In this piece for the project “A Dialogic Exploration of Gluten Ataxia“, Ruth talks to Sandra about counselling and long-term illness.
I’ve asked Sandra to say a little about counselling and its role in being therapeutic for patients with long-term conditions, and how it can help them come to terms with the changes in circumstance that often accompany these things.
I’ve asked her to explain a little about what we’ve done together, and how we have been able to incorporate my use of writing poetry and other creative responses to help me develop a clear perspective on my internalising the issues I am facing, and how she has been able to be a listener and a receiver of these in a way that has been deeply helpful to me. I think it’s important for the general public to understand why counselling is offered, and how it provides a safe and confidential relationship which for me has been life-saving and indeed life enhancing. In all the years that my counsellor has been doing this, I sensed that there would be themes that would re-occur.
Ruth: Sandra, Might I be right in thinking that one of the things you find rewarding in your work is that you are able to help people on the journey that reflects these common themes? You and I have talked about this at length and I know for me you have helped unpack many of these with me so that I can come to terms with things.
S: Ruth, I think what we’ve done is explore how when life changing events occur, such as the diagnosis and reality of a debilitating or progressive health condition, you embark upon a journey which encounters loss, adjustment, discovery, a venture into the unknown.
R: These are almost the North, East, South and West of my journey! How long have we known each other? Did you realise that it’s actually 20 years since the time I first came to you to begin to explore what it was like to be given a diagnosis (as one of the first in the world) with gluten ataxia and how this was a scary and controversial diagnosis at the time and how together you helped me think through what this could entail.
S: I think the counselling plays a therapeutic role in facilitating the exploration and expression of the impact this has had on you physically, mentally, emotionally and spiritually. You invited me as your counsellor along for part of the way. Together what we’ve done has been dependent on what you needed, on what your individual choices involved. It was a means of helping you to understand your needs, circumstances, your existing support network, and what was available.
For some, counselling could mean a brief contact, or joining for a longer part of the journey, or contact at different times along the way as required. Between us, you and I felt that this adjustment and regrowth would take time and investment in ways that have proved to be journeys for both of us. I realise that my background in Gestalt therapy has been of help to you in experiencing and exploring in the moment, and how the ‘now’ can be grown and developed and become a source of comfort to you.
R: Absolutely. Our counselling relationship is based upon respect for me as an individual and my choices, and provided a safe, confidential, therapeutic space where the many aspects of my journey were given time and attention. What became clear to me, as time went on, was that you were using a technique, just like my neuro physiotherapist was, that had a pattern, a structure, a set of values, an approach.
S: The process has for example been an opportunity to consider the many roles life brings as an individual, adult, child, sibling, partner, friend, colleague, occupational role, neighbour, team/group member, etc. etc. Not forgetting the role of patient. I think the benefit of our therapeutic alliance is that you have increased your awareness, knowledge and confidence to explore and identify options, and to develop sources of support and strength from many quarters. You have been able to use this to greatly support yourself.
R: What you are saying is that you gave me space . Space for exploring, and making sense of, the inner personal impact of such health changes on my sense of self identity. Also, the impact of others’ perceptions of, and their reactions and responses to the individual. That’s actually very interesting because this is something that P has touched on in her emails to me and so I’ve begun to ‘join up the dots’, as it were, to make sense of a bigger picture going on behind this therapeutic work… I’m so lucky to be given this chance and also the chance to be able to explore this through the project linked to Storying Sheffield. What has been wonderful is that you have been able to partner me in this and share the joys and ups and downs of it all and somehow, very skillfully, made our time together time to grow and change for the better; enabled me to stand up for myself and say “it’s okay to be ill, and I will support you as things go on, this time is for you and no one else, and it is your time to explore safely all that is happening to you with someone you can trust”.
S: It’s been a time and space for grief and all its emotions. And a time for reflection, for acknowledging those qualities, strengths, and coping mechanisms that help you meet life’s events and challenges. And it’s been an opportunity to open up possibility and options with you, helped you to consider your goals, your physical needs, to respect your personal wellbeing, autonomy and interdependence, for you to make changes, which I know can be so challenging and hard sometimes to do. It can take courage to face the difficult times in life.
R: I know you said to me that it’s a time to value experience whilst letting go of what was, to value what is and be present. This last one has been really hard!
S: Many people I have worked with have found counselling to be the time and space to find a way to adjust to change, gain perspective, understand what helps, and to manage and maintain a sense of identity and new and sometimes different quality of life.
I believe that self-expression comes in many forms, as in silence, smiles, tears, actions, role play, sound, music, singing, verbalising, metaphor, written words, or visually through colour, sketching, painting, making things; fabric; food. I think what is important is what works most effectively for the individual themselves. In my experience I have found that creative expression can be therapeutic and transforming, a potent means to filter and integrate life events at a pace that suits a person’s own rhythms.
Ruth, the way you employ creative expression to visit and fully engage with the compass points of your journey, through poetry and in so many other ways too, has been a rich experience for me, and at times an absolute delight. I have learned much from you.
I sometimes suggest to the people I work with, “think of yourself as a crystal with many facets”, when moved out from the shade these facets catch and reflect light, they represent the many and varied aspects of the self, each part or aspect benefits from the nurturing attention of light at different times.’
R: This blog can only be the briefest of insights into what this trustful respecting and caring relationship has allowed to flourish. I just want to say here to you, S, that this has been one of the most valuable things I’ve ever done and quite simply without you I could not have done it. You know this. I have learnt so much through your careful questioning and an unerring support that it is making things possible that would otherwise been impossible. Thank you as for all of this. I hope the poems can give some sense of what this – and I’m going to use an old-fashioned word here – hallowed relationship has encompassed. I’ve been so lucky to have had you in my life like this. I really am.