be a priority and a person needs to set aside time to do it. It should not be something a person only does when something goes wrong or at a time of crisis. Whether it is done once a week, once a month, or once a year, at some specific point, it is valuable to sit down with a piece of paper and a pencil. The person doing the self evaluation should write down things he likes about himself, then write down things that he doesn’t like. Then the person should write down suggestions of ways that these areas might be changed or improved. A counselor can teach a person how to do this, and monitor a first attempt at it, but the counselor cannot do the work for the client, because it is the client’s own self-image at stake.

At the same time the client can set some goals for himself, not only physical goals, such as to save a certain amount of money in a specific time, but personal goals concerning human relation skills and relationships with

others. Naturally, if the person has sought counseling for a problem, there should also be goals to resolve that problem.

The important thing about self evaluation is that its only purpose is to look towards the future. A person does not do it to reward or punish his/her past achievements or mistakes. What has happened in the past is over and done with. What matters now is what the person can take from those experiences to apply to present and future activities, coping skills, and interpersonal relationships.

POSITIVE THINKING

The importance of positive thinking is gaining renewed emphasis these days in the fields of psychology, business management, meditation, spirituality, and medicine. It has been discovered that patients with serious illnesses have a better chance of recovering if they maintain a positive outlook and a

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determination to fight and win against their disease. The same is true of people suffering from the types of problems that cause them to seek counseling.

Many people misunderstand what positive thinking is all about. They may see it as a naive and overly optimistic viewpoint where everything in the world is rosy and people should be happy all of the time. This is not the attitude to which we are referring.

Most reasonable people acknowledge that life can be difficult at times; they understand that we will all undergo periods of suffering and that we must be continually vigilant to protect ourselves from harm. People who practice positive thinking may vary greatly in their personal philosophies as to the meaning of life or how much happiness one can expect to find. However, what they share in common is a determination that, however good or evil the world around them may be at any moment, they are going to do their best to make the most of it. They are determined to take advantage of the opportunities that come their way, to minimize the dangers and the losses, and make the best life for themselves that they can.

Another element to the philosophy of positive thinking is not to become your own worst enemy. Do not let your own attitude and your own negative thinking add to the troubles you may

already have. It is bad enough when the rest of the world seems to give you a hard time. Consequently, when you end up giving yourself a hard time by dwelling on negative or hostile feelings or depressing and defeatist attitudes, then you take whatever is wrong in your life at the moment and actually make it worse.

The fact of the matter is that, despite suffering in the world, people in general are extremely successful beings. We can expect to live lives on average into our seventies, and we can expect a reasonably high standard of comfort and security for the better part of those years. We can expect to survive long enough to get married and have children and to see our grandchildren.

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Most of us will be able to find employment and earn enough to afford our own homes or comfortable apartments, and to purchase our own vehicles. We will have enough free time to entertain and amuse ourselves with a wide range of activities and interests. We will have the opportunity to develop friendships, fall in love and enjoy many of “the good things in life”. At no other time in human history have we enjoyed better overall health, a better chance at being able to recover from accidents or illnesses, and the ability to keep pain and suffering to a minimum in most cases. Yes, there are problems, there are challenges, and there will be many difficult moments. The point behind positive thinking is to make sure that we are ready for them and that we can do our very best to prevent them from interfering with the “good life” that we have every reason to expect will be available to us most of the time.

The other thing that practitioners of positive thinking understand is that in a very real sense our life is not only what we make of it, but also what we choose to see in it. People in our society are in the common habit of asking a courteous, “How are you?” whenever they run into someone they know. One person may be in the habit of answering, “Fine,” regardless of how he may actually be feeling. Another person may take the question literally and see it as an opportunity to make it clear

that he is not feeling well, is not happy, and that something is wrong with his life. These two individuals may have virtually identical situations in life: a lot of good things going for them, but one or two significant problems with their personal life, finances, or health. However, the person who feels a need to complain constantly is no doubt suffering to a much greater degree from the same problem or malady as the person who attempts to shrug it off and get on with the day. Not to mention that the person with the more positive outlook tends to be better liked and respected by others.

The following paragraphs present some basic guidelines for practicing positive thinking in your own day-to- day life, and advice you can pass along to your clients.

