PRINCIPLES AND TECHNIQUES OF COUNSELLING

CONCISE TABLE OF CONTENTS

Table of contents (Concise) . . . . . . . . 00

Table of contents (Detailed) . . . . . . . . 00
A. Preface . . . . . . . . . . 00
B. Introduction . . . . . . . . . 00
C. Counselling format. . . . . . . . . 00

I. PACING
FACILITATIVE DIMENSION

1. Welcome the client with a small talk . . . . . . 00

2. Observe the body language of the client . . . . . 00
3. Attend to the client physically . . . . . . 00
4. Let the client tell the story . . . . . . . 00
5. Reflect the content of what the client said . . . . . 00
6. Reflect the feeling of the client . . . . . . 00
7. Reflect the deeper feeling of the client . . . . . 00
8. Allow the client to speak sufficiently on the feeling . . . . 00
9. Facilitate the client to release strong negative feelings . . . 00
10. Pinpoint the problem and ask for a recent event . . . . 00

II. REFRAMING
ACTION-ORIENTED DIMENSION

11. Personalize the client’s deficiency . . . . . . 00

12. Find out alternative frame of reference . . . . . 00
13. Employ problem-solving techniques, behavioural strategies, and action programmes
14. Insights . . . . . . . . . 00
15. Define and operationzlize the goal . . . . . . 00
16. Make contracts and evaluate . . . . . . . 00

Endnotes . . . . . . . . . . 00
Bibliography . . . . . . . . . 00
 Principles and Techniques of Counselling-7 2

PRINCIPLES AND TECHNIQUES OF COUNSELLING

DETAILED TABLE OF CONTENTS

Table of Contents (Concise) . . . . . . . . 00

Table of Contents (Detailed). . . . . . . 00

A. Preface . . . . . . . . . 00
B. Introduction . . . . . . . . 00
C. Counselling format . . . . . . . . 00

I. PACING
FACILITATIVE DIMENSION
1
WELCOME THE CLIENT WITH A SMALL TALK

1. Welcome the client . . . . . . . . 00

1) Acquainting
2) Rapport building
3) Shaking hands
4) Providing privacy
2. Make the client comfortable with a small talk . . . . . 00
1) Small talk
2) Confidentiality
3) Time-limit
4) Previous counselling
5) Invitation to talk
3. Counsellee’s task . . . . . . . . 00
1) Willingness
2) Greater responsibility
3) Law of inertia
4) Fear of change
5) Reluctant client
6) Resistant client
7) ‘Coax me’ game . . . . . . . 00

2
OBSERVE THE BODYLANGUAGE OF THE CLIENT

1. Body speaks most . . . . . . . . 00

2. The unconscious peeps through the body
3. Body speaks a language
4. Displaced activities . . . . . . . . 00
5. Psychodynamics of Freud
6. Fixed muscular patterns reveal set attitudes
7. Sweat-shirts and ulterior transactions
8. Energy level
 Principles and Techniques of Counselling-7 3

9. Eye-scanning . . . . . . . . . 00
10. Breathing (Calibration)
11. Hand and arm gestures
12. Hand-to-face gestures
13. Arm and leg barriers
14. Readiness gestures
15. Courtship gestures . . . . . . . . 00
16. Head gestures
17. Smoking gestures
18. Ownership gestures
19. Other gestures . . . . . . . . . 00

3
ATTEND TO THE CLIENT PHYSICALLY

1. Physical attending . . . . . . . . 00
2. Modalities of physical attending
1) Distance . . . . . . . . 00
2) Zone distance
(1) Intimate zone
(2) Personal zone
(3) Social zone
(4) Public zone
(5) Counselling zone
3) Squaring . . . . . . . . 00
4) Seating arrangements
(1) Cooperative position
(2) Corner position
(3) Independent position
(4) Competitive-Defensive position
(5) Counselling Position
5) Eyeing . . . . . . . . . 00
6) Open posture
7) Leaning forward
8) Remaining relatively relaxed
9) Mirroring . . . . . . . . 00
10) Encouragements to talk
3. Initial silence
4. Silence in the middle of the session . . . . . . 00

4
LET THE CLIENT TELL THE STORY

1. Expressing . . . . . . . . . 00
2. Levels of expression
1) Ritual
2) Report . . . . . . . . . 00
3) Judgement
4) Feeling
5) Gut-level
3. Types of problem situation . . . . . . . 00
 Principles and Techniques of Counselling-7 4

1) Experience
2) Affect
3) Behaviour
4. Listening . . . . . . . . . 00
1) Kinds of listening
(1) Fake listening
(2) Partial listening
(3) Selective listening
(4) Projective listening
(5) Filtered listening
(6) Total listening
2) Reasons for inadequate listening. . . . . . 00
(1) Physical tiredness
(2) Preoccupation
(3) Attraction
(4) Distraction
(5) Similarity of problem
(6) Dissimilarity of problem
(7) Over-eagerness . . . . . . 00

5
REFLECT THE CONTENT OF WHAT THE CLIENT SAID

1. Responding . . . . . . . . . 00
2. Helping skills pre-test
3. Kinds of responses as per EISPU . . . . . . 00
1) Evaluative or advising response
2) Interpretative or analysing response
3) Support or reassuring response
4) Probing or questioning response . . . . . . 00
1) Facilitative question
a. Information question
b. Specific question
c. Elaborative question
d. Personal affect question
2) Non-facilitative question . . . . . 00
a. Curious question
b. Closed question
c. Two questions
d. Too many questions
e. Continuous questions . . . . . 00
f. Why question
g. Leading question
h. Threatening question
i. Ambiguous question
j. Poorly timed question
k. Quiz programme question
5) Understanding or paraphrasing response . . . . . 00
1) Internal and external frame of reference
2) Usefulness of understanding response
4. Reflect the content . . . . . . . . 00
5. Kinds of responses as per ego-states
1) Ego-states
2) Responses from ego-states
 Principles and Techniques of Counselling-7 5

6. Responses viewed from EISPU and ego-states

7. Responses seen as transactions . . . . . . . 00
1) Complementary transaction
2) Crossed transaction
3) Ulterior transaction
8. Spacing responses

6
REFLECT THE FEELING OF THE CLIENT

1. Feeling – emotion . . . . . . . . 00
2. The feeling chart

7
REFLECT THE DEEPER FEELING

Leads – Manner of communicating responses . . . . . 00

ALLOW THE CLIENT TO SPEAK SUFFICIENTLY ON THE FEELING

9
FACILITATE THE CLIENT TO RELEASE STRONG NEGATIVE FEELINGS

1. Grief . . . . . . . . . . 00
2. Anger
3. Guilt

10
PINPOINT THE PROBLEDM AND ASK FOR A RECENT EVENT

A. PINPOINTING THE PROBLEM

1. Developmental problems . . . . . . . 00
2. Personality disorders
1) Paranoid personality disorder
2) Schizoid personality disorder
3) Schizotypal personality disorder
4) Antisocial personality disorder
5) Borderline personality disorder
6) Histrionic personality disorder . . . . . . 00
7) Narcissistic personality disorder
8) Avoidant personality disorder
9) Dependent personality disorder
10) Obsessive-compulsive personality disorder
11) Depressive personality disorder (Research criteria)
12) Passive-aggressive personality disorder (Research criteria)
13) Self-defeating personality disorder (Research criteria)
3. Schizophrenia (Psychosis) . . . . . . . 00
1) Schizophrenia
(1) Paranoid type
(2) Disorganized type
 Principles and Techniques of Counselling-7 6

(3) Catatonic type

4. Other psychotic disorders . . . . . . . 00
1) Schizophreniform disorder
2) Schizoaffective disorder
3) Delusional disorder
4) Brief psychotic disorder
5) Shared psychotic disorder
6) Psychotic disorder due to a general medical condition
7) Substance-induced psychotic disorder
5. Mood disorders . . . . . . . . . 00
1) Mood episodes
(1) Major depressive episode
(2) Manic episode
(3) Mixed episode
(4) Hypomanic episode
2) Mood disorders proper
A. Depressive disorders . . . . . . 00
(1) Major depressive disorder, Single episode
(2) Major depressive disorder, Recurrent
(3) Dysthymic disorder
B. Bipolar disorders . . . . . . 00
(1) Bipolar I disorder, Single manic episode
(2) Bipolar I disorder, Most recent episode hypomanic
(3) Bipolar I disorder, Most recent episode manic
(4) Bipolar I disorder, Most recent episode mixed
(5) Bipolar I disorder, Most recent episode depressed
(6) Bipolar I disorder, Most recent episode unspecified
(7) Bipolar II disorder
6. Anxiety disorders . . . . . . . . 00
1) Panic disorder
(1) Panic attack
(2) Agoraphobia
(3) Panic disorder proper
a. Panic disorder without agoraphobia
b. Panic disorder with agoraphobia
(4) Agoraphobia without history of panic disorder
(5) Specific phobia (Formerly simple phobia)
(6) Social phobia (Social anxiety disorder)
2) Obsessive-compulsive disorder . . . . 00
3) Posttraumatic stress disorder (PTD)
4) Acute stress disorder
5) Generalized anxiety disorder
7. Dissociative disorder . . . . . . . . 00
1) Dissociative amnesia
2) Dissociative fugue
3) Dissociative identity disorder
4) Depersonalisation disorder
5) Dissociative trance disorder (Research criteria)
8. Impulse control disorders . . . . . . . 00
1) Common features of all impulse disorders
2) Intermittent explosive disorder
3) Kleptomania
4) Pyromania
5) Pathological gambling
6) Trichotillomania
9. Somatoform disorders . . . . . . . . 00
 Principles and Techniques of Counselling-7 7

1) Somatisation disorder
2) Undifferentiated somatoform disorder
3) Conversion disorder
4) Pain disorder
5) Hypochondriasis
6) Body dysmorphic disorder
10. Sleep disorders . . . . . . . . . 00
Primary sleep disorders
A. Dyssomanias
1) Primary insomnia
2) Primary hypersomnia
3) Narcolepsy
4) Breathing-related sleep disorder
5) Circadian rhythm sleep disorder
B. Parasomnias . . . . . . . . 00
1) Nightmare disorder
2) Sleep terror disorder
3) Sleepwalking disorder
11. Sexual and gender identity disorders . . . . . . 00
1) Sexual desire disorders
(1) Hypoactive sexual desire disorder
(2) Sexual aversion disorder
2) Sexual arousal disorders
(1) Female sexual arousal disorder
(2) Male erectile disorder
3) Orgasmic disorders . . . . . . 00
1) Female orgasmic disorder
2) Male orgasmic disorder
3) Premature ejaculation
4) Sexual pain disorders
1) Dyspareunia
2) Vaginismus
5) Paraphilias . . . . . . . 00
1) Exhibitionism
2) Fetishism
3) Frotteurism
4) Pedophilia
5) Sexual masochism
6) Sexual sadism
7) Transvestic fetishism
8) Voyeurism
6) Gender identity disorders . . . . . 00
12. Eating disorders
1) Anorexia nervosa
2) Bulimia nervosa
13. Adjustment disorders
14. Factitious disorders . . . . . . . . 00
1) Factitious disorder
2) Factitious disorder by proxy (Research criteria)
15. Substance related disorders . . . . . . . 00
1) Substance dependence
2) Substance abuse
3) Substance intoxication
4) Substance withdrawal
5) Alcohol intoxication
6) Alcohol withdrawal
 Principles and Techniques of Counselling-7 8

16. Delirium, dementia and amnestic disorders

1) Delirium
(1) Delirium due to a general medical condition
(2) Substance intoxication delirium
(3) Substance withdrawal delirium
(4) Delirium due to multiple aetiologies
2) Dementia
(1) Dementia of the Alzheimer’s type
(2) Vascular dementia
(3) Dementia due to other general medical conditions
a. Dementia due to HIV Disease
b. Dementia due to head trauma
c. Dementia due to Parkinson’s disease
d. Dementia due to Huntington’s disease
e. Dementia due to Pick’s disease
f. Dementia due to Creutzfeldt-Jakob disease
(4) Substance-induced persisting dementia
(5) Dementia due to multiple aetiologies
3) Amnestic disorders
(1) Amnestic disorder due to a general medical condition
(2) Substance-induced persisting amnestic disorder
17. Disorders usually first diagnosed in infancy, childhood, or adolescence . . 00
7) Mental retardation
8) Learning disorders (Formerly academic skills disorders)
(1) Reading disorder
(2) Mathematics disorder
(3) Disorder with written expression
9) Motor skills disorder . . . . . . 00
10) Communication disorder
(1) Expressive language disorder
(2) Mixed receptive-expressive language disorder
(3) Phonological disorder
(4) Stuttering
11) Pervasive developmental disorder . . . . 00
(1) Autistic disorder
(2) Rett’s disorder
(3) Childhood disintegrative disorder
(4) Asperger’s disorder
12) Attention-deficit and disruptive behaviour disorders . . 00
(1) Attention-deficit/hyperactivity disorder
(2) Conduct disorder
(3) Oppositional defiant disorder
13) Feeding and eating disorders of infancy or early childhood
(1) Pica
(2) Rumination disorder
(3) Feeding disorder of infancy or early childhood
14) Tic disorders . . . . . . . 00
(1) Tourette’s disorder
(2) Chronic motor or vocal tic disorder
(3) Transient tic disorder
15) Elimination disorders . . . . . . 00
(1) Encopresis
(2) Enuresis
16) Other disorders of infancy, childhood, or adolescence
(1) Separation anxiety disorder
(2) Selective mutism
 Principles and Techniques of Counselling-7 9

(3) Reactive attachment disorder of infancy or early childhood

(4) Stereotypic movement disorder . . . . 00

B. ASKING FOR A RECENT EVENT

II. REFRAMING

ACTION-ORIENTED DIMENSION

A. REFRAMING

1. Meaning reframing
2. Context reframing
3. Advantages of reframing . . . . . . . . 00

B. SKILLS

1. Genuineness . . . . . . . . 00
1) Unfeigning understanding
2) Expressing directly
3) Responding immediately
4) Being spontaneous
5) Manifesting vulnerability
6) Clearing pipelines
7) Being non-defensive
8) Being consistent
2. Respect . . . . . . . . . 00
1) Being available
2) Paying attention
3) Being for the client
4) Physically prizing
5) Valuing diversity
6) Valuing individuality
7) Assuming goodwill
8) Faith in his/her potential
9) Faith in his/her responsibility
10) Giving freedom
11) Remaining neutral
12) Being honest
3. Basic empathy . . . . . . . . 00
` A. Components of empathy
1) Understanding
2) Communication
3) To the satisfaction of the client
B. Sympathy-empathy comparison
C. Behaviour modalities
1) Report feeling and content (Experience or behaviour)
2) Checking accuracy
3) Picking up core messages
 Principles and Techniques of Counselling-7 10

4) Keeping the client on his/her agenda

5) Being flexible
6) Not parroting
7) No crazy talk
8) No dawdling
9) No long-windedness
10) Not being impulsive
11) Noting client resistance
4. Advanced empathy . . . . . . . 00
1) Expressing the implied
2) Identifying themes
3) Connecting islands
4) Concluding from premises
5) Less to the more
6) Summarizing
5. Concreteness . . . . . . . . 00
1) One at a time
2) Direct questions
3) Recent event
4) ‘I’ statement
5) Specific goals
6) Specific means
7) Present feeling
6. Challenging (Caring Confrontation or Feedback) . . . . 00
1) Challenging discrepancies between
(1) What he/she says and does
(2) His/her view of him/herself and others’ view of him/her
(3) What he/she is and what he/she wants to be
(4) Verbal and nonverbal expressions
(5) Past and present utterances
2) Challenging distortions
3) Challenging games
4) Challenging excuses
5) Challenging irrational inner rule
6) Kinds of challenging
7) Guidelines for challenging . . . . 00
(1) Based on relationship
(2) Out of love
(3) With care
(4) Depending on client’s state
(5) Build on success
(6) Be tentative
(7) Own your thoughts and feelings
(8) Present it neutrally
(9) Rest the responsibility on client
(10) Do not overdo it
(11)Be open to challenge yourself
(12) Be specific
(13) Challenge strength rather than weakness
(14) Encourage self-challenge
(15) Present challenges as feedbacks
7. Self-disclosure . . . . . . . . 00
1) Kinds of self-disclosure
2) Self-disclosure is a challenge
3) Advantages of self-disclosure
(1) Freedom from fear
 Principles and Techniques of Counselling-7 11

(2) Appearing human

(3) Modelling
(4) Direction
4) Dangers of self-disclosure
(1) Burdensome
(2) Appearing weak
(3) Dominating
(4) Counter transference
5) Facilitative self-disclosure
(1) Relevant and selective
(2) Appropriate
(3) Flexible
8. Immediacy (Direct, Mutual Talk) . . . . . 00
1) Kinds of immediacy
(1) Overall relationship immediacy
(2) Here-and-now immediacy
2) Components of immediacy . . . . 00
(1) Awareness
(2) Communication
(3) Assertiveness
3) Purpose of immediacy
(1) To be immediate with counsellor
(2) To be immediate with others
4) Context of immediacy
(1) Trust issue
(2) Dependency
(3) Different stages
(4) Directionless session . . . . 00
(5) Attractions
(6) Social distance
(7) Anger

11
PERSONALIZE THE CLIENT’S DEFICIENCY

PERSONALIZING

1. What one does . . . . . . . . . 00

2. What one does not do

12
FIND OUT ALTERERNATIVE FRAME OF REFERENCE

1. Solvable problem . . . . . . . . 00
2. Concentration on resources
3. Positive future
4. Dreadful future
5. Open future
6. Another angle . . . . . . . . . 00
7. Soft pedalling
8. Two perspectives
 Principles and Techniques of Counselling-7 12

9. Changing roles
10. Challenging values
11. Challenging beliefs
12. Using ‘I’ statement . . . . . . . . 00

13
EMPLOY PROBLEM-SOLVING TECHNIQUES, BEHAVIOURAL STRATEGIES, AND
ACTION PROGRAMMES

INITIATING

1. Find a leverage . . . . . . . . . 00
1) Attend to crisis first
2) Attend to pain
3) Attend to what client considers important
4) Attend to manageable sub-problem
5) Attend to the problem that will yield general improvement
6) Attend to problems for which benefits will outweigh the costs
7) Instil confidence in the client
2. Helping clients commit themselves . . . . . . 00
3. Economy in action
4. Reaching the goal through strategies
1) Suspend judgement
2) Encourage more strategies
3) Encourage crazy thinking
4) Let the client choose a strategy
5) Make use of old strategy
6) Sustain the strategy
5. Counsellee’s task . . . . . . . . 00
1) Willingness to appropriate
2) Courage to carry out
3) Sustained attempt
4) Resuming after a relapse
5) Investing the maximum . . . . . . . 00

