Counselling psychology and power Considering therapy and beyond

ABSTRACT

This case study examines the author’s therapeutic experience with one client presenting with anxiety, whilst working remotely due to the COVID-19 pandemic. Specifically, this work shows the interrelation between theory, practice, and research in the author’s counseling psychology training with a person-centered/experiential approach. Firstly, the beginning of therapy contextualizes the work with a formulation and presents the initial phase of the therapeutic relationship. Secondly, the development of therapy explores how empathic understanding was fostered with a focus on the themes of trust, acceptance, and power to illustrate the client’s process of change and the therapeutic alliance. Thirdly, a prospective ending is outlined as therapy was still ongoing at the time of writing. Finally, the therapeutic experience is evaluated within an understanding of counseling psychology practice as an ethical enterprise.

Cette étude de cas examine l’expérience thérapeutique de l’auteur avec un client présentant de l’anxiété, alors qu’il travaillait à distance suite à la pandémie de COVID-19. Plus précisément, ce travail montre l’interrelation entre la théorie, la pratique et la recherche dans la formation de l’auteur en counseling psychologique dans une Approche centrée sur la personne/expérientielle. Dans un premier temps, le début de la thérapie contextualize le travail en l’explicitant et présente la phase initiale de la relation thérapeutique. Deuxièmement, le développement de la thérapie explore comment la compréhension empathique a été favorisée en mettant l’accent sur les thèmes de la confiance, de l’acceptation et du pouvoir pour illustrer le processus de changement du client et l’alliance thérapeutique. Troisièmement, une issue est décrite de manière prospective car la thérapie était toujours en cours au moment de la rédaction de cet article. Enfin, l’expérience thérapeutique est évaluée dans le cadre d’une compréhension de la pratique du counseling psychologique en tant que démarche éthique.

Diese Fallstudie untersucht die therapeutische Erfahrung des Autors mit einer Klientperson mit Angstsymptomen, mit der er während der Covid-19-Pandemie im digitalen Kontakt arbeitete. Diese Arbeit zeigt insbesondere den Zusammenhang zwischen Theorie, Praxis und Forschung während der Beratungsweiterbildung des Autors in einem Personzentrierten/Experienziellen Ansatz. Zuerst konzeptualisiert der Autor seine Arbeit mit dem Beginn der Therapie anhand einer Formulierung und skizziert die Eingangsphase der therapeutischen Beziehung. Zweitens untersucht er mit der Entwicklung der Therapie, wie sich empathisches Verstehen durch einen Schwerpunkt auf den Themen Vertrauen, Akzeptanz und Macht fördern lässt und illustriert damit den Veränderungsprozess der Klientperson und die therapeutische Verbindung. Drittens wird ein prospektives Ende skizziert, da die Therapie während der Entstehung des Artikels noch andauerte. Schliesslich wird die therapeutische Erfahrung evaluiert, dabei wird die psychologische Beratungspraxis als ein ethisches Unterfangen verstanden.

Este estudio de un caso examina la experiencia terapéutica del autor con un cliente que presenta ansiedad, mientras trabaja de forma remota debido a la pandemia COVID-19. Específicamente, este trabajo muestra la interrelación entre teoría, práctica e investigación en la formación en counseling psicólogo del autor con un enfoque centrado en la persona/experiencial. En primer lugar, el inicio de la terapia contextualiza el trabajo con una formulación y presenta la fase inicial de la relación terapéutica. En segundo lugar, el desarrollo de la terapia explora cómo se fomentó la comprensión empática con un enfoque en los temas de confianza, aceptación y poder para ilustrar el proceso de cambio del cliente y la alianza terapéutica. En tercer lugar, se describe un posible final ya que la terapia aún estaba en curso al momento de escribir este artículo. Finalmente, la experiencia terapéutica se evalúa dentro de la comprensión de la práctica de la counseling psicológico como una empresa ética.