Concentrate primarily on what is going well in your life rather than what is wrong. You cannot sweep your

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problems under the rug, but do not spend a disproportionate amount of time thinking and worrying about them. Analyze them, deal with them as best you can, then try to put them out of your mind. Most of us may be in a situation where 80 or 90 percent of our life is essentially going well and only 10 or 20 percent is difficult or unpleasant in some way. However, we may spend 80 percent of our time thinking or worrying about the 20 percent that isn’t as we would like it to be. When we do this, the 20 percent becomes 80 percent for all practical purposes, because we are effectively crowding the good things out of our life by not allowing ourselves to enjoy them.

Establish an effective way of dealing with your fears. Many people can become overwhelmed or incapacitated with dread or fear. The fear may be directed at a specific person or event or it may be more general. General fears involve things such as a fear of developing a serious illness, a fear of being involved in an auto accident, a fear of being mugged or raped, etc.

There are several effective strategies for dealing with fears and not allowing oneself to be swallowed up by them. The first is to assess how realistic the fear is; in other words, how likely is the danger actually to arise? Your odds of being involved in a plane crash are very slim. Your odds of being mugged

and raped may be very slim in some parts of the world and may actually be very high in other areas or certain neighborhoods, particularly if you travel alone at night or leave yourself vulnerable in some other way.

Separate the “irrational” fears from those you need to pay attention to. In a sense, no fear is totally irrational in that the things we are afraid of do really happen somewhere in the world to some people. However, some scenarios are so unlikely that we would do well to put them out of our minds. If they should happen, then we will deal with them when the time comes, but they are not worth preparing ourselves for ahead of time. There are more important things to be concerned with.

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Once you have determined that your fear is reasonable, determine whether or not there is anything you can do about it. Can you improve the locks on your home or apartment or install more smoke detectors or change your route to come home from work at night if it takes you through a risky area? Is there something you can do about your health problems or some way that you can have yourself tested or screened to allay a particular fear that you might have? If there is some positive preventive action you can take, then doing so will make you feel better about yourself and somewhat allay your fear. On the other hand, if there is nothing you can do, you must accept this fact and try to prevent yourself from dwelling needlessly on the source of the fear. What you must avoid are dead-end loops where your

mind goes endlessly over the same events or the same anxieties without being able to come to any useful conclusions.

Another way of dealing with realistic fears is to imagine the worst case scenario. In other words, if absolutely everything you feared were to happen, what would you do about it? How would you cope, and how would you survive? If you are afraid that a nearby river will one day flood much higher than it normally does and drive you out of your home, then imagine the event actually occurring. Imagine moving in with a relative for a while. Imagine returning to your home later and getting your friends and neighbors to help you clean up. Imagine applying for insurance benefits or possible government assistance programs to help you get started again. Imagine having gotten through all that and being back in your home safe and secure once again. The same process can be used for a client who may have problems with an abusive spouse, and fears leaving and surviving alone.

If you can picture yourself surviving, then you know you are prepared for the worst. You know that no matter what, you will not be defeated. There will always be somewhere to turn, some way to cope. If you can come to this understanding, your fears will be much more easily managed.

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Deal in specifics and aim for definite results. Often, negativity shows itself in imprecise feelings of depression or frustration, a general sense that things are not the way you would like them to be, without any clear understanding of how or why. One way to overcome this tendency is to start being more specific about what you want or expect, not just over the long-term but also on a day-to- day basis. Set yourself an achievable goal each day, something that will take you one small step closer to what you want. At the end of the day, if you have met your goal, you can feel some satisfaction in having done so. If not, try it again the next day. You can only feel successful in life if you are able to identify specific and reasonable areas in which you hope to succeed.

Try not to lose sight of the big picture when little things do not go your way. A good example of this is if you are involved in a “fender-bender” in a parking lot or some other minor traffic accident with relatively little damage and no injuries. Such an experience is inevitably frustrating, whether it is your fault or someone else’s. It means your day is going to be disrupted. You are going to have to stop and attend to this matter. You are not going to get where you were going. The rest of your schedule will have to be rearranged. If the other person was at fault it may be difficult not to be angry with the person, even though you may have

made a similar mistake yourself at some time in the past.

At times like this, the challenge is to step back a little bit and look at the big picture. You are still alive and well. Neither you nor any of your family or friends were hurt. You have insurance and your car will get fixed. You still have a car, you still have a life. All of the good things that were in your life when you woke up in the morning are still there. Compared to the sudden death of a loved one, a catastrophic accident, a disabling injury, or other serious trauma, what you have just experienced is not such a big deal after all. You can get through it.