14
INSIGHTS

HELPFUL TIPS

1. Change what can be changed . . . . . . . 00

2. Let the client accept gracefully what cannot be changed
3. Prepare the client for the worst
4. Prepare the client to be happy with whatever decision he/she made

15
DEFINE AND OPERATIONALIZE THE GOAL

A. DEFINING THE GOAL

1. Day-dream the goal . . . . . . . . 00

 Principles and Techniques of Counselling-7 13

2. Power of possibilities
3. Define the goal
1) Outcome-oriented goals
2) Specific goals
3) Measurable goals
4) Goals with impact
5) Realistic goals
6) Goals with no obstacles . . . . 00
7) Goals under control
8) Economic goals
9) Goals consonant with client’s values
10) Goals with a time-frame
11) Satisfying goals
12)
B. KEEP THE GOAL SMART

1. Specific goal . . . . . . . . . 00
2. Measurable goal
3. Achievable goal
4. Realistic goal
5. Tangible goal

C. OPERATIONALIZE THE GOAL

16
MAKE CONTRACTS AND EVALUATE

A. MAKING CONTRACTS

B. EVALUATING

1. Ongoing evaluation . . . . . . . . 00
2. Client-centred evaluation
3. Self-evaluation
4. Advantages of evaluation
1) Support
2) Being with
3) Overcoming initial difficulties
4) Honouring the contracts
5) Modifying goals
6) Modifying strategies . . . . . . . 00
7) Getting strengthened
8) Learning process
9) Acknowledges learning
10) Moaning failure
11) Failure is a learning
12) Celebrating victory
13) Enhancing relationship
5. Reviewing

ENDNOTES
 Principles and Techniques of Counselling-7 14

B. INTRODUCTION
Counselling is truly a human encounter. It is not merely a chance meeting or a planned meeting with
another human individual where we hold our own masks and recognize only the mask in the other.
Encounter is differentiated from meeting since the former goes beyond the latter and the ‘we experience’
which emerges in encounter has a deeper meaning and is pervaded by a much more genuine humanity and
affection than is usually the case in routine meetings which fill our daily lives often marked by indifference.
Human encounters are the core of counselling and the basis of change and growth. 1 Adiran Van Kaam
speaks of human encounter thus:

An authentic human encounter always implies that I am, at least for some moments, totally present
to a person, that I am fully with him. In a true encounter, I participate in the personal existence of another
for whom I really care. To participate means literally to take part in. Thus encounter entails that I share the
life of the other, the existence of the other, and his way of being in the world. 2

In this context of encounter in which counselling takes place, we find that it is a two-way
collaborative process. Counsellors provide stimulation to the clients and the clients take advantage of the
stimulation provided and help themselves for more effective ways of living. If only counsellors were to
strive hard without the clients cooperating and taking their share of responsibility, counselling will be a one-
way traffic that will sabotage the effectiveness of the very process of counselling. Since it is a collaborative
concern, both the counsellors and the clients contribute greatly their share in the human encounter that
facilitates growth and change.3 It becomes clear when we analyse the direction that emerges in counselling.
When a counsellor counsels a client no one will be able to predict beforehand what direction the counselling
will take since it is not entirely with the counsellor or with the counsellee that the direction rests. 4 The
human encounter which is deeply caring brings about a direction that has been fathered by the counsellor and
the counsellee and hence it is rightly a human encounter which is collaborative.

We see this collaborative human encounter as a process of interstimulation. Since no encounter is a

neutral type of meeting nor is it a one-way traffic, the interaction between the counsellor and the counsellee
is bound to be interstimulating. What could be the implication of counselling being a process of
interstimulation? It simply indicates that a counsellor by attending involves the client and this is the first
stimulation. Because the client is involved he/she begins to express and explore his/her concerns which
make the counsellor understand the client and to respond to his/her internal frame of reference and this is the
second stimulation in the counselling interview; thus mutually reinforcing each other’s effort the counselling
glides on. But for the mutual stimulation, the counselling would get stuck midway. We come across certain
counsellors who are not able to provide stimulation by appropriate responding and probing and hence lack
the knack to reframe the mind of the client. At times, the clients are so dull and unresponding that the
counsellors do not get the minimal level of stimulation to maintain their effort which is shown in one way or
other as reluctance to counsel particular types of counsellees. 5

In a truly human, caring, collaborative and interstimulating encounter the counsellor gets involved in
the personal life of another human person who needs the counsellor in a very special way in some phase of
his/her life and development.6 Often we do not fully realize the therapeutic effect of presence. For a child
the presence of the mother is comforting, for a lover the presence of the beloved is pleasurable, for a friend
the presence of his/her friend is reassuring, for a person in bereavement the presence of his/her colleagues is
consoling and thus we can go on enumerating the effect of mere presence to human life enhancement. That
is why Rabindranath Tagore sings of the beauty of mere presence in an ecstatic vein in Gitanjali. He begs
the Lord to grant him the indulgence of sitting for a moment by His side. 7 This presence in order to be
totally present to the client involves by its very nature breaking through one's unconscious self-preoccupation
and leaving behind one's self-centred world of daily involvement. 8 Even if you are only a few minutes with
the client, let the client enjoy your total presence.
 Principles and Techniques of Counselling-7 15

The reasons that compel us to accept counselling as a human encounter, simultaneously impress
upon us that counselling is a living, organic process. 9 The living organism adapts itself to the constantly
changing environmental forces and in the same way both the counsellor and the counsellee keep themselves
adjusting not only to each other but to every new emergence of insights in their exploring, understanding,
and acting — the three main phases of counselling.

Having spoken a little in general, let me now propose a tentative definition or description of
counselling. ‘Counselling is an interpersonal and collaborative process by which one facilitates growth
or change in another by adopting certain attitudes and employing certain skills appropriate to the
context.’10

The word ‘interpersonal’ denotes a relationship between two human individuals. According to the
existential philosophy, I create a world of my own and you create yours. We are indeed worlds apart unless
we decide to enter into the realm of the other and let the other enter into ours. Here we need to give more
emphasis to the quality of the relationship. Not every type of relationship is conducive for counselling. By
the quality of relationship I mean a whole lot of nuances that uphold human relationship and more
specifically a non-possessive warmth born of genuineness and nourished by sensitiveness to the thoughts and
feelings of the client.11

The word ‘collaborative’ means that both the counsellor and the counsellee have to work together
for the success of the counselling. The responsibility rests with both of them and more with the counsellee.
If any one of them is not minimally cooperating, the outcome will not be encouraging. I have met parents
who compel me to give counselling to their unwilling wards. Their children have no need of counselling,
perhaps the parents are more in need. Whenever counselling is attempted on unwilling clients, it does not
works. The clients themselves sabotage the whole process and the results of counselling. Finally decisions
are to be made by the clients. The clients will not make decisions, and even if they did make to please you,
they will not carry them out. Therefore, such attempts could be a colossal waste. One of my professors gave
me an insight into how he used to handle such situation of unwilling clients who are thrust into counselling
as mandatory by Government officials or by well-meaning parents. In a gentle way, the professor used to tell
the clients that they have been referred to him for counselling. You are free to waste the time we are together
or to profit from this interview, he would say. If at all you are interested to profit from this, I am at your
service. At times this approach works. Most of the time, the willingness of the clients is not easily
forthcoming.

The word ‘process’ indicates movement, a forward thrust, a flowing. It is opposed to anything
fixed, definite, immutable and non-negotiable. The Greek philosopher Heraclitus said that the world is in a
flux and as an example he said that we can never set foot in the same river twice, for when we stepped into it
for the second time the river that flowed when we stepped into it for the first time has already gone away.
For him the symbol of change is fire, which keeps changing constantly. Counselling is like a fire that keeps
constantly transforming. The changes and turns that are being taken with every step in the counselling
interview is incredibly in a flux and therefore it is more apt to speak of the interaction as a process than
anything else.12

The word ‘facilitates’ puts the whole picture of counselling in the context of equality, of
collaborative partnership suffused with a tremendous respect for the awesome person of the other. In some
centres of counselling, counsellors scrupulously avoid using the word ‘helping’ so that the trainees do not get
the impression even unconsciously of giving something to the client. Harvey Jackins has termed his method
of counselling as ‘Re-evaluation Co-Counselling.’ By the word ‘co-counselling’ he means to respect the
dignity of the other and also negates the idea of one-up-and-one-down status between the counsellor and the
counsellee. Facilitation can be understood more in terms of stimulation, an invitation, which a client can
accept, or decline. Though we think of collaboration and equality among the counsellor and the counsellee
we should not forget that counselling is unilateral in the sense that the focus of attention is on the problem of
the counsellee and not on that of the counsellor. 13 Even though it is unilateral it is not helping a helpless
person but it is seriously stimulating the client to be awake and asserting, to be brave and possessing, to be
active and actualising, to be courageous and non-abusing and to be tender and forgiving. The idea of
 Principles and Techniques of Counselling-7 16

facilitation leaves the responsibility 14 to change with the client him/herself. Self-help and personal
responsibility of the client can be triggered off by facilitation and not by helping.

The words ‘growth’ and ‘change’ refer to the goal of counselling. It is with this goal in view that
one enters into a counselling interview. Whichever school of thought one may follow, one aims at the
clients’ managing their lives more effectively and solving their problems and developing opportunities. 15
The word ‘growth’ underscores the idea of clients’ becoming more effective self-helpers. The word ‘change’
refers to the ability to solve problems and the ability to develop or identify opportunities. The clients either
have unsolved problems or do not live as effectively as they would like to live or both together. Counselling
is not for nothing, neither is it for the sake of structuring time. It is with the idea of change that counselling
is undertaken. In short, the two words refer to the problems of living which are developmental tasks that
people face at different stages of their lifespan like getting married, forming a family, having children and
getting old, and the problems connected with the transitions that accompany every stage and the individual
tasks like becoming what they want to become.16

The word ‘attitudes’ refers to one’s mental orientation. It is a learned and more or less
generalized affective tendency. It is out of our attitudes that our feelings and behaviours proceed. If my
attitude towards you is positive, my feelings towards you will be one of sympathy and love and conversely if
my attitude towards you is negative, I feel angry and behave aggressively. A caring relationship of warmth
should be buttressed by a network of attitudes, which are interrelated. For example, respect is an attitude.
Because I am deeply convinced of your worth, individuality, and potentiality and value you as a person with
rights, I avoid giving advice or manipulating you. A counsellor is bound to have certain attitudes, which are
either positive or negative. However, for a warm human encounter we need positive attitudes to permeate
the whole relationship. More than the skills what is more appreciated by the clients is the positive attitude
the counsellor adopts.17

The word ‘skills’ means expertness, practised ability or facility in an action or doing something.
Counselling is not an aimless wandering for which one does not need skills. Skills are means or tools to
achieve the goals. Since we have a definite set of goals in counselling, it presupposes that some skills
specific to the field in question are a must. The skills are to be selective and related to the task in hand. By
employing the appropriate skills we avoid wasting time and we move in a focused way. 18

Finally we land on the word ‘context.’ Skills are to be exercised in certain settings. Take for
example the skill of challenging. This skill can be exercised at a later stage of the counselling process when
the counsellor judges that his/her challenging the discrepancies of the client will definitely enhance self-
awareness and decision making process of the client. If not used prudently, this very exercise of the skill of
challenging will be counter productive and one may lose the client. 19

The overview of the facilitating model I present here comprises of two main themes, namely
Facilitative Dimension (Pacing) and Action-Oriented Dimension (Reframing). Here ‘pacing’ means that you
go along with the client in agreement with him/her and ‘reframing’ means that you now are able to facilitate
the change of attitude or behaviour of the client.

Overview of Counselling
1. Pacing Facilitative Dimension
2. Reframing Action-Oriented Dimension

I know a group of students who attended a German language course in a reputed institute. The
course ended with an examination. A brilliant student got the first mark. In practice the one who got the
highest mark could not communicate in that very language effectively whereas the students who scored low
marks were able to communicate rather well. Therefore, it is not so much the amount of knowledge and
skills you may have, though of course we do not underestimate the value of such things, but what is
practically needed is your ability to make use of whatever you may possess to facilitate the client. Being
able to facilitate growth in others even with a little of knowledge should in a way motivate you to learn more
and become proficient.
 Principles and Techniques of Counselling-7 17

With this introduction, I suppose, you are ready to enter into the process of counselling, treading one
step at a time, learning it thoroughly and marching forward with a relentless spirit. And this is the microskill
model of counselling.
3. COUNSELLING FORMAT

Counselling format contains steps in counselling. More or less these steps are found useful in my
counselling practice. At any moment I check where I am with the client. For this, this format helps me. I
make sure that I rather meticulously follow the steps. After having seen many good counsellors and my own
professors doing effective counselling and having tried one by one in my own counselling practice I have
devised these steps which are given as a format. I have experienced that if I overstep any one step, then
counselling does not proceed or rather I get stuck. There are times when I come back to the previous steps
just because I am unable to proceed or the client is not prepared to deal with a particular step I am at.

The chapters of this book are more or less arranged according to the steps you find in the format.
Side by side, you will also be learning counselling skills. Skills are dealt with at the reframing section.
Skills need not be confused with the steps. Skills are techniques while steps are procedure. With this clarity
let us see what the steps are.

COUNSELLING FORMAT
I. PACING
(FACILITATIVE DIMENSION)

1. Welcome the client, and make him/her comfortable with a small talk.
2. Observe the bodylanguage of the client.
3. Attend to the client physically.
4. Let the client tell the story.
5. Reflect the content. of what the client said.
6. Deal with the feeling.
1) Reflect the feeling.
2) Reflect the deeper feeling.
3) Allow the client to speak sufficiently on the feeling.
4) Facilitate the client to release strong negative feelings.
7. Pinpoint the problem and ask for a recent event.

II. REFRAMING
(ACTION-ORIENTED DIMENSION)

9. Personalize the client's deficiency.

10. Find out alternative frame of reference.
11. Employ problem solving techniques, behaviour strategies, and action programmes.
12. Insights:
1) Change what can be changed.
2) Let the client accept gracefully what cannot be changed.
3) Prepare the client for the worst.
4) Prepare the client to be happy with whatever decision he/she has made.
13. Define and operationalize the goal.
16. Make contracts and evaluate.
 Principles and Techniques of Counselling-7 18

I. PACING

FACILITATIVE DIMENSION

The word ‘pacing’ is a term from Neurolinguistic programming. It is the same as mirroring.
The communication that goes on between two persons is mostly through bodylanguage. We do
communicate verbally, then vocally, and bodily, and that which fills most of the communication is
bodylanguage. It is estimated that about 55% of the communication is throughbody language. The
pacing directs its attention to this body language of the client.

I would consider this pacing in two ways: 1. mirroring, and 2. pacing.

MIRRORING

Mirroring is reflecting like a mirror the whole or part of the bodylanguage of the client. It could
be done just like a carbon copy does; for example, if you sit with your arms crossed on your chest, I too
do the same; it is a carbon copy reflection. Or it could be a cross-over mirroring in the sense that I keep
nodding my head according to the rhythm of your breathing. If I were to reflect your mere breathing it
is a direct mirroring and since I mirror your breathing not through my breathing but through another
organ of my body that is my head then it is a cross-over mirroring.

Mirroring can be done after learning what it is for, or you could discover mirroring
spontaneously without ever consciously initiating it. Just watch people when they are engaged in
conversation either in twos or threes, or even in a little bigger group. Those who are in perfect
agreement usually have the same bodily postures and gestures. The dominant one initiates a gesture or a
posture of the body and the rest of the group members imitate it without their being aware of it. Two
people who are mirroring are in agreement with each other, or they like each other. Lovers mirror each
other and it is love that prompts them to mirror each other. People with ideological identity too mirror
each other. It is an indication that a rapport has been established between two individuals.

PACING

I understand the mirroring not only at the physiological level but also at the psychological level
for which I would like to designate the word ‘pacing,’ though in effect both mirroring and pacing can
mean one and the same thing. In pacing I do not mean to say of the physiological reflection of a
behaviour, but the agreement of the mind. When people go for group discussion as two opposing camps
A and B, it is difficult to arrive at a particular common decision. Instead, if one of the parties (A) goes
in agreement with the other (B), later the group (A) that agreed with the other (B) can lead the other
group (B) to its own decision. This is actually pacing and leading. We pace someone in the sense of
going along with the person so that at a later time we can lead the person. Once the other person knows
that you are for him/her and not against him/her then he/she is ready to follow your lead even though
initially he/she would not have consented to it.
 Principles and Techniques of Counselling-7 19

At this stage of pacing you go along with the client almost being in agreement with him/her so
that later you can at the reframing stage lead him/her the way you want. At least later he/she will not
offer resistance to your initiatives. In this stage of pacing or facilitative dimension we are going to spell
out in what ways we can go in agreement with the clients.

1
WELCOME THE CLIENT WITH A SMALL TALK

1. WELCOME THE CLIENT

1) ACQUAINTING

Now we are entering into the first step of the counselling process especially in pacing. Here the task
of the counsellor is to get acquainted with the client. Mostly it is a stranger who comes to meet the
counsellor and therefore the thing that needs immediate attention is to get to know the client well. Here the
counsellor makes him/herself familiar to the person who has come with a lot of expectation. The first
impression is the best impression, they say. And the first impression usually lasts longer compared to the
impressions we form later. In a very few instances only we change the first impressions we get of people.
When a person meets you for the first time, he/she forms a judgement about you in 90 seconds. It is
estimated that 90% of the opinion he/she makes about you is made within 90 seconds. 20 The rest of the time
he/she spends with you is only to confirm the impression he/she has formed about you. Because of the
impact of the first impression on a stranger who is going to enter into a deep therapeutic relationship, the
counsellor will do well to take the necessary steps to present him/herself in a becoming way without being
over-enthusiastic or too dull.