Este estudo de caso analisa a experiência terapêutica do autor com um cliente que exibia ansiedade enquanto em teletrabalho devido à pandemia COVID-19. Este trabalho mostra especificamente a inter-relação entre teoria, prática e pesquisa na formação em psicologia de aconselhamento do autor com uma abordagem centrada/experiencial. Em primeiro lugar, o início da terapia contextualiza o trabalho com uma formulação e apresenta a fase inicial da relação terapêutica. Em segundo lugar, o desenvolvimento da terapia explora como a compreensão empática foi fomentada com ênfase nos temas de confiança, aceitação e poder para ilustrar o processo de mudança do cliente e a aliança terapêutica. Em terceiro lugar, é delineado um possível final pois a terapia ainda estava em curso no momento da redação. Por fim, a experiência terapêutica é avaliada dentro de uma compreensão da prática da psicologia de aconselhamento enquanto empreendimento ético.

This client study is based on my therapeutic work with “Robert” (pseudonym) with a person-centered/experiential approach (PCA) as theorized by Rogers (1951). Robert is a middle-aged White man, married, father of two children and working in the public sector. Robert was experiencing an exacerbation of his anxiety following the COVID-19 outbreak, describing physical symptoms (e.g. muscles tightness, shortness of breath, nausea, and sleeplessness) and psychological difficulties (e.g. fear of exposing himself and/or his family to viral infection). Despite having worked on his anxiety previously, Robert reported that some practitioners had been authoritarian, disregarding his frame of reference, which led to therapeutic ruptures (Warner, 2000). Robert added that he only trusted his family. However, having moved several times whilst growing up, Robert described his parents’ behavior as unpredictable. Additionally, Robert identified his puberty as a time of change because of the expectations his parents placed on him as a man.

Resonating with the emphasis in the PCA on interconnectedness and counseling psychology’s commitment to social justice (Cutts, 2013), the Power Threat Meaning Framework (PTFM) posits that psychological difficulties are evolved and socially influenced responses to adverse experiences to preserve agency and meaning-making (Johnstone et al., 2018). Drawing from an understanding of Power as the ability to gain advantages and meet one’s and/or others’ needs, the PTFM explores how the negative operation of Power threatens individuals whose response is aimed at ensuring physical, emotional, relational and social survival (Johnstone et al., 2018). Specifically, the PTMF provides a narrative of someone’s difficulties by asking (1) how Power operates in someone’s life, (2) what kind of threats Power poses, (3) what is the meaning of these situations and experiences to the person, (4) what the person had to do to survive, (5) what access to Power resources the person has and, finally, (6) how all this fits together (Johnstone et al., 2018). Combining the PTMF with a PCA perspective, conditions of worth can be understood as illustrating both the interpersonal and the intrapersonal power inherent in relationship dynamics whereas the actualizing tendency would express the person’s power to move toward their potential (Rogers, 1959). Accordingly, a tentative formulation can offer an initial understanding of Robert’s incongruence.

(1) How are conditions of worth operating in Robert’s phenomenological context?

As significant others were described as unpredictable and the environment as unknown due to his family’s relocations, Robert shared how showing fear was a sign of weakness which led to the withdrawal of parental love. Consequently, Robert seemingly introjected the values of independence and fearlessness from his parents to gain positive regard (Rogers, 1959).

(2) How did these conditions of worth affect Robert’s self-concept?

The pandemic seemingly confirmed to Robert that the world is unsafe and others are dangerous. However, the expression of fear was incompatible with Robert’s self-concept, arguably causing psychological maladjustment (Rogers, 1959).

(3) What is Robert’s understanding of his incongruence?

As the pandemic made the exposure to fear unescapable, Robert’s anxiety seemingly arose as a response to a permanent state of threat, linked to the expectation to protect his family, thus triggering a sense of unworthiness.

(4) What did Robert do to maintain his self-concept?

To preserve his ‘fearless self’, Robert arguably avoided unknown situations that could cause a fear response, limiting social exposure. To preserve his ‘independent self’, Robert arguably dismissed seeking support in close relationships.

(5) What access does Robert have to his actualizing tendency?

Robert’s actualizing tendency was manifesting through the development of his relatedness. Specifically, in his commitment toward building a family, being a husband and a father seemingly revealed Robert’s appreciation of intimacy and ability to provide care. Furthermore, Robert’s previous engagement with therapy suggested his willingness to trust others.

(6) How does Robert understand his self-concept, incongruence and actualizing tendency?

The denial of fear to awareness impaired the development of Robert’s trust in his organismic experiencing because it contradicted his self-concept (Rogers, 1959). Therefore, Robert’s anxiety arguably became the expression of his need for safety challenged by a pandemic over which he had no control.