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You have two choices on how to get through it. You can keep as positive an outlook as you can, do what needs to be done as quickly and efficiently as possible, then try to put it out of your mind. Or, you can let yourself get very angry and depressed, let it ruin the entire day or the entire weekend. Either way, the car is damaged and will have to be fixed. The price you end up paying is significantly greater, however, when you allow it to drag down everything else in your life. This technique can also be applied to human relations problems, minor substance abuse relapses, or any other situation that may cause someone to lose sight of their larger goals.

Finally, a very important rule of positive thinking is acceptance of the fact that you will not always come out a winner. Do your best, and then accept whatever happens. Hold yourself accountable for efforts, but not always for results. Sometimes the results are partially or even entirely beyond your control. This doesn’t mean that results don’t matter, but they are not the only thing that matters. You are not going to

win them all. Every day is not going to go smoothly. The positive thinker has bad days just like everyone else. However, over an extended period of time, the positive thinker has fewer bad days, because their attitude enables them to see over and above the immediate problem and appreciate all that is well in their lives as opposed to focusing on what is wrong.

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Notes

A Recipe for Psychological and Social Wellness 75

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CHAPTE R 6

COUNSELING TASKS AND COMPETENCIESCOUNSELING TASKS AND COMPETENCIES

In this section we will discuss more specifically the role of counseling in regard to social and psychological problems. Whatever setting or level of counseling, there are some fundamental elements that must occur. These may be described as the overall “tasks” of counseling. However, some educators in the field prefer to call these elements

“competencies”. In other words, a counselor or a counseling program can be assessed as competent or effective based on the ability to do the following:

• establish a helping relationship with the client

• help the client become sincerely engaged in treatment and recovery

• help the client set realistic goals and strategies that will allow recovery and minimize or eliminate a relapse

• adapt strategies that conform to the individual characteristics of the client

• help the client acquire knowledge, skills, and more constructive attitudes

• encourage positive actions taken by the client

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• discourage behaviors that interfere with treatment goals while keeping counselor responses constructive

• help the client develop and improve life skills needed for recovery.

ATTRIBUTES OF AN EFFECTIVE HELPING RELATIONSHIP

The first item in the preceding list of competencies involves establishing a helping relationship with a client. That relationship must have several key characteristics by which it can be described, characteristics imparted largely through the skill and the personal character of the counselor. These include:

Sincerity. The counselor must possess, and communicate, a sincere desire to help, as well as a sense of optimism that help is possible. If the

counselor appears to be merely role playing or processing the information in a detached, mechanical way, the client will lose faith in the counselor and the process.

Respect. The counselor must respect the client and communicate this respect. The counselor must not appear to feel superior to the client either morally or intellectually. If the client feels disliked, distrusted, or not taken seriously by the counselor, then little progress will be possible. One may disapprove of certain acts, but one should never disapprove of the individual.

Warmth. Warmth flows from respect. It is easy to define, but sometimes difficult to implement. It is composed of small parts of several elements, including positive energy, friendliness, attentiveness, and encouragement. We do not mean that the counselor should appear excessively jovial, unrealistically optimistic, or become personal friends with the client. However, the counselor should convey a sense that he is happy to be in the same room with the client, looks forward to working with the client, and wants the relationship to be productive.

Specificity. At some point the relationship must progress beyond “good vibrations” and positive rapport. There has to be willingness by both

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parties to engage in frank disclosure and discussion. Discussions should remain, as much as possible, focused on the problems that have compelled the client to seek counseling. There must be precision and clarity in the examination of the situation and the quest for solutions.

Empathy. The counselor must feel and convey a sense of understanding of what the client is feeling and experiencing. Empathy is not the same thing as sympathy and doesn’t connote approval. It is simply a profound understanding on both an intellectual and emotional level. Without empathy the counselor cannot truly, fully understand the problem, because there are two components to any problem. The physical or “logistical” details of the problem, and the client’s perception of the problem. Empathy means that the counselor absorbs the facts of the situation, and then delves into the next layer and understands how the client has perceived what has happened, and his/her reaction to that perception.

ACKNOWLEDGING AND WORKING WITH THE INDIVIDUALITY OF THE CLIENT

Another key item on the list of counseling competencies involves recognizing the client’s individuality and tailoring

strategies to the client’s mindset and social situation. The relevant individual aspects of the client include:

• gender and sexual orientation

• age

• level of intellectual, emotional, and social development

• physical and mental health

• ethnicity and culture

• fundamental belief system

COUNSELING PRECEPTS

There are no absolute rules for counseling that apply in all cases. However, there are some basic tenets or precepts about how counseling should be conducted that are universal and that meet with wide agreement among both theorists and practitioners. Five of these basic concepts are briefly discussed below.