Every time we conduct the counselling course, I notice something curious happening on the eve of
the starting of the course when the participants arrive. Some of the staff members make it a point to receive
the participants and see that they are accommodated and well attended to. When finally the course is getting
over and the participants are about to leave or during the time of evaluation of the course, the participants
recall with a grateful heart how they had been first received. What is surprising for me is the fact that a
particular individual who received the participants may not have contributed to their learning much during
the course compared to the others who spend themselves for the participants. But the participants remember
vividly only the person who received them first and not the ones who helped them most. This only goes to
tell that the clients form an opinion of the counsellor from the way they have been received. Here the first
impression the counsellor makes is of great importance for the ensuing task. Since the clients could form
both positive as well as negative opinion about the counsellor looking at the person instantaneously, there is
the necessity of having the appropriate skills to present oneself becomingly. When I speak of presenting
becomingly, I do not mean to say that one should fake and pretend to be sweet. What is required is far from
such manipulation; genuineness should permeate every movement of the counsellor.

You might have noticed when you yourself had been a guest to someone’s house or when you
received guests into your own house. The guest anticipates and expects a warm reception and every word or
gesture of the host is keenly read by the guest in terms of his/her acceptance or non-acceptance. The reason
is rather obvious. The one who comes to you is vulnerable because he/she is not sure if he/she will be
welcome. Something similar happens to the clients who approach the counsellor and therefore it is
recommended that the counsellor receives the clients warmly.

2) RAPPORT-BUILDING

In the first step, the counsellor sets the tone and the quality of the relationship that will last through
the counselling sessions. Therefore, we call this step rapport-building step. That which takes place between
 Principles and Techniques of Counselling-7 20

the counsellor and the counsellee is also termed as ‘therapeutic alliance’ or ‘workable alliance.’21 An
informal contract of what is expected of the counsellor and the counsellee is already drawn up as soon as two
enter into a counselling interview. In most instances, this alliance or contract is not formal. The alliance we
speak of implies interpersonal relationship. This helping relationship is not an end in itself. It is not for the
sake of relationship that counselling is entertained but this relationship serves as a means to reach the goals
of counselling. If a warm friendship were to flower from the counselling it is altogether another story but
counselling is not undertaken primarily with a view to establish relationship, though therapeutic relationship
is essential for counselling.

I remember to have frequented a reputed institute. First when I went for the interview, the one who
interviewed and conducted tests on me hardly revealed who he was except his name. Again in the same
institute when I had the mandatory one-to-one sessions, the one who was dealing with me was not any better.
Perhaps he was maintaining a certain therapeutic neutrality. But that did not help me in anyway.

Your active presence is a kind of social-emotional presence,22 which speaks in unequivocal terms
your willingness to work with the client. Since you commit yourself to his/her welfare, you should both
verbally and non-verbally communicate the warmth and willingness of being with the client and working
with him/her. I remember to have given an oral examination to a professor who on entering his room pointed
to a chair and asked me to sit down while he was busy with his work. He was dusting his table and trying to
trace out an object while asking me to talk. Such a behaviour hardly can support a counselling session.
Since much depends upon the reception one receives at the hand of a counsellor, the counsellor should take
the initiative to welcome the clients warmly without being affected too much in his/her manners. A natural
way of greeting that is expressive of genuineness and concern is called for. Clients feel either encouraged or
put out depending upon the tone of interaction during the first five minutes or so. Every culture has its own
ceremony of receiving a guest. That ceremony which is appropriate to your culture cannot be dispensed with
in receiving a client.23

3) SHAKINGHANDS

In welcoming, you shake hands with the person whom you are meeting. Here who extends the hand
first is significant. The person who is pleased with the arrival of another person is happy to extend his/her
hand to shake hands with the newcomer. Therefore, it will always give the feeling of being wanted for the
client if you take the initiative to extend your hand and gently shake hands with him/her. It shows that you
are pleased with the arrival of the client and are happy to meet him/her.

There are different styles in shaking hands. They are unconsciously purposeful. A person of
dominant character, or at least the one who wants to dominate the other, places his/her palm over the palm of
the other thus indicating that he/she wants to take control of the situation (Figure 1).

The one whose hand is down, palm looking upward, is submissive and he/she gives the control to the other
dominant person (Figure-2).
 Principles and Techniques of Counselling-7 21

Figure 1 Figure 2
Wants to take control of the situation Submisive

A partnership handshake with respect and rapport will be a vice-like handshake with both palms
remaining in the vertical position (Figure-3).

With your clients, we do not expect that you dominate nor should you be submissive but deal with
respect as a partner or collaborator. Then you have the ‘politician’s handshake,’ which is otherwise called
‘glove handshake’ that is just holding the right hand of the other with both the hands (Figure-4).

Figure 3 Figure 4
Partnership Handshake Glove Handshake: Politician’s Handshake
Wants to give impression:
Honest, trustworthy & affectionate
 Principles and Techniques of Counselling-7 22

The one doing it wants to give the impression that he/she is honest, trustworthy, and affectionate.
But to do that with a stranger at the first instance may be misunderstood. Perhaps with a very well known
person this gesture will be understood but not with strangers. If you are meeting a client for the first time, it
may not be advisable to use a glove handshake. In counsellor training sessions I make the participants
become aware of the type of handshake they use. A few of them in spite of the awareness brought about on
their behaviour give a ‘dead-fish handshake’ (Figure-5).

It is understood that the people who give a dead-fish handshake show a weak character and can
easily be manipulated. There are people who squeeze the fingers in such a way that the knuckles crack
(Figure 6).

Figure 5 Figure 6
Dead-Fish Handshake: Knuckles Cracking:
Weak character, can be easily manipulated Aggressive person

It is the characteristic handshake of an aggressive person. When either you give only the tips of your
fingers, or others give the tips of their fingers, the message is one of non-confidence; when you grab only the
fingertips of the other you show lack of confidence in yourself and when others hold your fingertips only
they are lacking in self-confidence. One who gives only his/her finger tips besides lacking confidence in
him/herself wants to keep the other at a comfortable spatial distance (Figure 7) .

The right orientation to handshake could be holding it warmly without being too cold or too
aggressive with sufficient interlocking of the palms instead of the fingertips. To show depth of feeling
towards the other, sincerity, and trust, people use double-handed handshake. While holding the hand of the
other with your right hand, you hold with your left hand the wrist or elbow or upper arm or shoulder of the
other (Figure 8).
This type can be misunderstood like the glove handshake and hence it is advisable to use only when
you are on intimate terms with the client and also when you perceive that such an ostentation of feeling is
welcomed by the client.24
 Principles and Techniques of Counselling-7 23

Figure 7 Figure 8
Giving the tips of the Fingers: Double Handshake:
No-confidence, Keeps the other Wants to show depth of feeling, sincerity, & trust
at a comfortable spatial distance

4) ROVIDING PRIVACY

It is imperative on the part of the counsellor to provide privacy for the client to speak freely without
the fear of being overheard by others. Privacy is also desired for the sake of emoting, especially weeping. In
a college set-up I was called by the principal to counsel a girl in the presence of the principal herself. When I
proposed that the girl could talk to me privately, the girl herself protested and wanted the principal with her.
Anyway a little while elapsed and nothing significant was spoken of. Then all of a sudden the principal had
a phone call for which she had to leave us. It was at that time the girl burst into tears telling me that though
she had every affluence she was an orphan adopted by the foster parents who are known to the principal as
the real parents. The whole problem of the girl was with that issue. Then I kept the principal away and
continued the counselling. May be due to the delicacy of the relationship the clients may not openly demand
privacy from the third party that accompanies them. But the counsellor should normally see that the clients
are provided privacy. Once an organizer of a counselling course wanted me to counsel his wife at his house.
I did go to his house. He would sit all the while with me to see how I counsel his wife. His wife was
speaking in a muffled voice the way he entertains her sister who is a young widow. The whole problem was
with the supposed relationship of her husband with her widowed sister. But no counselling could properly be
done because the client was not free to speak what she wanted. In any situation it is always safe to provide
privacy for the client. Otherwise you may be missing the real problem!

2. MAKE THE CLIENT COMFORTABLE WITH A SMALL TALK

1) 'SMALL TALK’

Clients come to speak about their problems and find solutions but they need to calm down and get
composed before they could enter into their problems. Therefore, counselling psychologists recommend that
we engage the clients after welcoming, in some neutral type of conversations only to ease the fear and
anxiety that is written large on the faces of the clients. It could be in the form of enquiring about the weather
or the current events that are spoken of or any topic of some interest, topics that are non-threatening.
Sometimes asking questions like ‘how are you?’ or ‘what are you feeling?’ may directly take them to their
 Principles and Techniques of Counselling-7 24

problems for which they may not be prepared. Therefore, initiating a talk on non-threatening and neutral
topics ill ease the uncomfortable feeling of the client. 25

2) CONFIDENTIALITY

In an official setting and even otherwise when someone comes to confide in you, it becomes highly
imperative to let the client know that you would keep everything secret and assure him/her that you would if
at all needed to speak anything about the issues shared, to the persons who referred him/her to you, do so
only with his/her consent and permission. One of the ways to deal with when people ask you a report of the
counsellee is not to take up such a commitment and instead tell the person in charge that you will instruct the
client to let him/her know what had happened between the counsellor and the counsellee. This method
safeguards the absolute secrecy of the concerns shared. Or you could get the consent and permission of the
client to talk about whatever is necessary for his/her own good to the person concerned and rehearse the
matter you would talk, to the client and get it edited and approved by him/her. 26

3) TIME-LIMIT

There are times when counsellors start the counselling session thinking that it might get over in 45
minutes or an hour. But, it can happen that the counselling drags on even after an hour. Or you have another
appointment after certain time. All these cases can be saved if you could tell the client beforehand how
much time you have at your disposal for the counselling. If you do not do that, you may meet with awkward
situations where as you are getting ready for another appointment, the client is interestedly talking about the
issue or the client is emoting for which you need to wait which means you are delayed in keeping up the next
appointment. It is the duty of the counsellor to speak about the time-limit in which case the client
him/herself will adjust his/her interview so that he/she is able to come to a conclusion on time. 27

4) PREVIOUS COUNSELLING

There are clients who go about shopping counsellors. They stick to a counsellor for sometime and
then seek another. If a client has received a particular form of therapy for the current problem and now going
to a new counsellor, this fact is not disclosed, then the new counsellor might try the same ineffective therapy
on the client. Or even to assess the gravity of an issue it is good for the new counsellor to know what type of
counselling or therapy the client underwent previously. In the medical profession, doctors do not undertake
treating a patient unless the patient has terminated his/her treatment with the previous doctor. In the same
way no counsellor will undertake counselling unless counselling with the previous counsellor is terminated
or the previous counsellor refers the client. In such cases the new counsellor should know what all
psychological treatment the client has undergone.28

5) INVITATION TO TALK

Once the small talk is over and more or less you perceive that the client is in a mood to talk about
his/her concerns you can speak about the confidentiality and time limit and invite the client to share his/her
concerns. There are clients who may go on talking unrelated things or may keep mum and in either cases the
counsellor, after the initial talk to calm down the client, can invite him/her to speak about the problem. Some
clients specially wait for the permission from the counsellor to talk about their problems. 29

What I have spoken so far is being referred to as ‘Initial Structuring.’30 The objective of the initial
structuring as a preparation for the oncoming counselling is to facilitate the process of counselling. Here we
find two aspects: one is person-oriented in the sense that it aims at establishing a therapeutic relationship of
caring concern with the client, and the other is task-oriented formalities that will reduce wasting of time and
energy and help both the counsellor and the counsellee to move forward in a focused way.
 Principles and Techniques of Counselling-7 25

It is also possible that when you give the permission to talk, the client keeps silent. Here you need a
certain knack to elicit a response from the client. If the client is confused as to where to begin you could
gently ask him/her to say whatever comes to his/her mind. You could also make a statement telling that it is
difficult to begin, or simply make statements about what you observe, like telling him/her that he/she seems
sad or depressed. You could also draw his/her attention to the obvious fact of what is going on in her mind.
These techniques might trigger off and the client might start talking. Perhaps your initial structuring could
be like the following: Sathian, I am happy that you have come to speak to me, and whatever you speak to me
is confidential. Now we have an hour together and you are welcome to share with me whatever you want.

While asking the client to speak about the problem the counsellor could be careful in the choice of
words he/she uses. For example, asking a client straight 'Tell me what is your problem?' might be too
frightening for a client, since it is a direct question which is personalized. Though clients come to deal with
their problems, they may not be very happy even to hear the word ‘problem.’ Therefore you could ask the
client like 'What is that you would like to share with me?’ or ‘What are your concerns that you would like to
work on in this session?' These kinds of invitations keep the problems non-personalized, and so the client
may not feel threatened.31

In the first step what you are using, whether knowingly or unknowingly, are what we call 'social
skills,' which comprise a number of other specific skills like saying 'Good Morning ' or 'Good Evening' and
introducing your name in a simple understandable way like 'I am Sounder, a full time counsellor at Anugraha
Institute and I am happy to meet you; then you have ‘politeness skills’ like ‘Thank you’ ‘Please’ ‘Excuse me’
‘Pardon me’ ‘Would you mind’ and the like; and there come ‘kindness skills’ like offering a chair, showing
the way, giving a glass of water, enquiring about the health and the like. 32 So far we saw the skills of the
counsellor in the first step and now let us turn to the task of the counsellee in the same step.

3. COUNSELLE’S TASK

Our main line of search is to know what makes for a successful counselling and what the counsellor
and the counselle ought to contribute towards the success of the session. In the preceding pages we have
spelled out the skills of the counsellor. I am particularly interested in knowing what the counselle ought to
do so that the efforts of the counsellor are fruitful. Hence in the following pages we are going to concentrate
on the task of the counsellee.

1) WILLINGNESS

One thing stands out rather prominently which a counselling psychologist cannot overlook.
Counselling cannot be forced; it can only be offered. No forced counselling will be a successful one. This is
almost a fundamental principle regarding the client. Clients’ goodwill is essential so that the desired goal is
achieved. Some counsellors make great attempts to convince the clients of the need for counselling and try
to do their best, but the unwillingness of the client sabotages the whole effort of the counsellor.

In a way the willingness of the counsellee comes prior to the initiatives of the counsellor. We had
seen in the foregone pages that it is the counsellor who takes the initiative to welcome the client, make
him/her feel at home and invite him/her to share her concerns. In fact the client should have come already
motivated and be willing to cooperate with the initiatives of the counsellor, at least by associating with the
counsellor in whatever way he/she could. Some counsellors are over-confident to the extent that they believe
that by their influence they could help even an unwilling client. I do not deny the social influence of the
counsellor and the indirect pressure that can be put on the client without his/her ever knowing it. Some
counsellors by their clever manoeuvring are able to make the client want counselling. In this case, it is no
more forced than wanted, though that willingness was brought about by the social influence of the
counsellor.

Adrian Van Kaam has something very succinct to say about the free response of the counsellee
without which the process of the counselling seems meaningless.
 Principles and Techniques of Counselling-7 26

The authentic counsellor wants to affirm the unique personality and the spontaneous initiative of his
counsellee; he wants him to grow in his own independent being. But this desire can bear fruit only when the
counsellee ratifies my therapeutic attempt by his own consent to my desire for him. Therapeutic care does
not want to force or to impose. What is more, as soon as the counsellor tries to overpower the counsellee, if
only by suggestion, then his activity is no longer therapeutic care. Counselling can only become authentic
by means of the free consent and cooperation of the other. 33

2) GREATER RESPONSIBILITY

In the introduction of the book, we have seen that counselling is a collaborative process, a two-way
stimulation. If it is a collaborative process then the initiatives of the counsellor alone is not enough. The
counsellor provides enough of stimulation towards the client’s self-help. Finally it is the counsellee who
achieves the goal he/she set, it is he/she who manages the problem, it is he/she who decides to live an
enhanced life devoid of psychological games. It is more correct to say that the clients achieve their goals
through the facilitation of the counsellor. The counsellors do not control the outcome of counselling. In fact,
the one who is more responsible for the process, outcome, and quality of counselling is the client
him/herself.34 His/her responsibility and cooperation start from the very start by his/her willingness, right
through the process, decision making, and finally rests with his/her execution of the decisions he/she makes.

It is widely accepted that counselling will be in good shape not in spite of the lack of goodwill of the
client, but because of the goodwill of the client. Take for example clients with antisocial personality
disorders who rarely cooperate with anybody and for that matter with any counsellor. It has been found that
such clients profit from counselling to the extent they are willing to cooperate with the counsellor. 35 In our
own lives we find that if we happen to want a thing we do get it; otherwise any amount of pressure from
outside is not going to make us get it.

3) LAW OF INERTIA

The cause of unwillingness could be many, and often it comes under one particular principle called
‘law of inertia’ which states that a thing will rest until something moves it. In human behaviour this physical
law can be seen in various forms. 36 The law of inertia is further reinforced by the psychological games the
clients play. Dr. Eric Berne speaks of a number of psychological games clients play. They seem to be
playing from three different positions or roles. In every society some ‘persecutors’ nag and ill-treat others.
There are also people who are always being persecuted and victimized and they are called ‘victims.’ Then
there come some people who are on the look out for rescuing the victims from the persecutors. They are
called ‘rescuers.’ Thus there are three roles: the persecutor, the victim and the rescuer. All the three
categories of people play their roles unconsciously. Here particularly with regard to the law of inertia, we
find that the people who play the role of victim want to perpetuate their role as victims and hinder their own
progress unconsciously.

For example, the people who play the game of ‘Poor Me’ will not venture to improve their lot but
will keep complaining about everything that happens to them. 37 They are paralysed by inertia and will not
take the necessary steps to get the help needed by way of approaching a counsellor or cooperate with him/her
for their own good. Take another example of a person who plays the victim's game of ‘if it were not for
you.’38 He/she would blame his/her family background and personal defects as reasons for not improving.
These are a kind of passivity and learned helplessness that come in the way of the clients and prevent them
from approaching a counsellor or to cooperate with him/her. The ugly face of inertia is thus seen in
numerous manifestations like passivity of not doing anything, learned helplessness thinking that one is
incapable of improving a situation, disabling talk telling that one does not have the potency to manage one's
life, and disorganization in which a person will keep his/her personal and social life in a mess and will not be
able to figure out what he/she could do to ameliorate the circumstances. 39 Thus we find that inertia can be
one of the main reasons why clients do not cooperate with the counsellors.
 Principles and Techniques of Counselling-7 27

4) FEAR OF CHANGE

Coupled with the law of inertia we also find the fear of change 40 that prevents the clients from taking
adequate steps. Though there is a desire for novelty deep down within us, we are also aware that we do not
want any change. There was a devastating flood in 1977 along the riverbed of the river Cauvery in Trichy
and Srirangam, as a result of a cyclone. Many of the poor people, living in a cluster, lost their houses and
property. When some of the voluntary agencies took up their cause and proposed a better place where they
would not be affected by flood any more, and where there were plenty of job opportunities, the people
simply refused to move, in spite of the new proposal being very appealing intellectually. Though the new
proposal promises a better living condition, the fear of a changed life style disturbed the people more than
the abject poverty they were facing in the flood affected area.