Rather than identifying goals, Robert and I explored our therapeutic relationship as a psychological intervention to foster change (Rogers, 1957). As Robert’s intention was to reduce his anxiety, we aimed to enhance his self-awareness so that he could experience fear without feeling overwhelmed, thus remaining open to his emotional experience through unconditional self-regard. In line with professional and ethical guidelines (British Psychological Society [BPS], 2018; Health and Care Professions Council, 2016), I explained the use of notes to keep a written record of the therapeutic practice and for training-related purposes whilst ensuring how the client’s anonymity would be protected. Whilst outlining consent, I specified the extent of confidentiality in case of risk to self or others and the role of supervision to ensure ethical practice (BPS, 2018; Health and Care Professions Council, 2016). Upon clarifying how the setting in which we were working provided open-ended sessions, I presented my theoretical orientation and encouraged a collaborative stance whereby we could regularly review our work (Health and Care Professions Council, 2015). Accordingly, I invited Robert to share his preferences. Elaborating on the person of the therapist, Robert emphasized a caring and non-judgmental stance as essential qualities (Rogers, 1957). Transcending the outcome of reducing anxiety, our ‘goal’ represented the direction of our therapeutic process to resolve Robert’s incongruence, thus facilitating his actualizing tendency (Rogers, 1958). Similarly, our bond could have become the expression of the six therapeutic conditions as ‘actualising processes’ to unfold during the course of our therapeutic relationship (Tudor, 2011).

In line with counseling psychology value of the client’s subjectivity (Manafi, 2010), I framed the process of therapeutic contracting as endeavor to build a relationship that would help Robert’s movement toward self-growth (Rogers, 1958). Consonantly, contracting appealed to my client’s choice to enter the therapeutic relationship as a dialogical enterprise (Rogers, 1957). Initially, I had an ethical dilemma about my competence as my client was skeptical about phone therapy and I had little experience of it. Accordingly, I discussed in supervision the anxiety related to remote working and being able to co-create the therapeutic space. Whilst adapting my practice (British Psychological Society, 2020), my supervisor helped me appreciate the importance of listening as a way of being with Robert. I relaxed into co-experiencing the therapeutic process in a moment-to-moment encounter whilst valuing the power of the conditions we could co-create in synergy with the client’s actualizing tendency. Eventually, Robert and I agreed to have weekly phone sessions.

Robert was not convinced about being able to experience my presence and develop trust, which would have created a power imbalance (Brown, 2007). As, to some extent, I represented the unknown for my client, in addition to our psychological contact, empathy, unconditional positive regard, congruence and Robert’s experience of these conditions would have been important to build our relationship. Despite my alignment with the PCA, I acknowledged the endeavor to embody this way of being as fallible. Whilst mirroring my client’s fear of judgment, I was concerned about meeting what I perceived to be Robert’s expectations. Nevertheless, he appeared to appreciate my transparency as a commitment to acknowledging any flaws in communication. Thus, I was asking Robert to trust me as a companion into an unknown therapeutic process which was vulnerable to ruptures but could also have the potential to facilitate the change he was seeking.

As my uncertainty about whether my client would continue therapy reflected Robert’s uncertainty of me as trustworthy, the value of our therapeutic experience would have resided in our power as ‘response-ability’ to one another. Accordingly, the question Robert and I faced was whether we could have ‘unconditional confidence’ (Harman, 1990, p. 251), as a state of openness to each other’s potentialities. Consequently, the beginning of therapy sowed three themes that intertwined throughout our sessions, namely trust, as embracing the unknowing (Spinelli, 2000); acceptance, as valuing the client’s subjectivity against objectification (Proctor, 2019); and power as the courage to be one’s self (Baldwin, 1987).

The theme of trust captures the vulnerability of entering a therapeutic relationship and Robert’s gradual openness to his experiencing. Initially, the onset of therapy required the exploration of psychological contact as being over the phone questioned our ability to make a difference in our experiential field (Rogers, 1951). Whilst encouraging my client’s feedback about physical and emotional sensations, we both shared our experience of the sessions, giving us the opportunity to be more transparent and become known to each other. Whilst relying on listening to the variation of my client’s emotional tone, the challenge was to trust myself and the therapeutic conditions (Rogers, 1957). Similarly, Robert’s difficulty to trust me translated into his reticence to communicate his ‘self’. Most of Robert’s narrative portrayed the pandemic as collective grief and absence of social responsibility. Despite his remoteness from feelings and focus on the external environment, Robert was expressing existential loss and anxiety, touching on shared human concerns (Schmid, 2013). Accordingly, Robert appeared to have started therapy keeping me and his emotional experience at a safety distance, without further processing (Rogers, 1958).