1. Emphasize the positive. Counseling must, first and foremost, be empowering for the client. In other words, from the start of counseling, the view is toward a day when the client will succeed by himself, without further need for the counselor. For this to happen, solutions cannot be imposed by the counselor. They must be discovered together, and the client must accept and believe the solution. This is very

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different from what sometimes happens in a classical medical situation, where the doctor prescribes medication, the patient is supposed to take it, but responsibility for understanding the medical problems and dealing with them lies ongoingly with the physician, and the patient’s only role is to follow instructions.

2. View substance abuse problems, and many other counseling issues, as a continuum, not as yes or no, good or bad, black or white. When is someone “an addict”, “an alcoholic” or “sexually dysfunctional”, as opposed to someone who simply “has a bit of a problem”? A client has a problem whenever he perceives a problem and is distressed by it, or when the client’s life is negatively impacted in noticeable ways, whether or not the client is willing to acknowledge the root causes.

In other words, there are degrees of problems and degrees of solutions.

3. Treatment must be individualized. To some extent there are many predictable patterns to specific drug addictions, or to specific types of sexual dysfunction, at least in terms of the biology and physiology of the problem. However, where clients differ, often dramatically, is in how the underlying problems are specifically affecting their lives, and what form of help they need as a result. Counseling theorists often refer to this as the “importance of context”. Clients are affected not only by their own

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addictions and problems, but also by others around them, and by their material and social situations. Counselors must try to treat the whole problem, which includes the underlying addiction or dysfunction, as well as its practical ramifications in the client’s life. The ramifications may include:

• legal problems

• marital problems

• financial problems

• domestic violence or instability

• primary and secondary health effects

• problems on the job or at school

• problems with a peer group

• psychological problems such as - depression - self-esteem issues - anxiety - anger management issues - lack of assertiveness - problems concentrating - problems relaxing - problems sleeping.

An individual counselor may not be qualified to deal with every one of these issues, but they all must be dealt with if present, even if some must be handled through other professionals.

4. Treatment must aim at long-term recovery. Clients often seek, or are forced to seek, help because of a crisis that requires immediate attention, such as an arrest, separation from a spouse, loss of job, suspension from school, an assault, a suicide attempt, etc. Certainly the immediate crisis must be dealt with at once. However, when a serious underlying issue is at the heart of the crisis, putting out the immediate fire does little to make the client safer or happier for very long. Whether or not the client appreciates or understands the long-term ramifications of what is happening, the counselor must gently but persistently focuse in that direction.

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5. Counselors must remain open to new methods, and must take a multicultural view of the client population they serve. There are many options available for recovery, and new approaches are tested and adopted on an ongoing basis. Besides one-on-one counseling sessions, the following options are often appropriate and helpful:

• couples or family counseling

• supportive group sessions

• peer counseling (“buddy system”)

• residential programs and day or half-day programs

• employment counseling

• pharmacological approaches, such as Methadone programs for heroin addicts.

Although there are times when exceptions are warranted, as a general principle, the first type of intervention should be less intensive and intrusive, then more extensive (and expensive) treatments are presented if initial efforts do not yield satisfactory results. The choice of methods must reflect a view of the individual client, and his/her cultural background. Ethnicity and culture affect not only the prevalence and types of problems, but also the communal attitudes toward addiction, dysfunction, and treatment. Sometimes cultural attitudes or beliefs work against certain treatment options, but in other cases they may open doors to new and better ways of helping clients of a particular ethnic origin or sexual identity.

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Notes

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CHAPTE R 7

RECOGNIZING AMBIGUITY AND COMPLEXITYRECOGNIZING AMBIGUITY AND COMPLEXITY

Early on in the training of any counselor dealing with social, sexual, or substance abuse problems, a sense has to be conveyed of the complexity of many of these issues and the people who suffer from them. Snap judgments, stereotypical perspectives, counselor biases, or rash assumptions must be carefully avoided if the counselor is to maintain the guiding principle we mentioned at the outset “at least do no harm”.

Human nature is complex, and no single issue, viewed in isolation, is ever the only thing going on in a person’s life. Assessment and treatment must include a look at the client as a whole, and often, at other important people in the client’s life.