Something similar happened in Bombay and Calcutta where slum dwellers were given better
dwelling places which were quite decent and neat. Before long, they all returned to their original dwelling
places in the slum because they could not tolerate change in their customary habits. In Andhra Pradesh some
bonded labourers were freed by the Government, and after a few months they went back to their landlords
begging to be taken back as bonded labourers. In the same way clients are afraid of a changed way of life
because the new way is unfamiliar, or they have to make a number of adjustments or simply they are
accustomed to the old ways only.

The feelings of the clients apparently desiring a change and unconsciously deep down fearing the
change they ask for, are well brought out in subtle verses by Rabindranath Tagore in Gitanjali when he sings:

The shroud that covers me is a shroud of dust and death; I hate it yet hug it in love. My debts are
large, my failures great, my shame secret and heavy; yet when I come to ask for my good, I quake in fear lest
my prayer be granted.41

This is a pitiable state of some of the clients who are afraid of taking up the responsibility of
changing their lives drastically, when they go for counselling or cooperate with the counsellor.

There are some categories of people who do not seem to benefit from counselling. Children, very
old people, and people whose intelligence is below average tend not to understand the dynamics of their
interaction and are in a way unable to go along the counselling process and also later lack the guts to execute
the decisions. In some sense they are unable to cooperate with the initiatives of the counsellor.

5) RELUCTANT CLIENT

Practically we can divide the clients into those who do not want to cooperate and those who though
willing cannot cooperate with the counsellor. They are the reluctant clients and resistant clients. Reluctant
clients are those persons who do not want counselling at all for their own personal reasons. 42 They are not
self-referred but rather referred to by others. Mala aged 45 is a married woman. Her husband feels that she
is in need of psychological help, and Mala too agrees to it but is unwilling to meet a counsellor, for the
simple reason that an intense interaction in a counselling situation frightens her. Siva’s case is quite
different. He is suspicious of everyone and has great difficulty in trusting others. His lack of trust comes in
the way of approaching a counsellor. Catherine is a cute girl doing her first year of graduation. Her problem
is she is very shy. She is not able to face an audience and even individuals separately. Besides, to share her
inmost thoughts and feelings with another person is something shameful for her. Her feeling of shame
prevents her approaching a counsellor. Thus we find a number of reasons for the reluctance of the
counsellee. At times, the third party is interested in counselling. This happens mostly with the parents of the
teenagers. The parents are sure that things do not go well with their teen-age children and they want by all
means that the children should get counselling, but unless the children themselves want counselling it is of
no use coaxing them, for they usually do not oblige. Similarly we find persons sent from correction homes
by the officials. Since they have to fulfil an obligation of meeting a counsellor they come and for no other
reason. From such clients what could be expected except reluctance and indifference? You can hardly
succeed counselling a reluctant client. Perhaps it is a waste of time and energy on your part.
 Principles and Techniques of Counselling-7 28

6) RESISTANT CLIENT

Another category is the resistant clients. They are persons who wanted counselling but later changed
their mind and resist every attempt of the counsellor. 43 Resistance could be either conscious or unconscious.
If resistance is conscious it almost amounts to reluctance and it is hard to deal with, but if it is unconscious
the counsellor can facilitate to remove the unconscious block and help them come up with the necessary
cooperation. When it is a question of unconscious resistance, making the clients to become aware of the
blocks would be helpful.

7) ‘COAX ME’ GAME

When speaking of reluctance and resistance I am reminded of a psychological game which the
clients might play with the counsellor. The game is called ‘coax me’ 44 which is played from the role of a
persecutor. According to the dynamics of this game, the person playing this game is intent on putting the
other person down. In the context of counselling, the client unconsciously puts the counsellor off by
declining every appeal from the counsellor. It might happen that a counsellor unaware of the game pattern
may get hooked by the client and might be playing the complementary role to maintain the game pattern.
The counsellor might have tried his/her level best to convince the client of the need for counselling at a
particular phase of his/her development. The client might say that a particular need has to be met before
counselling can be started. When that particular need is met, he/she might propose another need, and thus
the person will go on placing many unreasonable demands and keeping the counsellor coaxing him/her, and
finally the counsellor might get annoyed with the demands and leave the client to him/herself, meanwhile
feeling bad about the whole situation. It had been a perfect game plan that was worked out.

When clients are either reluctant or resistant, it is worth exploring if the clients are playing the game
of ‘coax me.’ If it is a game plan that is cunningly executed, then the counsellor can address the client in
words similar to the following and stop the game proceeding further: ‘You seem to be finding it difficult to
talk to me. I would like to assure you that I am available to you whenever you decide to speak up, and for
the time being we wind up the session.’ This unexpected response from the counsellor might shake the client,
and he/she might leave behind her game pattern and begin to answer.
 Principles and Techniques of Counselling-7 29

2
OBSERVE THE BODYLANGUAGE OF THE CLIENT
Human body is a vehicle of communication. It is purely the true aspect of our personhood. It can
speak more eloquently than any other medium of communication. As a counsellor one needs to know how
our body reveals inner dispositions and motives. The body is the surest and the most comprehensive
revelation of our personality.

1. BODY SPEAKS MOST

The surest way to understand a person is to observe his/her body language — nonverbal behaviour.
The training we receive in the schools and the society does not teach us to read the non-verbal behaviours.
In counselling situations, the counsellor can get lots of information (and more or less accurate information)
by observing the non-verbal behaviour of the counsellee. Robert R. Carkhuff recommends observing the
nonverbal behaviour thus:

Observing skills involve the helper's ability to see and understand the non-verbal behaviour of the
helpee. These skills are essential because the richest source of empathy is the helper's observation of the
helpee's physical behaviours. We must observe those aspects of the helpee's appearance and behaviour
which tell us about the helpee's energy level, her feeling and her degree of congruence (whether she really is
as she appears). The helpee gives us many cues to her experience in her physical behaviour and
appearance. When all other cues to the helpee's experience confuse us, we must return to the most basic
evidence of all — the helpee's behaviour.45

Now the counsellor is invited to focus his/her attention on the cues to read the nonverbal behaviours
of the client. Once I had been to a medical exhibition. Going through the various stalls, I came across a
room at the entrance of which was written "The body never lies." It was the forensic science stall. We have
different means or vehicles of communication. What is evidently known is the medium of a language
through which we communicate with one another. Even before language could develop humans would have
been communicating with one another. Certainly they would have communicated by their bodies, that are
also vehicles of communication. The primary mode of communication for the primitive man/woman was the
body.

The same phase of development is seen even now in babies. Babies rely purely on their body
language for communication along with grunts, cries, gurgles, and the like which later develop into a
language. The psychologist Mehrabian has estimated the percentage of each of the modes of
communication; and he came up with astonishing results. He says that we communicate 7% verbally, 38%
vocally and 55% bodily.46 In other words communication is mostly by body language, then by paralinguistic
behaviour (like accent, emphasis, intonation, and pauses), and the least is by words. The client who comes to
you, therefore, speaks mostly through his/her body. If you are not able to read his/her body language, then
you miss most of his/her communication. Hence I stress on reading the body language of the client. In this
step I am endeavouring to introduce to you in what all ways our body reveals hidden messages.

2. THE UNCONSCIOUS PEEPS THROUGH THE BODY

The interest of the psychologists in understanding the body language started some thirty years back,
though of course Freud himself observed in 1905 that patients revealed themselves through their fingertips. 47
People instinctively read body languages from the very beginning of the human race; yet real scientific study
began only in recent years. Kinesics, the science of body language, is in its infancy. All the same we are
endeavouring to exploit the knowledge gained through kinesics to understand the client and help him/her
better.
 Principles and Techniques of Counselling-7 30

Once I happened to see a group of men seated in the parlour of an institution. One among them
Prakash by name had already placed his legs on a small table, while the others were seated along with him in
a circle. The other men who sat with him were his equals or his juniors. In a way Prakash was asserting his
dominance, superiority, and his territorial rights. On other occasions also I had observed the same
individual; whenever his status is threatened, he immediately assumes the posture of placing his legs on the
table in front. On another occasion, I was animating a group of young girls for community building. All of
us were seated on mattresses that were well arranged in the room. A number of cushions were also provided
so that any one desiring a little more support or elevation could very well make use of them. On entering the
room, I found Clara, one of the participants seated on an elevated seat. She was very conspicuous by her
elevation. I did not pay much attention to her raised seating. During the interactions I could make out that
Clara was superior in intelligence and practical ability. She was showing to me and to the whole group that
she is superior to the rest. Both Prakash and Clara were speaking eloquently through their postures. The
unconscious somehow leaks through the body if not through the words.

3. BODY SPEAKS A LANGUAGE

In every language there are words, phrases, and sentences. 48 There are simple sentences, compound
sentences, and complex sentences. We have active voice and passive voice; and we have direct speech, and
indirect speech and a whole lot of grammar. Since body movements and gestures are a language, they too
should be having words and sentences as in a spoken language. Experts in Kinesics say that body language
in fact has words and sentences. A little gesture of touching the mouth or the nose is like words; and a
cluster of gestures (like dilated pupils, preening behaviour and thumbs in the pocket with the other fingers
pointing down) is like a sentence made up of many words. Words have different meanings in different
contexts; for example, the word 'light' will mean 1) an article that is not heavy, or 2) an article that emanates
luminous particles, or 3) the luminosity itself. Likewise every gesture has to be understood in its own
context; one and the same gesture may have different meanings in different contexts.
Having spoken about body language and the ways to read the body language, I should warn the
reader of the danger of misreading the language. Take for example crossed legs. It may be a sign of
defensiveness; but this same gesture will be used when a couple, for example, is seated on a bench with a
third person facing them. Since they feel divided between two desires (that of closing a circle between them
and of including the third party as well), the couple will solve the problem by crossing their legs in such a
way that they form a closed circle between two of them; at the same time their bodies will be turned to the
third person to include him/her.

While reading a gesture, it is good to go by cluster, context and culture. For example, crossed arms
and crossed legs with the head down forms a cluster of defensiveness or negative attitude. Likewise a frown
may indicate annoyance when someone is constantly making the same mistake, or it could be also a sign of
intense concentration. So here the context is very important to read a gesture. Culture too can colour our
gesture and may give different meanings. In some cultures people shake their head sideways to say ‘yes' and
move the head up and down to say 'no'; and the reversal is in practice in some other cultures. This is a
cultural difference. So when all is said and done, it is good to take into account the factors of cluster,
context, and culture to read a gesture accurately. Even after all these, it is good to keep your judgement
tentative lest you should make the blunder of being cocksure about a human behaviour.

We were born naked, both physically and psychologically. But sooner or later, we were clothed
physically; and also clothed psychologically. The psychological clothing are masks which we wear most of
the time. Just because we keep on our masks, others find it difficult to know what is behind. The clients
who come to you are also wearing masks, making it difficult for you to understand them. Spoken languages
may deceive us but the real person behind the masks leaks through the masks and peers out piercing the
masks without the conscious control of the individuals. The medium through which a client comes out of
his/her hiding (behind the masks) is his/her body. Hence observation of the body movements and
expressions and reading them become a necessity for the counsellor if he/she wants to help the client
adequately.

4. DISPLACED ACTIVITIES
 Principles and Techniques of Counselling-7 31

The counsellor observes what the counsellee manifests (reveals of him/herself). The counsellee
manifests his/her internal state (what is going on within him/herself). This manifestation can take place at
the conscious level or at the unconscious level. When a client weeps and wears a sad look he/she is
manifesting consciously that something is hurting him/her. Sometimes the clients may not be willing to tell
you what is going on within themselves. They may hide certain feelings of theirs or certain internal states,
thus faking something quite different from what they are experiencing within. The counsellor can be of help
only when he/she understands accurately what is happening to the client even though he/she is not willing to
express it. It may not be the ill will of the client not wanting to reveal. The fact that he/she is not willing to
reveal could be unconscious in the sense that it is outside his/her awareness. Whether the client is
consciously hiding or unconsciously hiding, his/her body language leaks out the true feeling of the client.
The body language comes in the form of displaced activities.

Displacement means expressing a certain emotion in a situation other than the one that aroused it.
For example, the husband scolds the wife; she is unable to express her anger against her husband but vents
out her feeling of anger on her daughter; the daughter will express her anger towards the mother to her little
brother; and the little boy being unable to retaliate his sister will go and kick the dog. Here we find a chain
of displacements, and in this case it is anger. Whenever direct expression of emotions is inhibited, the
emotions are expressed on some neutral or unrelated object or person. Some teenagers who are not able to
express their aggression and anger against their parents may commit suicide. It is a case of displaced
aggression. The anger against the parents is displaced on themselves and so they commit suicide. People at
times beating their own breasts and striking their heads against walls show displaced anger or grief. When
we are not able to accept our own defeats and failures, take responsibility for the same, but shift them on to
some other persons in the community, it is scapegoating which is a displacement activity. Once I was
counselling a couple with three boys; the counselling took place in their own home. The man complained
that his wife had not trained their sons properly especially the one who was putting on weight. The man took
the least interest in disciplining the sons, but blamed his wife who did more than her share. It is definitely
scapegoating, which we know is a displacement activity. A man was running a home for the aged in an
inadequate manner. On visiting the institution, I was wondering why could he not rehabilitate the old people
in other institutions that are well run. When I said this the man was very angry with me. He immediately
beat his own head strongly and gave me an abrupt answer. It was very clear that the blow was meant for me
but since he could not do that to me he turned it on himself. This, indeed, is a displacement activity. Here
the point I want to drive home is that body language is a displaced activity. 49

5. PSYCHODYNAMICS OF FREUD

When conflicts or unacceptable desires are unbearable for the conscious mind, they are pushed to the
unconscious by the primary defence mechanism. When something associated with the repressed materials
triggers off the materials in the unconscious, they would like to come to the surface of the conscious, in
which case the secondary defence mechanism, being unable to push the materials into the unconscious,
displaces them on an innocent object, and this is called phobia; if it converts the materials into bodily
ailments without physical cause, then it is hysteria; if in the unconscious the repressed materials become
independent and insulated, having their own autonomy independently of the conscious mind it is a
disassociated state like amnesia, somnambulism, fugue, dual personality, and devil or divine possession.
Thus the secondary defence mechanism keeps the repressed materials coming to the conscious by displacing
them in one way or other.

When even this displacing fails, then the repressed materials come to the conscious mind and the
individual has what is called anxiety; this anxiety can very well be observed by anybody. The principle of
the psychodynamics of Freud is at work in nonverbal language. When a feeling or emotion does not find
direct expression for whatever reason, the very feeling or emotion finds an outlet into bodily gestures.
Unconscious materials or the hidden thoughts, feelings and anxieties leak out through our body language. 50
Our body language is the truthful aspect of our personality. It reveals the truth we do not like or for which
we are not prepared.51
 Principles and Techniques of Counselling-7 32

6. FIXED MUSCULAR PATTERNS REVEAL SET ATTITUDES

Whatever feelings one experiences, these feelings are expressed physically. It is expressed in the
way you hold your body, the whole carriage and comportment, which result in fixed muscular patterns and
correspondingly set attitudes toward life in general. These things persist unless some interventions are made.
One could change the feelings and eventually correct the fixed muscular pattern, or one could also change
the fixed muscular pattern and thus influence the feeling. Deep massaging and stretching exercises work on
this principle.52

These attitudes and fixed muscular pattern reflect, enhance, and sustain one another. It is as if the
body sees what the mind believes and the heart feels, and adjusts itself accordingly. This gives rise to a way
of holding oneself, as pride can swell the chest or fear contract the shoulders. The muscular pattern in turn
sustains the attitude, as for example, slouching forward, which makes every action more difficult and so
makes life itself seem burdensome.53

From the foregoing passages it is obvious that we can read the thoughts and feelings of others even
from the way they hold their body in fixed muscular patterns. Thus a rigid posture is indicative of anger; a
relaxed posture shows happiness, a slouched posture betrays sadness and a tense posture points to anxiety. 54

The founder of gestalt therapy, Fritz Perls, gave much importance to body awareness; his clients are
expected to become aware of their body language, their breathing, their voice quality and their emotions.
This paves the way for the clients to own their own feelings and internal states. 55

7. SWEAT-SHIRTS AND ULTERIOR TRANSACTIONS

If I were to interpret Dr. Eric Berne's sweatshirts that are ulterior transactions, I would term them as
body language (of which we are concerned at present). One's behaviour, demeanour, comportment — all
speak much more eloquently than words. In Transactional Analysis, it is spoken of as ‘sweatshirts.' People
wear sweatshirts with some inscriptions on them. These inscriptions are messages. Mostly we find them
being written on the front portion of the sweatshirt. At times we find some inscriptions on the back portion
of the sweatshirt as well. Surprisingly enough, we find at times that the message written on the front portion
is just the opposite of what is written on the back. In all probability the people who wear certain sweatshirts
are communicating to the people with whom they are in contact.