Despite wondering how I could demonstrate trustworthiness, I felt comfortable with Robert’s pace as I was trusting him to come to see me as a safe person despite working remotely. Unable to see my reactions, Robert could only ‘hear’ my presence by listening to my responses, trusting I was attuned and that I could hold the space despite not being ‘physically’ there with him. Correspondingly, I experienced this distance with respect because I did not want to intrude into my client’s space. Whilst reporting increasing anxiety-related difficulties, which were affecting him emotionally and physically, Robert started to communicate his ‘self’ more openly. Specifically, Robert appeared to be ostracizing his fearful feelings from his ideal self, thus causing psychological maladjustment. Simultaneously, reporting positive emotions toward his wife and sons, Robert was realizing mixed feelings in his experience (Rogers, 1958). Nonetheless, this recognition appeared to be accompanied by a rigid differentiation of accepted versus unaccepted societal behaviors and emotions (Rogers, 1958).

By avoiding questions that could interfere with his narrative, I offered active listening and tentative reflections so that Robert could experience his ‘self’ as being received (Rogers, 1958). Whilst exploring the virus outbreak, Robert was leaving, as it were, a trail of breadcrumb, touching on childhood memories. Despite becoming aware of a felt sense of ‘heaviness’, I could not decipher my inner experience (Ikemi, 2005). However, I sensed there was something more to my client’s story than what we had been exploring so far. I felt like Robert needed a safe space to trace back the origins of his fear and anxiety, connected with the unpredictability of his parents and his childhood in order to explain the development of a lack of trust in others. Gradually, I realized how Robert had started trusting the therapeutic space I was providing and his trust gave me the confidence to respect my client’s pace. Accordingly, trusting my client meant treasuring each breadcrumb, remaining open to ‘unknowing’ and being surprised (Spinelli, 2000). Simultaneously, I was anxious about losing one of those pieces of information, wondering whether I was worthy of my client’s trust.

Consequently, Robert and I’s trust in each other meant overcoming the fear that physical distance due to remote working did not equate to a therapeutic distance that could have compromised our alliance (Mallinckrodt et al., 2015). Trusting Robert meant proceeding in our therapeutic work without knowing how his actualizing tendency would have manifested. Robert’s trust meant facing the ‘unknowing’ dimension of our relationship and choosing to share his inner experience. Accordingly, trust meant acknowledging each other whilst facing the other’s mystery (Proctor, 2019). Therefore, trust meant recognizing our distance as evidence of being in a relationship inasmuch as we could confirm our uniqueness as persons (Bazzano, 2014).

The theme of acceptance encapsulates the unfolding of the therapeutic relationship with Robert and our ability to relate with genuineness with each other. Arguably distancing himself from his emotional experiencing, Robert resorted to imagery to express his parental conditions of worth as being ‘inside a box’ and his preoccupation with mortality as a ‘black hole’ into meaninglessness (Rogers, 1958). Accordingly, I enquired about the sensations associated with being ‘inside a box’, revealing the client’s physical constriction and emotional distance from his most authentic self. By reflecting on the potentiality of an ‘out-of-the-box self’, we wondered about Robert’s longing for unconditional acceptance and how that would feel like as a novel experience that I was striving to offer (Rogers, 1957). Similarly, the metaphor of the ‘black hole’ allowed us to explore Robert’s exhaustion due to the force required to resist the pull of hopelessness and escape the existential threat of meaninglessness (Vanhooren, 2019).

Despite there being no change in his anxiety-related difficulties at this stage, Robert started reporting enhanced self-awareness. Correspondingly, as Robert was expressing more of his ‘self’, I started to feel more connected. I could share with my client my understanding of his frame of reference and my meaning-making of his experience became a way for me to reveal my ‘self’ to Robert. My client was attentive to my reflections of themes, such as the unpredictability of his family environment mirroring the unpredictability of a pandemic, and feelings, such as the fear experienced whilst growing up, arguably inducing internalized anxiety-related physical tension (Sachs‐Ericsson et al., 2017). As we were accepting each other, Robert and I were co-creating a way of being together underpinned by the trust to share ourselves without the expectation to know the other fully (Schmid, 2013).