The details of possible problems or complications vary from one context to another. Our main objective is to provide an overview of key issues and help instill the correct “mindset” for counseling in general. We can select some specific issues by way of example. The issues we will briefly profile here are:

• hidden dependency

• abuse and victimization

• the dual-diagnosis client

• the special needs of adolescents

• codependency and enabling.

Each of these issues could easily be expanded to fill a text by itself, and some of them point to problems that

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may require medical intervention beyond the expertise of a counselor. One of the most important skills a counselor can possess is an instinct for determining when the counselor is in a position to help the client, and when that client should be referred to another professional with a greater or different level of competency. Whenever a counselor accepts employment with a helping agency, an important part of the counselor’s orientation involves learning the center’s policies regarding the types of cases they do or do not handle, the limits of the counselor’s role, and the appropriate referral resources available. The brief discussions in the following paragraphs is not intended to provide expertise in diagnosing or treating the problems discussed. However, they lay a foundation of basic knowledge upon which subsequent training and experience may build.

HIDDEN DEPENDENCY

One of the first things that a future counselor has to learn with regard to substance abuse, sexual dysfunction, or other similar problems is that stereotypes are inaccurate. Many people think of alcoholics as “skid row” bums drinking cheap wine from paper bags. They think of heroin or cocaine addicts as troubled inner city youth, mostly angry young males. Pot smokers

are long-haired, sandal-wearing dropouts who sell crafts or play guitar on street corners or in subway stations. Certainly, there are individuals in any community who at least partially appear to match each of these images. However, what the stereotypes fail to identify and alert us to are the numerous other cases that include:

• physicians (or their wives) addicted to alcohol or prescription drugs

• former athletes (and former accident victims) addicted to prescription painkillers

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• housewives and young mothers addicted to anti-anxiety drugs or tranquilizers, and perhaps dangerously mixing them with alcohol

• successful high powered salespersons addicted to cocaine or alcohol

• relatively young married women who persistently experience pain and lack of pleasure during intercourse

• elderly people who are still sexually active but are experiencing specific problems related to ongoing enjoyment of sex.

Some of the previous examples comprise relatively small groups of individuals. However, other examples represent the “tip of the iceberg” for much larger groups whose problems are under-noticed and untreated. By way of example, let’s return our attention briefly to two such groups, women and the elderly.

According to Cohen (Counseling Addicted Women, 2000) substance- abusing women tend to be hidden, protected and/or abandoned. They frequently fail to come to the attention of the health care or social services system until some catastrophic event occurs, and by that time they are often long-term sufferers with deeply ingrained behavior patterns and numerous complications affecting many aspects of their lives. Women respond to specific chemical substances differently than men in many cases, and their patterns of use/abuse may be different. It is estimated that at least 40% of all people who are physically dependent on

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chemicals are women. Women make up fully 50% of those who are addicted to cocaine. In many cases, women addicts are even more at risk than men because of different, and often more dangerous opportunities to obtain the money to feed their addictions.

Similarly startling statistics emerge when one examines the problems of substance abuse and the elderly. Fourteen percent of the elderly seen in emergency rooms and up to 44% of the elderly seen in inpatient psychiatric treatment centers have alcohol abuse problems. And yet, substance abuse in the elderly is difficult to detect for several reasons. First, older adults who abuse alcohol are less likely to voluntarily visit a physician on a regular basis than younger or middle- aged drinkers. Furthermore, both the elderly, and those around them, tend to attribute health complications to

normal aging, rather than to the effects of drugs or alcohol.

In a few cases something close to a “stereotype” is, in fact, supported by valid research. For example, over 50% of the homeless suffer from some alcohol use disorder. Substance abuse, mental illness, or both, frequently lead to life on the street. When mental illness is present it can be an insidious complication because it may act against treatment efforts or rehabilitation.

ABUSE AND VICTIMIZATION

One factor that complicates substance abuse problems, particularly in women, but also in the elderly and other populations, is that a specific chemical dependency issue may arise from and lead to various types of abuse, violence, and victimization. Persons who suffer child abuse or spousal abuse, whether sexual, physical, emotional, or a combination of these, are more vulnerable to substance abuse issues and to sexual dysfunction problems later in life. If the abuse is ongoing, it may be almost impossible to treat a particular substance or dysfunction problem without first helping the client to correct or escape from the abusive situation.