Transactional Analysts have identified some of the common messages we convey by our body
language. There may be just one message or multiple messages or contradictory messages. Geetha acts very
tough. By looking at her, people keep a distance in the office. She is wearing a sweatshirt with the message
‘I am tough and so keep your distance.’ When this message is written large on her body, nobody will think
of approaching her. Geetha may be quite unconscious and in fact she is. Openly at the conscious level she
may be protesting when pointed out that she is wearing a message asking the people to keep their distance.
Sunil acts helpless; he is always in need of help. People around him judge him to be incompetent for any
worthwhile work and so he is marginalized. He is wearing the sweat-shirt ‘I am helpless and so please take
care of me.’ Those who play the role of a rescuer will immediately rush to render him help and even
volunteer to take care of him. There are actually persons who are helpless and yet do not play any
psychological game. It does not refer to such persons but only to those persons who are capable of looking
after themselves and yet appear to be helpless. Anil is an intelligent and efficient sales representative. He
has the right word at the right moment; he is polished and polite; his unconscious need is to wear the
message ‘I am smart and so admire me.’ Reka is a sweet lady; her walk and talk are graceful; she is
welcoming and warm in her relationship. People around her want to associate with her. Reka is wearing the
sweatshirt 'I am nice and so approve of me.’ Ricco does not seem to possess enough of intelligence. He
asks funny questions in the class and he is the butt of the class. Often he is singled out by the teachers to
vent their anger. Ricco is wearing the sweatshirt ‘I am stupid and so criticize me.’ Radhika has
proportionate features, a charming look, and anybody will fall for her. She is wearing the sweatshirt ‘ I am
sexy and so come and get me.’ People unconsciously wear certain messages; people around them pick up
 Principles and Techniques of Counselling-7 33

those messages unmistakingly; and a whole lot of ulterior transactions go on among us the whole time. Thus
through sweatshirts we communicate our hidden messages.

8. ENERGY LEVEL

Before anything else, what impresses upon the counsellor is the physical appearance of the
counsellee. The amount of disorganization can be made out from the way one appears. If one's energy is
very much drained by the conflicts and demands in one’s day-to-day living, we cannot expect the client to
appear neat and clean. When a person is neat, it only indicates that his/her energy level is at the optimum
level. Certainly it takes a certain amount of energy to maintain oneself clean and to appear neat. If the
grooming is markedly poor, then the person's energy level too is very poor and low. A drooping head,
slumped shoulders, a caved in chest, slow and burdened gait indicate clearly a low level of energy, and
therefore weakness and defeat in life. On the contrary, when a person carries his/her head erect, with his/her
shoulders flexibly straight, chest fully extended and a gait that is light, he/she indicates high energy and a
confident outlook.56 Along with the nonverbal behaviour, one should notice the body-build, posture, and
grooming. In certain cultures, individuals do not comb. They just come from bed and are comfortable to be
so in any social situation, because in those cultures most of them do so. In this case, it does not denote low
level energy because of the cultural difference.

9. EYE-SCANNING

Neurolinguistic Programming (abbreviated as NLP as developed by John Grinder and Richard

Bandler in recent years) has devised a method of getting information about what is going on within a person
by watching his/her eye movements. This is called ‘eye scanning’ 57 in NLP. When you remember something
from your past experience, your eyes move up to the left corner for a fraction of a second. (Visual Memory)
(Figure 9).

If the eyes move up to the right corner (Visual Construction) (Figure 10), then one is constructing a
visual image which one did not have early.

Figure 9 Figure 10
Visual Memory Visual Construction

For example, I am asking you to imagine yourself in the costume of a judge. Since you have never
worn the costume of a judge, you need to construct an image of yourself in that attire. Therefore, whenever
you are accessing by the movement of the eyes up to the right corner, it is sure that you are having something
visual which is being constructed; and if up to the left corner, you remember a thing you have seen. Lies are
constructed. If I tell a lie that I have seen a baby elephant, then automatically my eyes will go up to the right
corner, since I am reporting a visual image which is constructed. If I have really seen a person stealing,
when I speak of that my eyes will move up to the left corner. Care should be taken to read the eye
movements. Once I taught eye scanning to a group of counsellor trainees. One of them, after a few days,
reported that he was insisting with a peer counsellee that she was telling a lie since he found her most of the
time looking up to the right corner. Actually accessing a visual or auditory or kinesthetic mode is done
within a fraction of a second. As soon as you are asked a question, straight go your eyes to the specific
direction and return. Therefore look for the accessing rather than where the eyes rest.
 Principles and Techniques of Counselling-7 34

So far we have seen two eye movements. Thirdly if the eyes move to the left side straight, then it is
an auditory memory (Auditory Memory) (Figure 11)

For example I ask you to recall your favourite song; your eyes will move to the left side straight. If I
ask you to tell me how your girl friend's laughter changes into a loud lamentation, your eyes will turn to the
right on a straight line, since you have to construct the sound auditorily (Auditory Construction) (Figure-
12).

Figure 11 Figure 12
Auditory Memory Auditory Construction

If I ask you how it would feel like to run on the seashore barefeet, your eyes will go down to the
right corner. Down is the place when we are in touch with our feelings. When we ask a client, 'what are you
feeling right now?' he/she will look down to the right. He/she is accessing and is in touch with his/her
feelings (Kinesthetic) (Figure 13).

When you are all by yourself having a self-talk then your eyes will look down to the left
corner (Auditory Dialogue) (Figure 14).

Figure 13 Figure 14
Kinesthetic Auditory Dialogue

These eye movements are of a fixed pattern, revealing what representational systems (senses) you
are accessing at a given moment. Thus eye scanning will give you additional information about the client
sitting in front of you.

10. BREATHING (CALIBRATION)

Calibration is another way of observing a client's internal state. Calibration is external manifestation
of the internal state of mind. 58 Whether the client sitting in front of you has some visual experience or
auditory experience or kinesthetic experience can be made out from the location of his/her breathing.
Breathing high up in the chest, or even temporarily stopping of one’s breath, will indicate that the person has
visual images. When the breathing is mostly felt at the diaphragm, the person has auditory experience; and if
one’s breathing is very deep, low in the stomach, it will betray kinesthetic experience. A person really
having a strong kinesthetic experience will be breathing very low at the bottom of his/her stomach, that is at
the abdomen.
 Principles and Techniques of Counselling-7 35

By eye scanning and calibration, you will have some information about the client whom you are
going to counsel. Since we intend to understand the client in all his/her manifestation, we observe the eye
movements and breathing patterns. The more you observe the client, the better it is.

11. HAND AND ARM GESTURES

Rubbing the palms indicates positive expectation gestures (Figure 15). Tightly clenched hands is a
frustration gesture signalling that the person is holding back a negative attitude, suspicious, and is very
difficult to relate to (Figure 16).

Figure 15 Figure 16
Rubbing the Palms: Tightly clenched Hands:
Positive Expectation Holding back a negative attitude, suspicious, &
is very difficult to relate to

Steepling hands reveal a confident and superior attitude (Figure 17). It designates the confident and
sometimes smug, pontifical, egoistic, or proud gesture. Absolute self-confidence displayed in superior-
subordinate relationship.

Figure 17
Steepling Hands: Confident & Superior Attitude
 Principles and Techniques of Counselling-7 36

Gripping the wrists, hands, or arms behind is a confident and superior gesture (Figures 18, 19, and
20). Thumb displays, in whatever form are done, signal dominant and aggressive attitude and even ridicule
or disrespect for the other.59

Holding an arm behind the back and clenching the hand tightly while the other hand grips the wrist
or arm (locked wrist gesture) is a self-control gesture.

Figure 18 Figure 19 Figure 20

Gripping Wrist Gripping Hand Gripping Arm

All the Three indicate: Confident and Sperior

12. HAND-TO-FACE GESTURES

Covering the mouth (Figure 21), touching the nose or slightly rubbing the nose usually with index
finger (Figure 22), rubbing the eye (Figure 23), the neck scratch (Figure 24), and the collar pull (Figure
25): all indicate deceit, doubt, lying, rejection, ‘no,’ not sure how to approach a subject or what audience
reaction to it might be. Fingers in the mouth: Feels insecure and so wants reassurance.
 Principles and Techniques of Counselling-7 37

Figure 21 Figure 22 Figure 23

Covering the Mouth Touching the Nose Rubbing the Eye

All the Three Indicate: Deceit, Self-doubt (I don’t know) or lying

Figure 24 Figure 25
The Neck Scratch The Collar Pull

Both indicate: deceit, doubt or lying

 Principles and Techniques of Counselling-7 38

Touching the ear or earlobe (Figure 26) signals that one is fed up with what one heard and so wants
to talk. Hand supporting the head - Boredom (Figure 27).

Figure 26 Figure 27

Touching the Ear or Earlobe: Hand supporting the Head:

Fed up with what one heard & so wants to talk Boredom
Tugging ear: Interrupt gesture (wanting to talk)

Fingers or hand touching the chin, stroking the chin, touching the cheeks. It is also done by bringing
a hand to the face, putting one’s chin in the palm, and extending one’s index finger along one’s check, and
the remaining fingers are positioned below the mouth: are all (critical-) evaluation gestures, or decision-
making gestures (Figure 28 and 29).
 Principles and Techniques of Counselling-7 39

Figure 28 Figure 29
Fingers or hand touching the Chin, stroking the Chin, touching the Cheeks: Thinking, evaluation or
decision making gesture, communicates anything from boredom to evaluative interest.
Hand-to-check is a thinker gesture

Head-rubbing and head-slapping gestures (Figure 30) and palm rubbing the hair or the back of the
neck (Figure 31): frustration.60

Palm to back of neck which is understood as hot under the collar will also mean defensive beating
posture.

Figure 30 Figure 31
Head-Slapping: Frustration Hair, Back of the Neck, and Head-Rubbing: Frustration

Both of them indicate: Defensive beating posture

 Principles and Techniques of Counselling-7 40

13. ARM AND LEG BARRIERS

Folded arms (Figure 32), crossed legs (Figures 33 and 34), ankle-lock (Figure 35): Negative and
defensive attitude; displeasure; tough-minded and stubborn, closed attitude; holding back a negative attitude,
emotion, nervousness or fear and heated arguments take place. 61 Crossed legs and crossed arms means
adversary. Arms crossed on chest and the hands fist-like will indicate defensiveness and protective posture.

Figure 32 Figure 33
Folded Arms Crossed Legs

Both indicate: Negative and defensive attitude

Figure 34 Figure 35
Crossed Legs Ankle Lock
 Principles and Techniques of Counselling-7 41

Both indicate: Negative and defensive attitude

Locked Angles and Clenched Hands will indicate: Holding back strong feeling and emotions

14. READINESS GESTURES

Hands on hips gestures (Figure 36) hands on knee (Figures 37) or on thigh (Figure 38); learning
forward and gripping the chair while sitting as though one is about to move or start and sitting on edge of
chair: Readiness gestures and oriented towards action. 62

Figure 36 Figure 37 Figure 38

Hands-on-Hips Hands on Knee Hands on Thigh

All the Three indicate: Readiness

15. COURTSHIP GESTURES

Courtship gesture also consists of preening gesture which is performed for the benefit of the sexual
partner.

Women Preening: the head flicked back to toss the hair back over the shoulders, exposed wrists,
rolling hips, sideways glance, slightly opened mouth, wet lips and lipstick (Figure 39).

Men Preening: legs apart in an aggressive crotch display, thumbs tucked into the belt or the tops of
the pockets (Figure 40).63
 Principles and Techniques of Counselling-7 42

Figure 39
Figure 40
Woman Preening Man Preening

Both indicate: Courtship gesture

Sexual aggressiveness is shown when one tucks his thumbs into the belt or the tops of the pockets.
When two male persons are using the signals of thumbs-in-belt and hands-n-hips gesture, it means both the
males are engaged in sizing each other up and getting ready for an aggression. 64

16. HEAD GESTURES

When the head is up and straight (Figure 41): Neutral attitude to what one hears; when the head is
tilted to one side (Figure 42): Interested in what one hears and cooperative; when the head is down (Figure
43): Negative and judgemental attitude.

Figure 41 Figure 42 Figure 43

Head is up and straight Head is tilted to one side Head is down

(41) Neutral attitude to what one hears, (42) Interested in what one hears & cooperative, (43) Negative
& judgemental attidude
 Principles and Techniques of Counselling-7 43

Leaning backward with both the hands are interlaced behind the head supporting it, and at times
crossing the legs: One feels confident, superior, dominant and an air of superiority (Figure 44).65

Figure 44

Both the hands are interlaced behind the head: Feels confident, superior, dominant, and an air of
superiority.

17. SMOKING GESTURES

When smoke is exhaled in an upward direction (Figure 45): Feels positive, superior and confident.
When one blows the smoke down and also from the corner of the mouth: An attitude more negative,
secretive and suspicious (Figure 46).66
 Principles and Techniques of Counselling-7 44

Figure 45 Figure 46
Smoke exhaled in an upward direction: Blowing smoke down & from corner of the mouth:
Feels positive, superior & confident An attitude more negative, secretive & suspicious

18. OWNERSHIP GESTURES

Legs placed on the arms of the chair or on the desk or on things will indicate a carefree and relaxed
attitude, territorial rights, dominance and ownership right over the article on which one places his/her legs
(Figure 47). Sitting with a leg over arm of chair or straddling a chair that is sitting with the chair back
serving as a shield will mean announcing dominance, territorial rights, and domineering pose.

Touching, leaning against an article or

automobile and taking a photo of it: Pride of
ownership (Figure 48).67

Figure 47 Figure 48
Legs placed on the arms of the chair or on the desk: Touching, leaning
Ownership right against an article or automobile &
even taking a photo of it:
Pride of ownership

19. OTHER GESTIRES68

Non-verbal Behaviour Possible Meaning

1. The simple smile: The person is not participating in any
Teeth together, teeth unexposed typically outgoing activity. He/she is smiling to
nonsense smile. him/herself. The person is by him/herself and
happy.
2. The upper smile :
Upper incisors exposed usually with eye- Greeting smile between friends. Children
to-eye contact between individuals. greeting their parents.
3. The Broad Smile : Commonly seen during play and is often
Both upper and lower incisors exposed associated with laughing. Situations of
and eye-to-eye contact seldom occurs. pleasurable excitement.
 Principles and Techniques of Counselling-7 45

4. The oblong smile :

The lips are drawn fully back from both This is the smile or grimace when one is
upper and lower teeth forming the oblong pretending to enjoy a joke or off-the-cuff
with the lips. There is no depth to this remark.
smile.
5. The lip-in smile : Coy-girl smile :
It is much the same as the upper smile The person feels in someway subordinate to
except that the lower lip is drawn in the person he/she is meeting.
between the teeth.

6. Eyebrows are usually down, particularly

at the inner ends, producing a frown. Conflict.
The lips are tensed and pushed slightly
forward; the head and chin are thrust
forward, eyeball-to-eyeball contact.
7. Wide open mouth and the chin drops. Shock or great surprise or intense
concentration.
8. Avoiding eye contact. Unintentionally communicates doubts and
possible prevarication.
9. Frown. Displeasure or confusion.
10. Raised Eyebrow. Envy or disbelief.
11. Tightening of the jaw muscles or Antagonism.
squinting of the eye.
12. Scuffling along with hands in the Dejection.
pockets, seldom looking up or noticing
where they are headed.
13. Walking with hands on the hips. Sprinter.
14. Meditative pose while walking: head Preoccupied with a problem. The
down, hands clasped behind the back. preoccupied walker.

15. Walking with chin raised, arms swinging

exaggeratedly, legs are somewhat stiff, The self-satisfied, somewhat pompous,
and the pace is deliberate and calculated. wanting to impress. The strutter.
16. Open hands. Sincerity and openness.

17. Shoulder shrugging with open-hands, Open nature of the person.

palms upwards.
18. Unbuttoning coat or even take it off in Open and friendly. Concentrating on what
someone else’s presence. you are saying.
19. Dropping eyeglasses into the lower An evaluative gesture that causes a negative
bridge of the nose and peering over them. emotional reaction in others.
20. Slowly and deliberately taking the
glasses off and carefully cleaning the Procrastination, or pausing-for-thought
lenses or after removing the glasses gesture or gaining time.
putting the earpiece of the frame in the
mouth.

21. Glasses are removed either quickly or Emotional outburst indicating ‘now you are
with much emphasis and thrown on the going too far.’
table.
22. Pinching the bridge of the nose with Great thought and concern about the decision
closed eyes. to be made.
23. Sideways glance. Distrusting attitude.
24. Feet and /or entire body pointing to the Wishes to end the meeting, conversation, or
exit. whatever is going on and is anxious to leave.
 Principles and Techniques of Counselling-7 46

25. Arms spread while hands grip edge of ‘Listen to me, damn it, I have something to
table. say’ position.
26. Moving in, speaking confidentially. Indicates an aggressive readiness covertly.
27. Physically narrowing down the distance An attempt to dominate the other.
between the two.

28. Clenched hands with the thumbs rubbing

against each other, cuticle-picking and
hand-pinching, sticking a pen or pencil in
the mouth to chew or suck. Touching the Wanting reassurance.
back of the chair before sitting down.
Slowly and gracefully brings her hand to
her throat, pinching the fleshy part of the
hand, thumb sucking and nail biting.
29. Short breaths. Angry.
30. Wringing hands. Required to answer serious charges against
him/her.
31. Determination, anger, possible hostile action,
Clenched fist. extreme emphasis, vehement declaration,
fierce determination, desperate resolve,
defiance.
32. Pointing index finger. Communicating orders and discipline.

33. Kicking at the ground or imaginary Feeling angry, frustrated or generally irritated.
object.
34. Hands joined together at the back, chin Authority position.
thrust upwards. Authority: the sergeant.
35. A partner putting his/her arm around the
other’s waist, walking hand-in-hand, or Communicates ownership or belonging.
indulging in some other type of holding.
36. Placing an object on a desired space. Extending territorial rights.
37. Elevating oneself. Dominance or superiority.
38. Cigar smoking ceremony. Status symbol, associating cigars with wealth.
Confidence and self- assurance.

39. Clearing the throat. Nervousness.

40. Cigarette-smoking. Relaxed, when the tension is released.
41. Whistling. Frightened or apprehensive.
42. Fidgeting in a chair. 1. Tired, 2. What is being said is not
stimulating, 3. Programmed their bodies to
responding to a specific time say, lunch time,
4. Chair is not well adjusted 5. Preoccupied
with other things.
43. Putting the elbows on a table, forming a Playing cat-and-mouth with their opposers
pyramid with his/her forearms, and until they felt it opportune to open up.
holding both hands together directly in
front of the mouth.
44. Jingling money in pockets. Very much concerned about money or lack of
it.

45. Restraining an arm or gripping the wrist. Expresses inner conflict.

46. Doodling. Interest is waning.
47. The blank stare. Interest is waning.
49. Hand to chest. Loyalty, honesty and devotion.
49. Touching gestures. Wanting to interrupt or emphasize a point,
 Principles and Techniques of Counselling-7 47

calming gesture, showing affection, feels

comfortable in the company.
50. Woman sitting with one leg tucked under Comfort in another’s presence.
the other.