Whilst I could have hypothesized how the impact of adverse childhood experiences on his attachment, self-beliefs, and emotional regulation predisposed Robert to anxiety (Joseph et al., 2012b), I would have put myself in the role of the expert, objectifying the client’s difficulties. Conversely, I had to accept Robert as essentially unknowable (Proctor, 2019). As I was aiming to be ‘non-directive’, which involved risking silences and following the client’s pace, I accepted the ‘unknowing’ of our therapy process, focusing on the immediacy of our encounter (Grant, 2004). Nevertheless, and despite respecting the client’s preference, I found myself withholding the desire to know more about Robert’s past experiences and contextualize them within a developmental history that could have clarified his conditions of worth (Rogers, 1959). Reflecting on my inner process made me realize that denying this part of my ‘self’, which sensed an underlying traumatic history, could have reinforced Robert’s distrust in others because I would have not been congruent (Rogers, 1957). Thus, upon sharing my uncertainty regarding the direction of the therapeutic work with Robert, congruence became an ethical act of ‘nondirectiveness’ translated into the ability to accept the unknowable dimension of Robert’s experience whilst trusting his resourcefulness to access his actualizing tendency (Grant, 2004).

Consequently, overcoming the focus on a ‘therapeutic goal’, acceptance meant experiencing a moment-to-moment relationship with Robert to whom I responded by sharing my ‘self’ and communicating my experience of our relationship. Accepting Robert’s pace meant respecting his frame of reference without imposing interpretations (Grant, 2004). Acceptance also required the openness to my client’s ‘self-revelation’, letting go of the presumption to know his otherness (Proctor, 2019). Similarly, Robert’s acceptance toward his experience facilitated a deeper self-exploration and initiated the transition from self-blame to self-compassion. Furthermore, Robert’s acceptance of my therapeutic experience allowed us to participate fully in the dialogical space we were co-creating. Therefore, acceptance was the expression of how Robert and I could reciprocally acknowledge each other’s way of being.

The theme of power illustrates the ongoing endeavor to equalize the therapeutic relationship. Specifically, ‘being counter’ to each other’s otherness posed the issue of recognizing the therapeutic power, thereby acknowledging the dynamics inherent in our client-therapist ‘roles’. As Robert elaborated on the impact of relocating several times throughout his childhood, I voiced the desire to know more about his experiences, departing from the non-directivity of the PCA. This more directive stance was driven by a difficulty to tolerate the unknowing that seemed to surround the client’s phenomenological world. Additionally, I resonated with the theme of relocation, thus running the risk of assuming the impact of this event and losing the appreciation of the idiosyncrasies of our different lived experiences. Whilst growing up, relocating hindered my ability to develop a sense of community belonging and contributed to my experience of aloneness and being ‘other’. Conversely, during my adulthood, relocating was the result of the intentional decision to pursue my goals and ‘become’ myself by living congruently. Subsequently, the formation of meaningful relationships was pivotal in my choice to undertake professional training as an endeavor to actualize the potentiality inherent in human encounters to undo the aloneness at the foundation of suffering.

Although the exploration of my client’s relocation could have illuminated his experience of otherness, Robert restated his need for nondirectiveness and the power of his choice by making me realize how I was demanding him to show his ‘self’ instead of allowing his ‘self-revelation’ (Proctor, 2019). Thus, I welcomed this honest response with humility by acknowledging how my assumptions could have interfered with the ‘as if’ quality of empathy (Rogers, 1959). Accordingly, Robert and I re-contracted so that he could choose the focus of our sessions. Consequently, power meant being there for my client and affirming his right for self-determination without justifying my intentions or trying to persuade him of what I considered could be best for him (Grant, 2004). Arguably, my openness toward Robert’s feedback was empowering as my client observed how my response helped equalize our relationship and reported less anxiety. Perhaps, experiencing a sense of control enabled my client to lessen the discomfort around the ‘anxiety-provoking’ unknowing of our therapeutic process (Carleton, 2016).