The term “victimization “ is worthy of a brief discussion here. This word

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often takes on a special meaning over and above merely “being a victim”. The term can refer to a process in which persons who have suffered some form of abuse continue to experience an ongoing type of self-inflicted harm as a result of how they view themselves and the world. This can often be a complex scenario involving self-esteem issues, unrealistic fears, or inappropriate emotional and physical responses. In brief, you suffer victimization if long after an incident occurs and the immediate effects of it have been dealt with, you continue to suffer harm that impedes you in other, seemingly- unrelated life relationships and social functions. For example, women who

have been sexually abused as children or adolescents often suffer from unhealthy or semi-dysfunctional sexual relationships much later in life or even throughout their lives. Sadly, any form of child abuse is truly a harm that keeps on harming, and the ultimate testament to this is the alarming number of formerly abused who become abusers themselves.

THE DUAL-DIAGNOSIS CLIENT

The term “dual diagnosis” refers to clients who suffer from two distinct but interrelated problems at the same time. In most cases the term is used to refer to a combination of chemical addiction and mental illness, although some apply it to other combinations of coexisting problems. How common is this issue? According to some experts, up to two-thirds of patients who enter substance abuse programs have some symptoms of psychiatric problems at the time they are admitted. Not all would fully qualify as dual-diagnosis (the term being properly reserved for cases where the psychiatric disorder is of approximately equal significance to the chemical addiction and exists independently of it). However, we can see that the opportunity is present for a great many clients to start out or eventually become worthy of the dual- diagnosis label. If mental health

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problems are rampant, and substance abuse problems are also rampant, it seems inevitable that the two are often going to be linked.

It is not our intention to equip the reader either to diagnose or to treat a dual-diagnosis case. In many cases, counselors who become aware of or seriously suspect such a case should refer the client/patient to a more qualified level of intervention, such as a psychiatrist or medical doctor. However, it is not difficult to imagine that in such situations one problem clearly complicates treatment of the other, and this type of case is an important example of ambiguity and complexity.

ENABLING AND CODEPENDENCY

Another frequent complicating factor, particularly in cases of chemical addiction, occurs when another person is drawn into the web of sustaining the user. An enabler is someone who knowingly assists by sheltering the user from the natural consequences of his/her problem. We are not referring to drug dealers. Rather, we are referring to family members, acquaintances, or colleagues who try to shelter the user from harm by covering for the person, or in some cases contributing financially to the costs involved in acquiring the abused substance.

The motivations of enablers vary and can sometimes be a mix of self- serving concerns and misguided attempts at helping. For example, a parent may enable a teenaged child out of fear that, if caught, suspension from school may result and the teenager may not graduate or go on to university. Some enablers believe that if the situation can simply be “waited out” something will happen and it will correct itself on its own. They either don’t see professional help as necessary, or don’t feel they are in a position to persuade the user to seek it. In some cases, the enabler may have a substance abuse problem also, but in a surprising number of cases the enabler does not have the same problem, or approve of what the user is doing. Often, the enabler is afraid to try to stop the situation, either afraid of the user, or afraid for the user. They may believe that greater harm will come in exposing the situation than in helping to maintain its current level.

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The enabler is almost always wrong in these assessments or assumptions.

Psychologists identify some specific types or “styles” of enabling. These can be briefly profiled as follows:

1) The messiah. This type of enabler thinks he or she is fighting against the user’s addiction. The enabler may believe that he or she knows best how to do this, or is the only one in a position to do it successfully. Although the name given to this type of enabler may suggest someone with an enormous ego, and very self-assured, often “messiahs” are parents desperately trying to hold their family

together as best they can. Unfortunately, by sheltering the user from consequences, the messiah’s efforts are not only largely ineffective, but actually counterproductive. The situation gets worse instead of better.

2) The buddy. This is an enabler who also indulges, although perhaps not to the same degree as the addicted person. This is the typical “drinking buddy”. For example, in a marriage both spouses may drink, but only one does so to the point where a serious drinking problem has developed. The person who has drinking under control doesn’t want to give it up. Perhaps he or she feels that the other person can regain control and cut back to a more acceptable consumption level. The buddy enabler may actually be trying to “lead by example”, to show the user how to “know when to say when”. The problem is that the user is unable to learn that lesson without help, and the implicit approval of the abuse that comes from the buddy’s behavior is a disincentive to admitting to the problem or seeking treatment.