3
ATTEND TO THE CLIENT PHYSICALLY
 Principles and Techniques of Counselling-7 48

By now you have completed the initial formalities and have been observing the client to decipher
any nonverbal messages. Now starts the important task on the part of the counsellor. He/she is actively
going to plunge into counselling. This is the stage of laying the foundation for the edifice of counselling.
The counsellor is building a power base for all the tasks that ensue. Here the counsellor will be using a
number of skills that will prepare the client to get involved. In the first step, we saw the task of the
counsellor as acquainting and at the very same time we realized that the client has to associate with the
counsellor. Client's goodwill alone is not enough but he/she needs to involve actively in the counselling
process. This can be done with the counsellor's practical ability to set the stage by attending physically to the
counsellee.

1. PHYSICAL ATTENDING

To start with, the counsellor attends to the client. There is more to attending than we can think of.
We use the word 'attending' instead of 'attention,' for the simple reason that the gerund attending indicates a
process whereas the noun 'attention' portrays a static concept. At a given moment we are aware of many
things in our environment, but we do not attend to all of them. When we attend to something we make a
selection of a few objects and we concentrate our awareness on them. Really speaking we can attend only to
one object at a time though we are aware of a number of things at the same time. Hence attending is a
concentrated awareness of a selected object in our environment. In attending, the object is singled out
for close observation. It is a kind of give and take process of adjustment. There is a constant adjustment that
goes on in the individual as he/she narrows down his/her awareness on a particular object. With attending
we can observe an object carefully; we harness all our energy and channel it in a chosen direction; because a
number of things are ignored, the efficiency in attending a particular object is enhanced, and this facilitates
remembering. We can say that attending is a state of mind set for a certain kind of stimulus.69

There are factors that influence our attending as objective factors, as well as subjective ones.
Objective factors (like a changing stimulus, an intense stimulus, a large stimulus, a novel stimulus and a
contrasting stimulus) usually catch our attention. These are of little value to us in the counselling context,
because we take the client as he/she appears; and for our sake of attending we cannot make him/her
colourful, contrasting, and changing. But the subjective factors are of real value to us, for, by manipulating
them we can augment our attending. For example, interest is one of the subjective factors. If you are not
interested in the client and in your helping profession, it is unlikely that you attend properly to the client.
Your attitude is also responsible for your rich or poor attending. If you have a negative and hostile attitude to
the client, then your attending will be averted automatically. The mood of the moment also affects your
attending. If you feel lousy after an attack of virus fever, you are unlikely to attend properly. By adjusting
your subjective factors, you can definitely increase the efficiency of your attending. In counselling, the
attending that is called for is a voluntary one. It might also happen that after habituating yourself over a
period of time, you find that you are habitually inclined to attend to clients (that is your attending has
become a habit).70

Two kinds of attention are spoken of in counselling. One is physical attending, and the other is
psychological attending. One will know that an individual is attending psychologically from the way one has
picked up the client’s message along with his/her feelings.

Physical attending is understood by a number of skills related to attending. It is worthwhile to get

acquainted with such skills so as to be able to attend to the client more functionally.

2. MODALITIES OF PHYSICAL ATTENDING

1) DISTANCE

Right distance between the counsellor and the counsellee is one of the components of physical
attending. Animals are known to have territories, which they claim as their own, and fight tooth and nail
 Principles and Techniques of Counselling-7 49

when some other animals transgress them. A dog, however small and weak it is, will be great and powerful
even against a big dog in its own territory. Its territory is clearly demarcated, and also acknowledged by the
other dogs. Take for example two dogs belonging to two neighbours. Each of the dogs will have its own
territory and a no-man's land between their territories. In its own territory the dog is ferocious when
someone violates its rights; it maintains calm in the no-man's land; and in the territory of the other dog, it is
very cringing realizing that it is not the boss. If you rear pigeons or if you watch birds building nests, what
will meet your eyes is the fierce battle that takes place before a couple of birds establish their nesting
location and the imaginary boundary that surrounds the nest. Even fishes are credited with territorial rights.
Likewise, a human person too has his/her own territory or zone or space. Much research has been carried out
in the field of determining the zones of human individuals. 71 It has also been found that all humans have
their territories; the distance of the boundaries are influenced by culture and environment. The space a
person can claim as his/her own in a crowded area is less, whereas one who is brought up in a thinly
populated area will have more personal space. With this caution let us examine a standard zone distance for
a human person.

2) ZONE DISTANCE (FIGURE 49)

ver 3.6 mt or ov
n eo er
Zo - 3.6 mt o
12
lic 1.2 fe
b n e r 4-
Zo
Pu

c m - 1.2 mt o 1
et

al
46 r1
2
i
c

e
fe
So

4 6 c m
n

et

-
8
l Zo

15 o
-4


Persona

r6

8 inc s
a te Zone

- 18 inc he

he
tim

In s

Figure 49
Zone Distance

(1) Intimate zone: An individual claims a certain area as his/her intimate zone, a space measuring
about 15 to 46 centimetres (or 6 to 18 inches.) This I call 'porcupine distance' in the sense that a porcupine
will not let anyone normally within a close range. When someone approaches the close area, the animal
makes its thorns stand on their edges, thus preventing the stranger from coming close to it. This is what
human beings do, and defend such an intimate zone. People who are very close to you emotionally (parents,
children, lovers, and friends) are permitted to enter into this intimate zone. If you meet your schoolmate
after a long time you just go close to him/her without any formality, enter into his/her intimate zone, and
even put your arm around him/her shoulders without your friend getting angry or uncomfortable about it.
One enters the intimate zone of another, either with love or with aggression.
 Principles and Techniques of Counselling-7 50

(2) Personal Zone: This is the space between 46 centimetres and 1.22 meters (or 18 and 48 inches).
It is neither too close nor too distant. When we attend parties like marriage, any other function, or gathering
of social nature, and in our work places, we maintain this zone. It is the zone where people with friendly
feelings are entertained, and official works are undertaken.

(3) Social Zone: It is a space measuring between 1.22 and 3.6 metres (or 4 and 12 feet). It is the
courtyard of the strangers. The people whom we do not know very well, and at the same time we have some
business to do with them like workers who come to our houses, are kept at this zone. All business
transactions are carried out in this area.

(4) Public Zone: Finally we have the public zone ranging from 3.6 metres (or 12 feet). When you
address a gathering, you naturally take a position from 12 feet onwards. Thus we find that one's territory is
broken down into four distinct (but fluid) zone distances. According to the level of intimacy and
acquaintance, people remain close or far. Someone meeting you automatically takes his/her position in the
zone indicated nonverbally by you. At times aggressively the stranger might enter into a zone or mistakenly
enter into a zone you would not want him/her to do. A young man was referred to me for counselling. As I
met the man for the first time, he came very close and wished me as though he was a very intimate friend of
mine. While talking to him, I realized that he was under the influence of a drug, and that his social
sensibility which goes with personal territory was lacking. His intrusion into my intimate zone was by
mistake since he was not much aware of what was happening to him. 72

(5) Counselling Zone: By experience we realize that a distance between three to four feet is normal
between a counsellor and a counsellee. That means, in terms of zones, the client will be seated towards the
end of your personal zone. If you sit closer than three to four feet, the implications are: first of all you are
very intimate with the client, or you are making sexual advances, or you are getting ready to attack him/her
by intimidating him/her by your aggressive presence. It is intimidating because it weakens the client's
territorial defence. The reaction of the client when you enter into his/her intimate zone, is interesting to note.
If you are still a stranger and enter into his/her intimate zone a number of physiological changes take place
within him/her. The heart beat is faster, and since it is considered as an emergency, adrenalin is poured into
the bloodstream profusely, and blood is pumped to the brain and the muscles vigorously, making the client
either to fight or to flee. That is why when a person aggressively enters into another person’s intimate zone
with sexual advances, the person whose territory is invaded attacks the intruder or attempts to flee from
him/her.73

3) SQUARING

Squaring means facing the person straight. You sit in front of the client facing him/her. Turning
away from the client will betray your lack of interest in him/her. For getting the most out of the client and to
assure him/her of your total presence, it is required that you face the person. If there are more than one
person, you can adjust your position in such a way that you are able to see all of them equally well. If there
are more than three, it is better to form a circle. Even in a circle, if one of the participants is talking to you,
you should incline your body position to that particular person so that, to him/her and to every one in the
group, it is clear that you are physically attending to him/her. It is better to avoid major seating changes in
the midst of counselling lest they should distract the client.

Not all the clients are happy about your facing them. I have often observed with some teenagers,
some women if they are talking to men counsellors, and some men while talking to women counsellors, and
some people having physical defects on their faces, unwilling to face the counsellor directly. Since the
purpose of squaring is to assure the client of your presence and interest and to make him/her comfortable, if
your squaring is threatening to him/her it is better to adopt an angled position. This way of angling yourself
will lessen the degree of uneasiness in the client, while assuring at the same time that you are with him/her. 74

4) SEATING ARRANGEMENTS (FIGURE 50)

 Principles and Techniques of Counselling-7 51

Figure 50
Seating Arrangements

First let us consider the positions where you and the clients sit.

(1) Cooperative Position: (A-B or C-D)

When you and the client are seated on the same line side by side by a rectangular table, this position
is called ‘cooperative position.’ Here the clients usually cooperate with the counsellor because they are
neither confronted nor left out by being seated in this position.

(2) Corner position : (A-E)

You are seated by the length of a rectangular table near a corner, and the client sits by your side by
the side of the breadth, with a corner in between both of you. This position is called ‘corner position.’ This
position is maintained for friendly and casual conversations.

(3) Independent position: (A-C or B-D)

When you are seated near a corner by the length of a rectangular table and the client sits on the
opposite, not against you but far removed, then it is the independent position. People who are very much
threatened take this position to be at a safe distance.

(4) Competitive-Defensive Position: (A-D or B-C)

When you are seated on one side, the client is seated on the opposite side across the table. It is a
very vulnerable position. Sometimes secretive, negative, and hostile officers arrange this position (They put
those visiting them on the opposite side across the table). However, this position as research has shown, is
also helpful, if you face the other directly (when there is no desk or table in between).

(5) Counselling Position (Figure 51)

 Principles and Techniques of Counselling-7 52

Figure 51
Position for Counselling

Facing each other without any table or desk in between, is ideal and it is called a 'closed formation'
since no third party could intervene without the two changing the position. If you happen to sit by a table,
the corner position will be the one next suitable, because the client is close to you.

After considering the position, we now turn to the types of seating provided. The height of the back
of the chair indicates one's power and status in the society or in a given situation. The higher the back of the
chair, the greater is your status. That is why people in high position are placed on high-backed chairs. If
your chair is higher than that of the other, it means you are superior to the other. Swivel chairs are
considered to be belonging to a superior status, and chairs with arms are superior to chairs without arms. For
counselling, a comfortable chair for you and the client is appropriate. If it is an easy chair, it may not be
conducive for the type of work that is undertaken. The heights of the chairs should be scrupulously kept
equal, and if by chance yours is raised above the other person's chair, then you will be understood as
dominating.75

5) EYEING

Maintaining a fairly steady eye contact with the client is called eyeing. Your quality of attending can
be judged from the way you keep the eye contact with the client. It is not the same as staring. The steady
eye contact which a counsellor maintains in counselling is usually marked by frequent blinking of the eye
lids (six to eight blinks per minute), whereas in a stare the frequency of blinking is far between and it is
almost keeping your eyes on the eyes of the other and keeping them locked there for a longer time. We know
the lover's gaze which is a kind of stare. This kind of stare may not be helpful in a counselling situation.
Counselling is not dating, and so staring is unwelcome. Some counsellors may have the compulsion to rest
their eyes on the physical defects of the clients. There are other counsellors who rest their eyes on the beauty
spots or attractive features of the clients. All these activities will only say aloud that your interest is not in
the client him/herself, but in your own enjoyment of his/her attractiveness. As with the squaring so also with
the eying, we have clients who are threatened by the normal look. If you know that a client is uncomfortable
with your looking, then you could look down, and once in a way keep looking at the client. Not to look at
the client at all because he/she is uncomfortable will not in the long run serve the purpose of eliciting the
appropriate response from the client.

EYEING IN SPEAKING AND LISTENING

Eyeing can be analysed from two angles: While you are speaking and while you are listening.
Research has shown that people maintain more eye contact while listening than while speaking. This in
general will indicate that the speaker is steady on the theme he/she presents, the explanation he/she gives and
the arguments he/she adduces, and it could be a signal to ward off distraction and interruption. After the
talking when one looks at the listener, it is a signal that he/she has completed what he/she wanted to say, and
the other is given the permission to talk. This being the general rule, in individual cases, a certain pattern is
perceived. Let us see what the pattern is.

When you speak if you keep looking at the person fairly often, it means that you are certain of what
you are saying, and if you look away you may be saying that you are not sure about what you are saying.
While listening, if you keep steady eye contact, you are nonverbally saying that you are with the speaker and
are interested in what he/she says, and conversely looking away while listening will mean that you are not
completely satisfied with what the speaker says and so you are having certain reservations; it could also
mean that you want to conceal your real feeling from the speaker, especially if the speaker is a critical and
 Principles and Techniques of Counselling-7 53

evaluative type. Avoiding eye contact may unintentionally communicate doubts, possible prevarication and
concealment.

FREQUENCY OF EYEING

The frequency of the gaze is culturally coloured. It has been found that people of different
nationalities may have a certain variation in the frequency of the gaze. Besides, in general if a person's gaze
meets your eyes less than two-thirds of the time of the conversation it may be an indication of dishonesty or
withholding of some information. Eyes betray our emotions. When one is pleased with another, his/her
pupils will dilate; while in displeasure, the pupils contract. When lovers intently look at the eyes of each
other, what they may be looking for is the dilation of the eyes which will be a sure telltale sign of the other
person's liking for you. If a person looks at you more than two-thirds of the time of the conversation with
dilated pupils then he/she is interested in you and in what you say; in contrast when he/she looks at you less
than one-third of the time with constricted pupils, then he/she is hostile to you or dishonest with you. If you
use dark tinted glasses in conversation, you are either staring the other person with interest or with hostility,
or you do not want that the other person to know what you are feeling, since the pupils will betray your
emotions. You also may be greeted by some sideways glance. It too denotes either interest or hostility.
Sideways glances are used in courtship and in sexual invitation, and if it is coupled with down-turned
eyebrows it will communicate suspicion and hostile attitude.

EYE BLOCKING

There is a phenomenon called eye blocking. If you are looking at a client and blink the eyes and
keep the lids closing the eyes longer than the usual rate of six to eight blinks per minute, then you are using
an eye block gesture. It could be also perceived in half-closed eyes with the tilted head and looking down at
the client. The simple eye-block gesture will communicate that you are not interested in the client and if it is
coupled with other negative gestures like head tilted backwards then you are saying nonverbally that you are
superior to the other as though looking down upon him/her. From the foregoing pages it becomes amply
clear that the use of our eyes is a vital nonverbal signal, and appropriate gaze behaviours are necessary for
counselling interviews.

KINDS OF EYEING

Eyeing can be of three kinds (1) Business Eyeing, (2) Social Eyeing, and (3) Intimate Eyeing. In
business eyeing you look at your partner's eyes and the centre of his/her forehead, forming a triangle with the
two eyes and the centre of the forehead. In any case, your gaze should not be lowered below the eyes of
your partner. In maintaining this type of business eyeing, you keep the situation under control. In social
eyeing again, your look is directed towards a triangle, but this time the triangle is upside down, that is, you
look at the eyes and the mouth of your partner, in which case you get a triangle with two eyes and one
mouth. This is the type of gaze we engage in while conversing with our friends, relatives, acquaintances and
known persons in gatherings and other social situations. In intimate eyeing, you form an upside down
triangle which is long. You look at the eyes of the other in the eyes and then below chest, and if you are
looking from a distance, down to the crotch. This type of gazing communicates your interest in the other for
intimacy and sex. In counselling it may not be appropriate to make use of intimate gaze. To oscillate
between business gaze and social gaze would be helpful, maintaining mainly the social gaze. 76

6) OPEN POSTURE

If you yourself are closed, then you cannot expect your client to be open. Besides, your closed
postures will trigger off something negative in the client that he/she will automatically develop closed
posture and thereby closed attitude which will jeopardise the counselling process. For example, if you sit
with your arms and legs crossed and your hands held fist like, these gestures communicate your closedness.
Not that you cannot cross the legs or arms once in a way during the conversation, but to be locked like that
most of the time will be indicative of a closed posture. Hence you realize the importance of positioning of
your entire body in the counselling session that will indicate your openness. 77
 Principles and Techniques of Counselling-7 54

7) LEANING FORWARD

When delivering a lecture if you notice one of your audience is leaning back on his/her chair with
his/her head flung far back, his/her legs extended in front and his/her arms crossed on his/her chest, it is a
clear indication of his/her not being interested in your talk or his/her becoming bored with it. It can also
mean that the person is physically very tired. On the contrary, when one of your audience is leaning forward,
perhaps resting his/her forearms on his/her thigh and thrusting his/her head towards you with tilted head, it
communicates that he/she is interested in what you are saying. Therefore leaning forward is a sign of
interest, and the clients usually appreciate this gesture and nonverbally they are impelled to get involved and
talk more about themselves because they perceive that the counsellor is all out to help them. Whenever you
find two persons engaged in intimate conversation they usually incline their bodies, that is the upper parts of
their trunk, forward. While sitting, this can be done when you bend forward and make your forearms rest on
your thighs, or while you stand you can go closer or stand in such a way that your right foot is one step ahead
of you. When you are over-worked or you are physically tired after listening to the client for a while, then
you can move back for a while; and moving back and forth can be of convenience to you as a counsellor; but
in any case see that you are not seen leaning back most of the time. It is presumed that when we lean back
we are interested in ourselves, our comfort and convenience, and when we lean forward we are interested in
the other whom we are listening to.78

8) REMAINING RELATIVELY RELAXED

Have you ever observed in yourself or in others that when one of the persons engaged in
conversation is nervous, the other too becomes the same eventually? Nervousness is contagious! If you are
facing someone who is uncomfortable with you, the outward manifestation of his/her nervousness (by way of
fidgeting, rubbing wet palms against a fabric and clearing the throat) prompts you unconsciously to take to
displacement behaviours.