As ability to express his ‘self’, Robert’s power reverberated through the therapeutic process. Following our review session, his emotional processing intensified. Seemingly reflecting the movement toward accurateness of symbolization (Rogers, 1958), the metaphor of the ‘black hole’ evolved into a ‘black door’ that Robert wanted to open to look into his traumatic memories. Eventually, he disclosed the physical and emotional abuse experienced as a child as well as life-threatening situations throughout his adulthood. Whilst feeling held, Robert approached his trauma at his own pace by experiencing a climate of safety wherein he could access his actualizing tendency (Joseph, 2015). Consequently, inside Robert’s ‘door’, we could illuminate the idiosyncratic meaning of unpredictability, safety, fear, and distrust in his experience, whilst regulating his more intense affect expression through a grounding relationship (Vanaerschot, 2013).

Therefore, adventuring in trauma work reflected the power of our therapeutic process to facilitate Robert’s self-discovery (Joseph, 1999). Robert’s power emerged in his decision to adventure in trauma work and use our therapeutic relationship as an anchor to avoid being sucked into the ‘black hole’ (Vanaerschot, 2013). Correspondingly, my power was the ability to hold a space for Robert to address his interpersonal trauma by enhancing his affect while regulating his emotions. Therefore, our power was the willingness to take a risk to reveal the potential of my client’s actualizing tendency so that addressing trauma could become an empowering experience.

As Robert and I embarked on exploring the roots of his anxiety linked to his conditions of worth, my supervisor’s guidance allowed me to make sense of Robert’s difficulties, thus enriching the aforementioned formulation as follows: (1) In his childhood, Robert had experienced his ‘self’ as unworthy of love and defective. Additional traumatic experiences reinforced the introjected belief (Rogers, 1959) that others cannot be trusted and safety is precarious. (2) Developmental trauma might have caused a fragile processing compromising Robert’s ability to modulate his emotions due to the lack of co-regulating attachment relationships (Warner, 2000). (3) By threatening his need for safety, the pandemic resembled Robert’s traumas, arguably aggravating his sense of powerlessness. (4) Robert might have preserved his ‘independent self’ through the introjected belief that others are the enemies, compromising his belongingness. (5) However, through the relationship with his wife and children, Robert experienced his ‘self’ as lovable. Furthermore, his preference for ‘nondirectiveness’ suggested the strengthening of his internal locus of evaluation (Rogers, 1958). (6) The introjection of Robert’s conditions of worth thwarted his direction of growth, preventing the integration of his traumatic experiences, thus causing psychological disturbance (Rogers, 1951). This formulation determined a change in the therapeutic plan driven by Robert’s willingness to explore his traumatic experiences to unearth the roots of his anxiety. Further, the formulation was a further occasion to reveal my ‘self’ by making meaning of my client’s difficulties whilst remaining open to Robert’s expertise in his own subjective experience. Consequently, our therapy continued by exploring the development of Robert’s conditions of worth that had been obstructing his movement toward becoming a fully functioning person (Rogers, 1958).

Within a counseling psychology framework, supervision offered me a dialogical space to reflect on the therapeutic work with Robert and the aforementioned themes. Akin to client work, supervision was delivered online which provided me with an experiential understanding of a ‘remote’ therapeutic relationship. Despite the physical distance, the supervisory relationship provided me with a sense of connectedness that anchored my practice and reduced the isolation of working remotely. Further, my supervisor’s experience in online work was valuable in learning how to hold the therapeutic process by looking at practicalities, such as planning for possible reception issues and ensuring Roberts had a confidential space. Whilst I was relying on supervision for guidance, I felt held and became more transparent in sharing my own process (Bryant-Jefferies, 2005). Accordingly, I experienced the acceptance of my anxiety and uncertainties within a caring environment which gradually allowed me to build trust in my own competencies and appreciate the power inherent in the ‘response-ability’ to my client.