3) The passive sufferer. This type of enabler is often, though not always, a female spouse. She has learned to live with the problem. She sees little hope of improvement. Publicly, she pretends there is nothing seriously wrong. Her main goal is security, and she always wants to avoid or defuse conflict.

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Perhaps in the past confronting the addict has led to emotional or physical abuse. The philosophy is to give him what he wants, stay out of his way, and clean up after him as best you can. The passive sufferer will also do things to shield the abuser from consequences, calls to the addict’s employer to try to justify an absence; perhaps taking the blame for accidents or damage caused by the addict while high or intoxicated; perhaps doing without household necessities to free up money for the abuser to continue his habit.

What all enablers have in common is that they know they are abetting the user. These people are not simply naive or being duped. For whatever reason, they have decided to help the addict with his or her habit, rather than help him or her seek and find real help.

Co-dependency is a concept closely related to enabling. In fact, in some

individuals, the two concepts overlap. However, the term codependency refers to something a little different than merely helping an addict indulge or avoid the consequences of addiction. A co-dependent is by definition a person who lacks psychological wholeness, and seeks a substitute for that wholeness in his or her relationship with the user. The codependent needs the user, materially and emotionally, so he or she cannot afford to let the user pursue any independent path, even a path to recovery. A co-dependent person needs external sources of self-worth, specifically, the relationship with the user. A co-dependent person tends to become over-involved with the user, and may make great sacrifices to try to cure the user of the habit or problem. This may sound a bit like the messianic enabler, but the co-dependent operates from a position of weakness, not one of perceived strength. A co-dependent tends to become obsessive and often neurotic in his or her attempts to deal with the situation.

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Co-dependents often feel misplaced guilt. A classic example of a co- dependent, in a setting other than alcohol or drug abuse, is the battered wife who believes that she deserves what happens to her, that she is not good enough for her husband, and this is what provokes, and justifies the attacks.

Co-dependents often become enablers. However, all enablers are not necessarily co-dependents. It is important to understand that in a misguided way, the co-dependent is often working hard to try to “cure” the user of the problem. However, when the user fails or relapses, the co-dependent may see it as a personal failure. Sometimes parents fall into the role of co-dependent by this definition. In a treatment setting, a co-dependent parent may be swift to defend or make excuses. Any suggestion that the child might need to learn a lesson the hard way is apt to be greeted with disapproval and perhaps even panic. Anything unpleasant that the child will endure, the parent will also experience in magnification.

Psychologists have observed that sometimes a co-dependent person is reacting to or reliving some unresolved issue in a previous relationship. For example, a parent’s co-dependent relationship with a child may originate from the parent’s own childhood. However, one should never be quick to

jump to such conclusions. This type of case is best treated by psychiatrists. Most often, the co-dependent person needs help just as much as the addict.

RESPONSES TO RECEIVING HELP

Any professional helper, or person training to assume this role, needs to understand that the human response to being helped is surprisingly complex and often conflicted. While reactions vary, there is sometimes a strong but subtle resistance to accepting help from other people that even the client might not recognize or understand. Some people react differently to receiving help from professionals than from peers. For example, some people feel ashamed or humiliated if they need help from a loved one, but are more accepting of turning to a professional, someone with whom they have neither a history nor any emotional involvement. However, for others, the opposite is true. They will accept advice or assistance from friends

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or family, but the thought of going to a professional counselor either frightens them or repels them. In some cases, the reason may be that they wish to view their problem as minor, or within the range of the “normal” ups and downs of life, and not serious enough to need professional help. If they agree to counseling, they fear this will be seen as an acknowledgement that there is something seriously wrong. Because it is impossible to generalize a person’s response to being helped in the case of professional counseling, we can examine reactions to help in general. Counselors should be aware of the variety of instinctive reactions they may face.

Reactions to help are generally mixed at best. There may be embarrassment or wounded pride in having to reveal information about personal inadequacies or failings. The need for help may leave the client feeling weak or dependent. In some cases, this is more than a feeling. Dependence on the counselor can become a serious problem in some cases. There may be frustration with the type or degree of help that a client is receiving. Some clients have unrealistic expectations about the counseling process They may feel that it is like taking their car into the shop for repair, the counselor will do the work, and when it is done, the client simply drives away. Solving substance abuse or problems of sexual dysfunction is neither quick nor easy. It involves much effort, often painful, on the part of the client. It may also mean that the client has to hear and learn things about the reality of the situation. The counselor may end up being blamed for the pain associated with the process.

