Counselling is never a straight path. It requires a lot of hard work and patience. This is what I learnt from my first customer, Jennifer (name changed to protect privacy).
I am trained as a person-centred counsellor, and I have used this approach with Jennifer as well as narrative therapy and solution-focused therapy.
All our sessions happened over the phone. I “met” Jennifer a month into my placement, and she immediately jumped into what she was experiencing. She had been diagnosed with anxiety and a panic disorder, and that’s all she talked about in the first fifteen minutes of our session. I couldn’t get a word in edgewise because she was telling her story at such a fast and anxious pace that I was afraid it would trigger an anxiety attack right there on the phone. Through her anxious talk, I learnt some things about her. She had anxiety and panic disorder. She was afraid to go outside alone. She had left her job due to this as she couldn’t pick up on the signs that she was experiencing major anxiety and about to have a panic attack.
Jennifer had been to a psychologist and was comfortable talking about herself to me; however, it took some effort to pause her when she started talking. In the first session, I was stumped about what I should be saying or not saying to Jennifer, as is the case for any newbie when we meet our first customers. It took me a few minutes to get my bearings and to be present with Jennifer in the “room”, so to speak.
I found her to be very self-aware, and she knew what she wanted to say. What she was having trouble with was pausing herself so that she wouldn’t get worked up. I asked Jennifer if she would like to engage in a mindfulness activity with me to practice a bit of controlled breathing. At first, she was hesitant, saying that she had already practiced breathing but reluctantly agreed to try again. After a few minutes of engaging in the activity, she sounded calmer, and she admitted to feeling better. I was happy to see that the effect was what I had hoped and that she was able to slow down. I invited her to engage in this activity whenever she felt overwhelmed, or her anxiety was piquing. She hesitantly agreed.
The next time I spoke to Jennifer, she shared an incident that occurred over the weekend where she thought she was about to have a panic attack. She had been out to brunch with her family, and it became too much for her. She had picked up on the signs of a panic attack, decided against taking her medication and started to focus on controlling her breathing. She shut everyone and everything out to focus on her breathing instead. She regained control in a few minutes and asked to be taken home when she felt well enough to stand. I acknowledged how great it was to hear how she had managed to calm herself down by focusing on her breathing and commended her for overcoming something she had referred to as debilitating in our first session.
She wasn’t ready to accept my words and began to say that it was nothing and just a small panic attack. I acknowledged her triumph again, saying that big or small, a win is a win, and she did win, so she should celebrate that.
The next few months went by the same. Jennifer repeated her story over and over again. She talked about her anxiety and panic attacks and her agoraphobia. I began to question whether anything was coming out of our time together. Was I being helpful at all? I wondered what we were doing in our sessions. How much could I reflect and empathise about the same thing months on end? I had heard the words anxiety and panic disorder hundreds of times now, and nothing seemed to be changing. Jennifer confessed that she did not expect anything from me because she knew I was just there to listen and that her psychologist would be the one to offer her tool and solutions. That was a massive blow to my confidence, and again, I questioned myself about what I thought I was there for. I persevered because I hoped that maybe just my listening to her story over and over may help her.
Jennifer hadn’t been applying for jobs since she had left her last one, and we had been speaking for months. One day she told me that she had applied for a few jobs and had interviews lined up. I was ecstatic for her. The young woman who said she was afraid to meet me in person or engage in video calls was about to do interviews on Zoom. I was amazed at her bravery and wished her the best for her interviews.
In our following session, she told me that she had been offered three jobs, and she was unsure which to choose. We spent most of that session weighing out the pros and cons of each job to help her decide and say yes to the position that suited her situation best at the time. I congratulated her on such a huge achievement and asked her what it was like getting to this stage, knowing that she didn’t even want to think about working again when we started our sessions. While she was happy, she was also anxious that they would ask her to come into the office, which she was not ready to do. I acknowledged how scary it was to think about going back to the office after months of being at home and having her panic attacks. Jennifer surprised me again by saying that she had not had a panic attack since she talked about it in our second session and that she feels that it might have been a misdiagnosis. I was amazed to see how far she had come. Was this really the same person who had used the words anxiety and panic disorder hundreds of times in our sessions?
In one instance, I remember she mentioned that she missed driving and how she loved to drive her car and go out and meet people, and now only her partner drove her car while she sat on the passenger side, which always upset her. I asked Jennifer if she had driven at all since everything happened, and she told me that her partner had made her drive once with him in the car. It was a five-minute drive, and she said her anxiety kept telling her that she would crash and that she didn’t know how to drive. I reflected on how terrible and nerve-racking that must have been, and asked her how it would feel if she challenged her anxiety and flipped the narrative, so every time her anxiety told her she would crash, she could consciously tell it that she was a great driver who loved driving. She wasn’t keen on the idea and sounded sceptical, although she agreed to try it.
In another instance, she talked about how anxious she was when she went to get her first dose of the COVID-19 vaccine. She had to wait in the car because she couldn’t handle standing in the line, even though she was with her sister and partner at the time. She stated that she also needed to keep her car in her line of sight to remain slightly calm because she was afraid of being outside. I acknowledged her feelings of being afraid and asked her how she felt about taking walks with someone or by herself. I suggested she set goals for herself about how much she was willing and comfortable to venture out of her house and slowly increase the distance as she became more comfortable. Jennifer was sceptical and said she wasn’t sure if she would do it. I reassured her that it was up to her if she wanted to try it or not.
During one of our last sessions together, Jennifer surprised me yet again. She said she had been doing her breathing exercises, she had begun to address her anxiety and flip the narrative, and had even started taking walks on her own, while in view of her house. I was speechless. After months of being reluctant to take any of my suggestions on board, she had started doing all of them. She stated that when I had initially made the suggestions, she had thought them crazy and did not think it could be that simple to start making changes but now, after she had tried them a few times, she had realised that they do work and were the stepping stones she needed to bring some change into her lifestyle. I commended her for trying them even when she was not comfortable and that I was glad to hear that they were working for her.
After our final session, I was left so amazed at how much work we had accomplished together and how some patience on my part helped the process along.
Jennifer had only expected me to listen, and I listened. She did not expect me to help her; still, through the process of just being present and genuine, showing her unconditional positive regard and empathy, and accepting her for who she is, I was able to build that trust with her to empower her to take my suggestions on board and make some changes in a way that worked best for her.