We tense up when we attend to something. Look at a dog that looks up and turns the head towards
the direction of the noise and inclines the ears in a funnel like fashion to channel the noise into the inner ears.
The whole body of the dog becomes tense. In the same way when our sense organs get ready to receive
stimuli, the entire body is tensed up to a considerable extent. If you seriously study a subject, you sit with
tensed muscles; if you are reading some light materials like short stories, then you are relaxed. Therefore,
high concentration requires tensing up of the muscles of the body. Since listening, responding and exploring
along with the client is such a concentrated activity, your muscles are bound to tense up. But when the body
muscles are tensed up too much, it works against your efficiency. I have observed students in oral
examinations. Even the clever students do not answer properly though they know the answer well just
because they are very tense, and this can be made out on their bodies. So, on the one hand not tensing up of
the muscles is an indication of your non-involvement, and on the other hand, your too much of tensing up the
muscles is detrimental to listening to the client properly. Therefore, the via media will be being relatively
relaxed. The principle of relative relaxation applies to the client as well. One of my professors gave us some
tips to deal with clients who are too tensed. If the client is too relaxed, then he/she may not be serious in
working out his/her problem, in which case straight looking into his/her eyes will make him/her feel
uncomfortable and he/she will start becoming serious. Your gaze has awakened him/her from his/her
lethargy. And when he/she is too much tensed, look away for a while, and that will make him/her feel at
ease. The ideal situation will be when both the counsellor and the counsellee are relatively relaxed. 79

9) MIRRORING

If you are abroad and happen to come across a person from your country or a person from your
culture or language, then irrespective of his/her character, at the first sight, you begin to like the person for
the simple reason that he/she belongs to your nationality or in other words he/she is like you. There is an
unconscious affinity established as soon as you meet a person who looks similar to you. The sameness in
two individuals brings about a liking for each other. This concept of similarity can be further exploited for
 Principles and Techniques of Counselling-7 55

the benefit of the clients. This was done by giants in psychological field like Virginia Satir, Fritz Perls and
Milton Erickson who reflected certain behaviour patterns of their clients. This was only to make the clients
feel that they are with someone who understands them and who is like them. To feel at home with a
counsellor and also to feel understood, a certain rapport has to be established. This can be achieved by the
counsellor through reflecting the behaviour patterns of the clients. The reflecting of the behaviour patterns
of another in a subtle way is called ‘mirroring,’ just like a mirror reflects whatever action you do in front of
it. This mirroring is otherwise called ‘pacing.’ If you copy or mirror the behaviour of a person, it
communicates that you are in agreement with that person. Once agreement is established, which is in itself a
kind of rapport, then the other will not resist to what you are saying. If you pace a person, it is first of all to
establish a good rapport, and then later to lead the person. Pacing is followed by leading. I shall be speaking
about pacing and leading at a later stage, but at present I would like to underscore the idea of body mirroring
and vocal mirroring. Mirroring or pacing can be done at three levels: First of all, it can be at the body level
or physical level. Then it can be at the vocal level; and the third level is with words. Just like we have three
mediums of communication like verbal, vocal, and physical, in mirroring too we have these three mediums
of reflecting the behaviour. Here I would like to underscore the idea of vocal and physical mirroring, leaving
the verbal mirroring or pacing and leading to a later stage.

The vocal and the physical pacing is done for the sake of establishing a rapport. Vocal mirroring will
be like imitating the tempo, volume, pitch, rhythm, and accent of the language of the client. Physical
mirroring will be when I adopt the body posture, gestures, breathing location, breathing rate and blinking of
the eyes. Again mirroring can be either direct or crossover. Direct mirroring is reflecting the vocal and
physical behaviours of the client exactly by the same medium of either vocal or physical. For example, if I
am imitating the head posture of a client, I would keep my head the way he/she holds it. A crossover
mirroring is done when I tap the table in accordance with the breathing rate of the client. The breathing rate
is imitated not directly breathing in the same way, but by tapping the table. In the beginning of the
counselling sessions, counsellors make use of the mirroring techniques to establish a reasonably good
rapport.80

10) ENCOURAGEMENTS TO TALK

You talk to a person and the other person attends to you in such a way that you feel like continuing
your talk and revealing more about yourself; there are also persons to whom while talking you feel you
cannot proceed further. When we analyse what happens between the two individuals, we find that if a person
encourages the speaker in one way or other, then the speaker is pleased to speak more. These may be done in
minor ways like nodding the head, leaning forward quite often, moving a bit closer when the client is saying
something very important to you, saying 'umhum,' repeating one or two significant words of the client, and
repeating the last words of the client. These little techniques go a long way in establishing a good rapport
and making the client feel understood and wanted.

These encouragements to talk are termed by Richard Nelson-Jones as ‘continuation messages,’

which are more bodily than verbal. The bodily continuation messages include what we have so far seen in
mirroring, plus responsive facial expressions, good eye contact, and body orientation. The verbal
continuation messages include words like ' Tell me more', 'Really', ' Go on ', ' Then', ' I see' and 'So.' These
messages become essential for the continuation of a narration. You could test it by telling a story to
someone. If the person listening to you does not give any continuation messages, then you are frustrated and
would stop telling the story. It is required all the more while listening to the clients. 81

3. INITIAL SILENCE

Silence is an enriching experience. It is in silence that great insights are gained. Both the
counsellors and the counselees can utilize silence for the optimum outcome. For whatever reason silence
does occur, the counsellor should be prepared to deal with it. It is likely that silence opens the very session.
After your initial formalities and invitation to talk, the client might sit quiet. As I have already remarked, the
counsellor could invite the person to say whatever comes to his/her mind, or could say that he/she is thinking
 Principles and Techniques of Counselling-7 56

of something, or he/she is finding it hard to speak or something is going on in him/her. Check if the client is
in need of something, or needs some more time to start or wants to have the session at another time. After all
these, if the client keeps silent, then better respect the silence.

4. SILENCE IN THE MIDDLE OF THE SESSION

In silence, valuable insights are attained both by the counsellor and the counsellee. It offers room for
the client to look into him/herself and explore his/her problem deeper, gain new insight into the dynamics of
his/her behaviour, and to see a changed perspective of the problematic situation. For the counsellor, it is a
time to understand the client better, and see the possible step he/she could take with regard to the problem
that is presented. Silence can be right at the beginning of the interview, or in the middle of the interview. I
have already spoken about the silence you might encounter at the beginning of an interview. Now let us
consider silence in the middle of the counselling session. At this time, silence can occur due to various
reasons. In any case, see that you have responded to the previous statement of the client, for he/she might be
waiting for you to respond to him/her. If you had responded to his/her previous statement, then take this
golden opportunity to summarize and present in a neat and orderly way what you both have so far dealt with,
and this might form a stimulus statement to the client. You could also make statements like ‘You are
thinking of something' or ‘Something is going on within you.’ Even after this, should silence continue, you
could perhaps raise a question or make a probe. After all this should silence persist, then respect the client,
telling him/her that when he/she is ready, counselling can be resumed, and that for the time being, the session
is over.

Silence can be due to various reasons. May be that you have a client who is usually very reticent and
so he/she finds it difficult to talk to you. Another reason for his/her silence could be that he/she is struggling
to get at the root of his/her problem. Or, he/she is trying to pull his/her thoughts and feelings together before
exploring further. It is also possible that he/she has reached the end of a theme. At times it could be a sign
of preparing to reveal further.

Once I met a girl aged 19; she was highly disturbed. At the beginning of her puberty, she had
witnessed her parents having intercourse a number of times; the parents thought that she did not know it.
What she had witnessed flooded her mind, and she was unable to concentrate on anything. As she came, she
opened the topic and went on to explain how she was affected by those images coming quite often. She
would hardly start a sentence to explain, then stop dead and remain shy. It was very evident that she felt the
whole thing too delicate to disclose to a stranger that I was. Then something struck me, and I told her that
she need not tell this particular problem to me at all and we could deal with other issues if there were any.
Immediately came the reply 'I want to tell the whole thing since this troubles me.' Here what I realized is that
when you give the freedom to express, the client usually talks, and if you compel the client to talk then
he/she is likely to close up.

Silence can be a method of manipulation by way of playing the game of ‘coax me.’ According to Dr.
Eric Berne, this game is played by people in the persecutor's role to put others down. The counsellee might
unconsciously play this game. If you are caught up in this game, you usually request the client to speak and
he/she will remain silent; then you plead all the more; the client becomes all the more silent, and thus finally
you get fed up with requests and end the conversation feeling so bad about everything. If you realize that
silence is a game pattern, then giving him/her the freedom to express will spoil the game right at the very
start, and the person will start expressing breaking his/her silence. Also keep your eyes wide open to observe
nonverbal behaviours during silence. The nonverbal behaviours will betray more or less why a client keeps
mum at a particular stage. Having understood the reason for the silence, you could take the appropriate
measures to overcome this hurdle. If one method does not work, try another, and by trying various methods
you are likely to succeed.82
 Principles and Techniques of Counselling-7 57

4
LET THE CLIENT TELL THE STORY
(INVOLVING AND EXPRESSING)

The counsellor took the initiative to attend to the client. Attending is like giving an invitation. If
you receive an invitation you are bound to answer saying either you are attending or not attending the
function. Involving is the reaction you elicit from the client by attending to him/her. But for the attending,
involving would not take place. Being involved is getting interested to work out his/her problem, taking the
courage to look into his/her situation, and wanting to take the appropriate steps. The client is set for work,
and now he/she needs to do a number of things. His/her involving will be seen from the way he/she engages
him/herself in certain activities that we will see immediately. Here we are speaking of clients who have shed
their reluctance or resistance, and are set to work.

1. EXPRESSING

If the client is involved, he/she starts expressing his/her concerns. Let the client tell the story.
He/she needs to tell the story fully. Half-truths will not help the counsellor to understand the entire context.
Once in my pastoral ministry, a young man was sent to me for counselling. The young man had developed
psychiatric symptoms. There was nobody in his family with such histories; nor had he any brain injury,
epilepsy and the like. Then I enquired about any habit of his like taking drugs or alcohol. He flatly refused.
Anyway I managed to send him to a psychiatrist who reported to me that the young man was a habitual user
of drugs. It was a case of drug-induced psychosis. When a vital information is hidden from the counsellor
the diagnosis of the real problem is not possible. The young man who came to me did not have any of the
things I asked about; so I concluded that he was suffering from functional psychosis, which was not true
since his condition was drug induced. Hence telling the whole story and the real story is important for an
assessment by the counsellor.

2. LEVELS OF EXPRESSING

Expressions could be at five different levels.

1) RITUAL

The lower level of self-disclosure is ritual expression like greeting a person, or enquiring about some
neutral subjects, which do not touch the personality of the speaker.

2) REPORT

A level higher than ritual expression is the expression of facts. If you speak about history, events
that have taken place, you are at the second level of expressing.

3) JUDGEMENT

The third level will be to give your judgement about a fact, thus also revealing your attitude and
mental affiliation. Here you start to reveal about yourself.

4) FEELING
 Principles and Techniques of Counselling-7 58

The fourth level is to speak about your feelings. Feelings are very unique to every individual. By
feelings we understand a person better than by his/her sharing. This is one of the high levels of revealing
about ourselves.

5) GUT LEVEL

The fifth level is to reveal yourself without any reserve, which one may achieve only with a very few
individuals. Here we share everything about ourselves. This does not happen with every individual. This
gut level communication does not exclude one’s privacy and secrecy. Right to one’s privacy and secrecy is
an inalienable aspect of our personhood. All the same revealing at this level is the highest we can achieve in
our interpersonal relationships. Of course, it could be risky. But every interpersonal relationship is risky.

3. TYPES OF PROBLEM SITUATION

Counselling psychologists are of the opinion that the clients speak about their problems in three
ways.

1) EXPERIENCE

Clients may express what has happened to them, that is, their experience. Durairaj who is a field
officer in a company says: ‘I am sent out too often, and I am unable to be present for most of the family
functions.’ That Durairaj is being sent out is what happens to him.

2) AFFECT

Clients could speak about their affects. 'Affect' refers to counsellee's feeling and emotion, which
accompany his/her experience or behaviour. Sheela says: ‘I am angry with my husband for coming too late.’

3) BEHAVIOUR

Clients may express what they are doing or not doing, that is, in terms of their behaviour. Neeta is
working in a store and she complains: ‘I answer back my boss whenever he points out my mistakes.’ This is
a behaviour which she does. Her another problem is: ‘My old parents are eking out their existence; even
though I am materially well off, I do not lend a rupee to them.’ Here she explains what she fails to do.

It has also been found that clients willingly talk about what happened to them, less about their
feelings, and much less about their behaviours. Expressing the concern in terms of experience, feelings, and
behaviour is to be aimed at for understanding the dynamics of the problem the client is facing. Otherwise,
you may be lacking in clarity to pinpoint the problem and take the necessary steps.

There are also clients who talk in a non-stop fashion and bring out a lot of material, which are not
actually related to the problem. Often client-rambling is a block to clarity. The clearer their expression, the
better disposed are they towards healing. The counsellors who help their clients express clearly achieve
greater success than the ones who allow their clients to wander about.

4. LISTENING

The counsellor listens to what the client says. Accurate listening is required so that the message of
the client may not be missed. One of the things poorly done by people is listening. This can be
demonstrated by asking two volunteers among whom one narrates an incident and the other listens and
reports the narration he/she heard. In most instances, the listener reports leaving out certain facts, or he/she
 Principles and Techniques of Counselling-7 59

interprets and includes materials that were not narrated. Listening is being attuned to receive a message. It
is not mere hearing. We hear a lot of noises, but we do not listen to all of them. Listening is differentiated
from hearing by the fact that in listening we understand the meaning of the sound. If you are not looking for
the meaning, then it is only hearing. Properly speaking, listening implies the capacity to hear the sounds,
understand their meaning and remember them accurately. This hearing, understanding the meaning, and
remembering it, requires a certain amount of discipline. Therefore, listening can be termed as disciplined
hearing.

1) KINDS OF LISTENING

Counselling psychologists have analysed the various levels of listening in terms of its
appropriateness in a counselling context.

(1) FAKE LISTENING

Betty is a counsellor trainee who has learned the skills of physical attending. Her physical attending
was judged to be at its maximum by the peer counsellors. But Betty has the habit of switching herself off
when she listens to the counsellee. When responding to the counsellee, Betty stumbles and is not able to
recall what she heard from the client. But her continuation messages like 'I understand' and ' That is really
interesting' were real stimuli for the client to go on talking. Here the counsellor was faking good listening,
especially maintaining certain nonverbal behaviours and the counsellee was duped into thinking that Betty
listened to her very well. This is a case of faking to listen. This is one of the poorest services you can do to
the client.

(2) PARTIAL LISTENING

Dass is a good listener and a good counsellor as well. The counselling started in earnest, and
meanwhile Dass was surprised to find himself dozing every now and then. The need of the client was such
that she continued talking irrespective of the counsellor's dozing. Dass could not help the lady because he
had not fully heard the core messages of the client. It is a case of partial listening. Unless the entire episode
with its meaning and context is understood, no good counselling can take place.

(3) SELECTIVE LISTENING

Cynthia is a well-experienced counsellor working in a college. Usually the students have a lot of
things to talk, things connected with their problems and things that do not pertain to their problems.
Tactfully, Cynthia listens to the students and selects only the talking that is relevant to the problem in hand,
and leaves out all crazy talk. This is a case of selective listening, and in this instance very useful for the
counselling process. For, listening to all the crazy talk and the client’s rambling is a waste of time. But if the
counsellors predetermine early what to listen and what to leave out, they might leave out important messages
on account of the selection, then it is a disservice to the client. Selective listening may leave out, by chance,
messages that are vital to the counselling process.

(4) PROJECTIVE LISTENING

There is a story told of a family in a farm house. Towards late in the evening there was a man
calling out something on the lane nearby. Usually vendors call out the things they sell through the streets.
The father of the family asked his young daughter to go and listen to what the man was selling. She went
and returned very shy. The father asked her what did the man call out. She was not willing to tell. However,
the father insisted that she tells him. With much reluctance she said that the man was asking if there are
maidens to be married. The father was surprised and so he sent his wife to listen. She went out, listened,
and came back to tell that the man was selling brazen pots. The father was not satisfied. He sent his son to
listen and report. The son went and came to tell that the man was selling ploughshares. The father could not
believe any of these. He said that he would go and hear for himself. The old man went out, listened and
 Principles and Techniques of Counselling-7 60

came back trembling all over. The other members of the family asked him what did he hear. He said that the
man was an undertaker and he wants to know if anybody is dead! Here each one listened to what was in
his/her mind, perhaps, their own needs or fear. The young girl was waiting to be married; the mother wanted
a brazen pot; the young man wanted a ploughshare to till the land; and the old man was afraid of his own
death! This story illustrates how we may listen to things we want or are interested in, and not in what was
being said!

(5) FILTERED LISTENING

Vijay is a well-educated man. He has acquaintance with various theories of personality and has a
wide psychological background. When Nancy came for counselling, he could perfectly analyse her character
and describe what type of problem she suffered from, and what the immediate and remote causes were. But
Nancy was not in the least satisfied, for she felt that she had not been understood. Vijay was wearing
blinkers as it were and was able to see persons and problems from one particular angle only. This is a case of
filtered listening, in the sense that our prejudices and personal, familial, social, and cultural biases prevent
our listening to the client totally. Even psychological theories could serve as blinkers.

(6) TOTAL LISTENING

There is a colleague of mine who can sit hours together with people who pour out their problems.
He does not have much formal training in counselling, and yet a lot of people were flocking to him to speak
out their problems. Perhaps the clients did not get much of action-oriented direction from the counsellor, but
all of them felt that they were understood because he could listen to them fully, being present totally and
being able to pick out the messages accurately, without distorting and understanding the problem, as though
he were in the place of the clients. This is in fact total listening. It is understanding the client in his/her
internal frame of reference, and communicating this understanding of the counsellor to the client. 83

2) REASONS FOR INADEQUATE LISTENING

Total listening is a rare gift. Some may have this to a certain level quite naturally, and others have to
acquire this skill. By motivation and effort with prolonged practice, one can acquire this skill. It is
worthwhile to consider various hindrances that prevent you from listening totally.