However, there is more to people’s reactions to being helped than mere emotional responses to the effects of counseling sessions. Psychology teaches us that there are deeper forces at work. One of these is called ATTRIBUTION THEORY. People have a need to figure out why they require help in the first place. In a sense, they need to assign blame for their problems. How they

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assign blame depends largely on how they view what psychologists call the LOCUS OF CONTROL in their lives. The locus of control is a term for who controls my fates. The two poles of the locus are internal and external, and there is a sliding scale between these two extremes. A person with a strong internal locus of control believes he or she is the captain of his or her own ship, and the master of his or her destiny. Such people tend to be confident and aggressive, but if they fail, they take it hard because they hold themselves responsible. On the other hand, a person with a strong external locus of control sees himself or herself as largely at the mercy of the actions of others. They feel comparatively helpless and powerless. They easily take on a defeatist attitude: “What’s the point of trying? They’ll only knock me back down again.”

It is hard to work with people who are at either extreme in the locus of control spectrum. Highly “internal control” people don’t see the need for counseling, and highly external people don’t see that it can possibly do any good. However, few people fall completely at one end of the pole or the other, and like most aspects of psychology, the situation is often more complicated than that. For many people, maintaining a somewhat external control philosophy becomes a strategy for deflecting blame, and indirectly maintaining their own self esteem. It can be a way of escaping responsibility for their own role in their problems.

Interestingly enough, various studies have shown that many people are more willing to accept help if they believe that the root cause of their problems is a difficult situation they happen to be in, rather than some personal failing on their part.

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Sometimes they hope that a counselor will be able to fix their situation for them, or at least that the counselor will be sympathetic and agree that the situation is the problem, so they can continue to avoid feeling guilty. There are many examples where individuals agree to participate in couple or family counseling sessions solely because they believe that some other person in the relationship is the problem, and they are confident that this fact will emerge triumphantly for them during the counseling. If it doesn’t end up going that way, or not entirely, there may be resistance or hostility with continuing the counseling unless or until the individual comes to accept the need for a shift in attribution away from others and at least partially toward himself or herself.

Another strong psychological factor in resistance to being helped is called REACTANCE THEORY. It asserts that all people have a strong drive to maximize their personal freedom and the ability to make their own decisions and choices. In part this is self-serving, but it may also spring from an underlying fear that having to conform with someone else’s choices or decisions may be difficult or painful. The desire for independence and control over one’s own life is called autonomy, and it is strongly evidenced in human beings, from toddlers insisting they can tie their own shoes, to seniors who stubbornly refuse to let caregivers

help them with ambulation or personal hygiene tasks. For some people, accepting counseling may mean surrendering autonomy. This is certainly a strong issue in reluctance to accept the more advanced or extreme forms of help, such as allowing oneself to be committed to a full-time treatment facility.

A subtler and less predictable psychological impediment to accepting help involves what psychologists call the NORM OF RECIPROCITY and the notion of indebtedness. People often feel that if they let someone help them they will owe the helper something in return. This is more likely to apply to accepting help from friends, family, or colleagues than from professional counselors, but it can arise in professional relationships also. When it does, it sometimes manifests itself as an inappropriate gift as a “thank you”. This may be a sign that a client is feeling an uncomfortable indebtedness and the counselor must explore this and try to defuse or discourage this perception so that it doesn’t interfere

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with the counseling relationship. While it is often okay for the counselor to accept a token of gratitude such as a thank you card, invitations to dinner or offers of expensive gifts must be politely but firmly discouraged. This should not be done in a way that evokes shame or a sense of wrongdoing, because in a nonprofessional helping relationship between two friends or siblings, such thank you gestures would not be inappropriate; indeed they might be a natural and healthy way of fulfilling a person’s sense of the norm of reciprocity. The client simply needs to understand that this normal instinct for reciprocity isn’t necessary or helpful in a professional counseling setting.

What does this whole discussion of client reactions to helping mean for the prospective counselor-in-training? Hopefully, it gives you a sense of the sophistication and challenge of the mission you will be undertaking. Approach it with persistence, but with humility and compassion. Expect

obstacles, and understand them enough not to feel discouraged or take them personally. What matters is helping the client, and the focus must be on the eventual results. Certainly, early successes in the counseling process are important, but early stumbles should not be blown out of proportion. Often the client will look to the counselor for a sense of how the process is going. If the counselor conveys disappointment, impatience, or annoyance, the client may lose confidence that the calmer, happier, and more successful days lie ahead.

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Notes

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