Firstly, supervision was the opportunity to process feelings that could have obscured the appreciation of my client’s frame of reference. As a collective trauma, I was co-experiencing a pandemic that was also impacting me personally. Although, the exposure to the virus could have been an existential touchstone to enhance empathic understanding (Mearns & Cooper, 2017), I had to ensure that my narrative did not replace the client’s idiosyncratic experience, maintaining boundaries and attending to personal therapy and self-care to avoid secondary traumatization (Health and Care Professions Council, 2015). For instance, I used supervision to explore my meaning-making of Robert’s experience in the lead up to our review sessions. By remaining sensitive to my client’s emotional material, my supervisor made me aware that my reflections could bring to the fore themes that might have been at the client’s ‘edge of awareness’. Thus, drawing from person-centered experiential approaches allowed me to integrate process work to remain attentive to my own inner experience and the multifaceted expressions of Robert’s self, whilst exploring degrees of ‘nondirectiveness’ (Warner, 2000).

Secondly, I used supervision to reflect on the therapeutic process, thus deepening my reflexivity (Donati, 2016; Lambers, 2007). As I shared a sense of being under scrutiny whilst working with Robert, my supervisor invited me to observe my response with curiosity in the context of the client’s relational patterns. For instance, Robert had experienced a sense of defectiveness from significant others which might have reverberated throughout our relationship in a co-transferential dynamic (Sapriel, 1998). Additionally, my response might have mirrored Robert’s anxiety-related defensive behaviors where my safety as a practitioner could come into play. Subsequently, as my supervisor enquired about my experience of the sessions with Robert, I became aware of how I had also been feeling on edge, which affected my ability to be congruent as if by revealing my ‘self’ I would have shown my inherent incompetence. This realization allowed me to accept and empathize with how Robert might have felt and encouraged me to model openness by sharing how I was feeling in the here-and-now. Consequently, my client could start responding to me as a person within the relationship we were co-constructing, thus experiencing acceptance and positive regard (Rogers, 1957).

Thirdly, the metaphor of the ‘black hole’ introduced the threat of meaninglessness that warranted a risk assessment due to the association between hopelessness and suicidal behavior (Vanhooren, 2019). Despite the absence of suicidality, I wondered with my supervisor whether dwelling on life-threatening memories could be retraumatising (Joseph, 2015). However, avoiding the ‘black hole’ could have exacerbated the client’s sense of isolation, thus potentially perpetuating his anxiety and denying a part of his experience. Accordingly, I discussed safety planning with my supervisor whilst resorting to immediacy to ground my client in the holding space of our relationship. Thus, if we were to co-create a facilitative therapeutic environment, recognizing the limits of my competence meant ensuring that my own anxiety would not interfere with the trust in myself and my client’s ability to flourish (Joseph, 2015).

Finally, in line with the scientist-reflective practitioner model in counseling psychology, supervision validated my emergent professional identity by holding pluralism and explore the tension with a person-centered practice (Ong et al., 2020). Whilst holding the understanding of my client’s difficulties within a person-centered framework, my supervisor supported me in considering alternative theoretical models. For instance, anxiety may relate to the fear of the unknown which would impair cognitive and emotional processing and feature insecure attachment (Carleton, 2016). Additionally, I explored a relational framework to address Robert’s trauma, whilst monitoring the effectiveness of my intervention (Health and Care Professions Council, 2016; Joseph, 2015). Consequently, by integrating different psychological paradigms, supervision ensured that my person-centered therapeutic approach did not translate into a psychotherapeutic ‘sectarianism’ (Milton, 2010).

Unknowing represented the thread running through the therapy with Robert. As traveling for sessions could have intensified Robert’s distress or facilitated threat exposure, we did not know how the process would have unfolded. Whilst allowing client’s control and anonymity, phone sessions relied on our courage to reveal ourselves to each other. Due to Robert’s anxiety and life experiences, unknowing was synonym of danger to avoid (Carleton, 2016). Similarly, unknowing was anxiety provoking for me as I did not know how the sessions would have gone. However, unknowing progressively became the birthplace of potentiality. From strangers, Robert and I deepened our relationship whilst acknowledging unknowing as expressing our otherness in a process of self-discovery (Rogers, 1961). Thus, unknowing meant acknowledging that we were both in a process of change wherein we could be unconditionally present.

The open-ended nature of the service will call for our choice to end therapy as the result of a collaborative decision to promote client responsibility. Perhaps, if I convey a grounding presence as Robert explores his trauma, his emotional experience will flow, thus resembling the features of the Rogerian process of change (Rogers, 1958). However, as ending might be anxiety-provoking, Robert and I might explore the interrelation between change, loss, and acceptance. Additionally, supervision will be a space for me to reflect on ending as a reciprocal process of letting go whilst holding in mind. Therefore, we might co-experience ending as confirmation of our ‘relational self’ transcending the boundaries of our therapeutic relationship (Proctor, 2019).

At the onset of therapy, Robert focused on his intrapsychic process, seemingly objectifying his experience as a problem (Schmid, 2013). Subsequently, shifting to his interpersonal processes, he related to his experience as ‘self-in-context’ embedded in relationships with significant others and social values. Although I did not utilize outcome measures in the sessions presented, I could introduce psychometrics for risk assessment if the client’s process became more fragile (Warner, 2000). Furthermore, the evaluation of my work has been informed by my client’s and supervisor’s feedback so that I could ensure ethical practice (Health and Care Professions Council, 2015). Specifically, my client shared how he sensed my presence through a non-directive approach and my supervisor observed how change manifested as Robert allowed me to see more of his ‘self’ (McMillan, 2004). From sharing only the part of him who was feeling anxious due to the pandemic and wanted to be a caring figure for his family, my client came to reveal the part of him that was holding his childhood trauma as a shameful secret. Robert trusted me with the story of what had happened to him and emerged as a real person whom I could encounter. Finally, regular review sessions will aid the evaluation of my work by sharing reformulations encompassing my client’s process toward becoming fully functioning (Rogers, 1958).

Writing about Robert required managing the balance of preserving the uniqueness of our therapeutic encounter without disclosing identifying information (BPS, 2018; Health and Care Professions Council, 2015). The process of gaining consent from the client and the agency to use therapeutic material for an anonymized case study posed the question of considering ethical issues that are related to power dynamics wherein trust and acceptance were fundamental in prioritizing clients’ safety. Accordingly, within this case study any information pertaining to the client and the service has been altered to preserve confidentiality. Nevertheless, I aimed to offer a sense of the sessions with Robert by revisiting my notes whilst we were working together. Whilst sharing my reflections in a ‘therapy-in-progress’, I could observe where I was in my personal and professional development and where I am now that I am looking back at the process. Thus, I strove to hold the tension between the idiosyncrasy and the universality inherent in our shared therapeutic encounter in a way that could shed a light on my experience of being a counseling psychologist in training. As I was selecting salient moments, the process of writing and rewriting proved to be challenging whilst also expanding my self-awareness as an ongoing process which provided additional insights. During the work on the client’s conditions of worth, I faced mine, related to acceptance and belonging, noticing how they played out in the therapeutic work. In the hope of establishing a person-to-person relationship, sharing myself authentically, including my own anxieties and uncertainties, meant being vulnerable to rejection (Amari, 2020). Simultaneously, I was challenged to convey my respect in the humbling experience of witnessing and attempting to alleviate my client’s suffering. Moreover, I endeavored to frame our therapeutic experience within the themes of trust, acceptance, and power that I have identified as featuring my client work during my training whilst attempting to offer a sense of my ‘self’. Despite the limitations of making our therapeutic encounter alive through a one-sided account, I became aware of how the sessions with Robert have enriched me as a person. Therefore, this piece of work is my acknowledgment and expression of gratitude for the shared experience of our therapeutic relationship.

To summarize, the themes of trust, acceptance, and power illuminated my therapeutic relationship with Robert, my use of self and my experience of counseling psychology practice. Firstly, trusting my client meant striving to be a contactful congruent, empathic, and unconditionally positive regarding practitioner. Consequently, trust featured my practice as openness to the unknowing of the other and myself, allowing therapeutic change to unfold. Secondly, accepting Robert’s right for self-determination meant embarking on a process of becoming with my client whilst respecting our subjectivities. Acceptance meant letting go our need for control and enter the ‘presence’ of our relationship. Consequently, acceptance featured my practice by moving toward a way of being that could cope with change through shared resilience. Thirdly, an appreciation of power meant embracing my vulnerability whilst holding my client to encounter the other. Power also expressed Robert’s actualizing tendency and my ‘response-ability’ to help us find meaning in his suffering. Consequently, power featured my practice as affirmation of my ‘response-able self’ that demands justice for the other’s suffering. By writing about my encounter with Robert, I hope to have conveyed a sample of my counseling psychology practice as effective practice and as an ethical endeavor to show personal and professional accountability.

No potential conflict of interest was reported by the author(s).