(1) PHYSICAL TIREDNESS

Amal is a much sought after counsellor in his locality. People from far and near throng to him for
counselling. He tries to oblige all of them since people come from far, and after meeting a few counsellees,
he is unable to listen to the rest of them as he is physically tired. Physical tiredness, as well as mental
tiredness, can come in the way of your listening to the client fully. Because of the tiredness you experience
in various systems of the body, you are unable to concentrate. Usually a tired counsellor is a poor counsellor.
Even though you may have the knowledge and the skills required for counselling, on account of your
overwork, or while recuperating after a serious illness, you are unable to listen to the client.

(2) PREOCCUPATION

If you receive a sad news or too good a news, then you will not be in a position to sit for counselling
session, since your mind will be dwelling on the news you had received. Anything out of the way by way of
news, either good or bad, that shakes your personality, demands some time to settle down. You may push
these things aside, but your mind automatically goes back to these news. Every sad news has to be grieved
for a while as a grieving process, and likewise every good news has to be cherished for a while, before it
could be kept aside. Therefore, these concerns are a hindrance for listening totally. If you just had an
experience of being fired from your job and then you were to sit for a counselling, you can be rather sure that
 Principles and Techniques of Counselling-7 61

you will not be totally present to listen to the client. Let us suppose that you got a big sum of money by
lottery! Do you think immediately after hearing that news you will be in a position to listen to a client?
Definitely not, because you will be hilariously joyous over the news of your good fortune. For example, you
are planning an all India tour of one month. If you are very occupied with that plan, during that time it will
be difficult for you to listen to someone totally. When you are deeply distressed, or hilariously exuberant, or
passionately engrossed in something absorbing, you will not be able to lend a listening ear to your client,
since those experiences will keep you occupied.

(3) ATTRACTION

It has been observed that if the clients are attractive, then they seem to receive more attention from
the counsellors; likewise if the counsellees are unattractive, then the counsellors are not eager to pay
attention to them. This being the case, the experience of being pulled or repelled might occupy the attention
of the counsellor, and so he/she concentrates on what he/she feels rather than on what the client says. In the
same line of thought, it is also true that if you have a strong negative feeling towards a client, you are
unlikely to render your total listening to him/her.

(4) DISTRACTION

Sometimes couples or even individuals come for counselling with their children. The small tots do a
lot of things that may distract the counsellor from listening. At times, they do not leave the elders and cling
to them crying. As far as possible you could ask the clients to come alone leaving their children in the care
of others. In case they have come with their children you need to be extra attentive to listen to what the
clients say.

(5) SIMILARITY OF PROBLEM

Kamala is a counsellor in a marriage bureau, and she is a widow past middle age. Esther, another
widow of the age group of Kamala, comes for counselling and shares her financial worries in educating her
children. Precisely this is what Kamala herself is experiencing with her limited salary to make both ends
meet. As Esther was narrating her problems, Kamala was lost in her own worries and remained dazed.
When the problems you hear are similar to the ones you are experiencing currently, your listening
performance may be at a lower level.

(6) DISSIMILARITY OF PROBLEM

Agnes from Europe had come to India for experience, and she was quite fluent in the local language.
While she attended the counselling course and was sent to the hospitals for fieldwork, she met a number of
people over there. Whenever people spoke of some local problems of not being invited for a marriage and
how it ought to be done, Agnes was totally at a loss, because culturally the local problems were so different
that she could not understand them. Thus dissimilarity of problems also can be a hindrance to your listening
to the client.

(7) OVEREAGERNESS

Often counsellor trainees, and those who are practising counselling for the first time, have problems
in listening, because they are so overeager to respond properly that they miss the clients and what they say.
Even if you had been clumsy in responding, you need not worry about it since it is only the beginning, and
with the passing of time and experience you are likely to improve your listening capacity. By over-
eagerness, you only miss what you want to preserve. This idea came home to me very strongly recently
when I was talking to someone on the banks of the river Cauvery. Suddenly we heard a human voice, and
 Principles and Techniques of Counselling-7 62

we saw a man drowning in the river. The man was caught in the current while taking bath about half a
kilometre away from where we were. The current was so forceful that he was swiftly being carried to
another half a kilometre ahead, where some people walking on the bridge spotted him and finally rescued
him. After the rescue operation when I was talking to the drowning man, I realized that he did not know
swimming and he was suffering from psychotic symptoms and he was not very much aware of what was
happening to him. Because of his lack of awareness of what was happening to him, he was safe though he
was being carried away by the current for about a kilometre. Had he been aware and anxious, I am sure he
would have been drowned within a few metres. Even with regard to snake bites, it is said, that more people
die due to fear of the snake bite rather than the bites themselves. So any over-eagerness or anxiety only
works against what we want to achieve. Hence one should beware of over-eagerness in listening and
responding.84

Also, remember to avoid noisy places, distractive scenes, and bothersome people nearby.
 Principles and Techniques of Counselling-7 63

5
REFLECT THE CONTENT OF WHAT THE CLIENT SAID

Reflect the content using the formula ‘You say….’

Now that you have carefully listened to the client, you are ready to go to the next step of building a
power base, that is, responding to the client. The clients who talked so far want to know if you have listened
to them carefully. Whether you listened to them carefully can be made out from your verbal report of what
they have narrated. Like the first impressions you make on the clients, the first responses are also going to
affect the clients either positively or negatively. Without being overanxious, you need to be skilful enough to
word your responses. Primarily, it is meant to give the assurance to the client that you understood his/her
message; secondly, to make him/her hear his/her message in an orderly way, that is, just the real message
leaving out all that accompanied the message; thirdly, it gives a certain clarity to the narration of the client
since you pick and choose the real message; and finally it gives clarity to the counsellor him/herself
regarding what he/she understood. Your responding serves as a stimulus statement for the client to talk
further.
Previously we spoke about physical attending. Now is the time to speak about psychological
attending. Psychological attending can be made out by the way you are able to pick up the message of the
client and reflect it to his/her satisfaction. This is what you are going to do now.

1. Responding

Responding is not always necessary! Have you not met people who come and express and emote and
get up and go. They did not even want any response from you. All that they wanted was to discharge,
especially their emotions. They had a cathartic effect of having expressed what was bottled up in their
selves. When the clients are not particular about your response, you need not thrust your response upon
them. They got what they wanted! Let them go. In case, as it happens most of the time in counselling, you
have to respond, let us see how you ought to do.

In the communication model, after listening comes responding. Responding is the task of the
counsellor. Having listened to the problems of the client the counsellor has to respond. The quality of
his/her response determines the further progress of the counselling. There are clients who are encouraged by
the response they receive from the counsellors. Therefore we give importance to the response, specially the
first ones. The first impression is the best impression, they say.

2. Helping Skills Pre- test

Now sit back and relax. You can have some fun in your study. You will have a taste of what
responding is by doing the following test. It is to judge for yourself the natural capacity you have at present
in responding to people in crisis. Imagine that you are interacting with the following counsellee for about 30
minutes. The counsellee is a seventeen years old student from a broken family fed up with the family
atmosphere.

‘I am unable to bear any more. My house is in a mess; my father is a drunkard and whatever he
earns he drinks and brings home nothing. My mother is not able to manage the house. She beats and scolds
my brothers and sisters. There is no peace at home and I don’t know what to do.’

On the following lines, write out what you would say to this counselee. Write the exact words you
would use if you were actually speaking to this student.
 Principles and Techniques of Counselling-7 64

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Now, to give you an idea of how well you can judge helpful responses, we will consider here below
five responses made by five different counsellors. Next to each of the responses, you can write a score to
indicate your rating of the effectiveness of that response.

Use the following rating scale. If the response is very ineffective, give 1 score; if ineffective, give
2; if minimally effective, give 3; if very effective, give 4; if extremely effective, give 5.

Very ineffective 1
Ineffective 2
Minimally effective 3
Very effective 4
Extremely effective 5

Helper Responses Your rating

1. You are saying that you are unable to stand the family situation created by your
irresponsible and drunkard father and the abusive mother.

2. Your father may have hundred and one reasons for drinking. How are you
going to understand his situation? You should have some patience to understand
your father and mother.
3. You are helpless and angry with the family situation created by your drunkard
and irresponsible father and the abusive mother.

4. You feel hopeless about your family situation on account of the irresponsibility
of your drunkard father and the overburdened mother and you would like to do
something about it. Perhaps you could as your first step explore the possible
means of helping your father.

5. You are helpless and angry with your family situation made by your
irresponsible father and abusive mother and you would really want to do
something about it.

Pre-Test Discrimination Score

Response Your Rating Expert Rating Difference Score
Number
1 2
2 1
3 3
4 5
5 4
Total of Difference Score

Pre-test discrimination Score = Total of difference Score / Number Five

 Principles and Techniques of Counselling-7 65

To calculate your pre-test discrimination score, do the following:

1. Without regard to whether the difference is positive or negative, write down the difference
between each of your numerical ratings and each of the expert’s numerical ratings.
2. Add up the difference scores.
3. Divide the total of the difference scores by 5. The result is your pre-test discrimination score.
4. The lower the score the better is your ability to judge helpful responses. If your pre-test
discrimination score is 0, then you are an expert!

There are two ways of analyzing responses as we will see in the forthcoming pages. The one and the
same response can be analyzed by EISPU (EISPU is an acronym made of the first letters of Evaluative,
Interpretative, Supportive, Probing, and Understanding responses) or Ego States. Let us consider them in
detail.

3. KINDS OF RESPONSES AS EISPU

Amar is a twenty-three year old young man given to drugs, and he approaches the counsellor to get
some help for his problem. He says:

‘It all happened like fun. Actually I did not want to experiment with drugs, but my companions
forced this habit on me. Once I started, I liked the kick I got from the drug. Now I am unable to get rid of
this habit. I am mostly preoccupied with obtaining the drug by all means. My whole life revolves around
drug. If I stop for a day, my hands tremble.’

Counsellor A: How foolish you are to have spoiled your precious life so
early, my son. Your respectable parents may consider you a disgrace
to your family. Is it so difficult that you can't give it up? I wonder if
you have the goodwill to give it up.

Counsellor B: You have become dependent on drugs by prolonged use;

and the trembling hands are a sign of withdrawal symptom.
You are heading towards a chronic stage, as far as I see.

Counsellor C: Nowadays youngsters get into such habits, and it is quite

common in high schools and colleges. It is not such
a serious problem, and with some help I am sure you can
get over this difficulty and start a new life.

Counsellor D: I would appreciate your telling me how long you are taking drugs.

Counsellor E: You are worried about your condition as a result

of taking drugs, and upset about your inability to come
out of the habit.

You have seen five counsellors giving five different responses to the presentation of the one and the
same problem. One can invent even more types of responses. Let us limit ourselves to the above five types
of responses, and analyse them with regard to their usefulness in the counselling process. Counselling
psychologists have grouped the responses which counsellors usually make into five categories, depending
upon the intentions of the counsellors. The intention underlying the responses is taken as the criterion to
place them under different categories. Let us go into the details of the nature of the five responses.

1) EVALUATIVE OR ADVISING RESPONSES85

 Principles and Techniques of Counselling-7 66

Counsellor A indeed is very much concerned about the counsellee Amar. His response on account of
his concern for Amar comes in the form of a reprimand; an advice though given indirectly, is making a
judgement about the relative goodness, appropriateness or effectiveness of the way Amar is functioning.
Whenever you give advice, or correct, or moralize and even suggest, you make an evaluative response.
Of course, those who give advice mean something very positive, and their concern for the clients also is
great. It has its own place in counselling; and on the whole it may not be that useful as it appears to be. Not
every client can see the care and concern behind such a reprimand. The counsellor feels sorry that such a
young man like Amar should spoil his life in his tender age. The reasons why such an evaluative response
may not be helpful are many and we shall see some of them:

i. It alienates the client from the counsellor and he/she will not further cooperate with the counsellor
lest he/she should receive more reprimands. People tend to avoid punishments and scolding, and if
the counsellor at the beginning itself were to be punitive by his/her words, the counsellee will only
attempt to leave the situation.

ii. It makes the client feel worse than what he/she felt when he/she came for the counselling. While
coming for the counselling, the counsellee would have come with the expectation of being
understood and helped, but on the contrary an evaluative response puts him/her off, and he/she
depreciates him/herself more than he/she did earlier.

iii. It undermines the capacity of the client to solve his/her own problem. By just giving your solution to
the problem, you deprive the client of the opportunity to mobilize his/her resources for the solution
of his/her problem.

iv. It is one way of avoiding involvement with the client. When you are involved, you will explore the
possibility of making him/her take the necessary steps; but when you are not involved, you just give
a ready-made advice.

v. Perhaps you do not care for the client sufficiently, for if only you care for the client, you will take the
trouble of sitting together and spending some time to facilitate him/her to explore, to understand, and
to act.

vi. In a way, in giving advice, you indicate that your judgement is better than that of the client.

vii. Advice usually betrays your attitude rather than the attitude of the client.

viii. In giving advice, you may be indirectly inviting the client to enter into the unhealthy psychological
game called ‘Yes, but.’ Every suggestion you make is eagerly accepted, and the client presents a
certain difficulty why he/she cannot put that piece of advice into practice. After a number of
suggestions, for which you receive counter arguments, you finally give up giving advice, feeling
very bad. Here both of you have played a perfect game: ‘Why don't you …’ by you, and ‘Yes, but…’
by the client (which is complementing). By this game, nothing is achieved, except feeling negative
by the counsellor and the counsellee. People usually will not carry out decisions made by others.
Advices are nothing other than decisions made by the giver of advice. Usually the client rejects the
advice by giving arguments against the advice. If at all the client accepts your advice, it may be
because he/she does not want to offend you by his/her non-acceptance of your advice but later he/she
is not likely to carry it out.

Can we say that evaluative responses are all bad? Are there not moments when giving advice is
beneficial? Perhaps we need to consider the type of persons and the type of situations one might encounter.

(1) May not be useful:

i. People who are capable of self-management and are highly intelligent in fact resent your giving
advice. They can run their own show.
 Principles and Techniques of Counselling-7 67

ii. People who have enough resources but are unwilling to tap their resources to make their situation
better may become lazier and become ever dependent on you.

(2) May be useful:

1. Children and old people (who are practically like children) may be helped by advice. Children have
not built up their ego strongly and are not able to stand on their own. They need to depend on elders
whose authority counts much for the children. Old people too may respond well to suggestions or
advice since their defences are deteriorating, and they stand vulnerable like children wanting to be
guided. (Here again let us keep in mind that how sometimes children and old people are adamant on
carrying out their own will!)

ii. People who are seriously disturbed or ill may respond to evaluative responses. Even strong people
when disturbed emotionally are disoriented and need guidance immediately, but not later when they
can stand up on their own legs. People whose relatives met with an accident may not know what to
do, and what not to do, even though they are able individuals. Once I visited a sick patient in my
pastoral ministry. The patient was a lady doctor dying of skin cancer. She had received every kind
of available treatment. In her terminal stage she was asking me what medicine she could still take.
She knew for certain that I was not a medical personnel, and the fact was that she knew more about
medicine than I did; and yet because of her desperate state, she was asking my advice even in
medical field! So people in desperate situations respond to suggestions.

iii. In confrontational counselling, evaluative responses are useful.

(3) Giving Information

Giving advice is one thing, and giving information is quite another thing. When you are giving
information, you are supplying the client with facts and data about experiences, events, and people. In
giving advice it is your judgement that is predominant, but in giving information it is data that you provide
that are important. Perhaps the information you provide the client with may be vital in reaching a solution.
Ordinary people who are not well lettered usually do not have enough of information. A widower who was a
daily labourer had a seven-year-old son, and his wife had eloped with another man leaving behind the boy.
This widower did not know where to entrust his son for study. His decision to educate his son and bring him
up well was there; but the information where a seven-year-old boy would be taken care of was the one I had
to give him. In giving information we do not force our decision. Therefore, keep in mind while giving
information that you do it as a matter of fact. Obviously you could give the information when the clients ask
for it. Even if they do not ask for it, you could provide information. The clients may be blissfully ignorant
of the consequences of their decisions, and any amount of probing may not help them since the knowledge is
not within their reach, and in such circumstances you could provide the information about the consequences
of the decision. What would be wrong is to force them to act according to the information you have
provided.

When you provide information, see that what you give is correct. Let not your opinion be given as
something factual. Present your opinion as your opinion. Some of the vital information like the knowledge
of a dreadful sickness may have an emotional impact on the clients, in which case you need to deal with the
impact as well. Let not vital information be withheld from the clients just because you shy away from giving
unpleasant information. If vital information is known to you alone and withheld from the clients, you may
be doing a disservice to them.

2) INTERPRETATIVE OR ANALYSING RESPONSES86

In the case of Amar, Counsellor B has given a response which explains why Amar is having such a
problem. He/she explains that the problem is because Amar has become addicted to drugs, and that is why
he is not able to give them up. Again an explanation of the shaking hands is given.
 Principles and Techniques of Counselling-7 68

The shaking hands is explained as withdrawal symptom that results in, when someone gives up
drugs or alcohol to which one is addicted. Whenever you give reasons why such a problem (as presented to
you) exists, you are interpreting. Whenever you attempt to explain why the client has such a problem or
impart some psychological knowledge to the client for his/her problem, you are making interpretative
responses.

The reaction to interpretative responses may be varied. Mostly clients do not like to be overanalysed
and become very defensive and closed up, lest they should be analysed still further. There are also clients
who would ask the question ‘why’ about their problem. Such clients would welcome interpretative
responses. In confrontational and educational kinds of counselling, counsellors make use of interpretative
responses.

3) SUPPORTIVE OR REASSURING RESPONSES87

When we were small and were in difficulty, we ran to our parents or elders for support. As we grow
old, we still need someone to support us in our crisis. When we realize that someone is supporting us, our
problem may begin to disappear, or at least lessen in its gravity. In crisis, we tend to exaggerate the gravity
of the matter and the situation, whereas in fact it would not have been that serious. A bachelor of twenty-five
years came to me for counselling. He had contracted a venereal disease, and was greatly troubled. He
thought that he had contracted a very peculiar disease and was very depressed. I told him that it was
common among youngsters to contract venereal diseases, and it could be very easily cured with modern
medicine. When he heard that it was a common disease among youngsters and could be cured easily, he felt
a great relief.

In our example of Amar, Counsellor C reassured him and told him that the problem of drug
dependence is a passing phenomenon and can be got over easily, and that Amar need not feel as intensely
negative about his condition as he does.

Whenever you attempt to reduce the intensity of the feeling of the client by your responses, you
make supportive responses. Statements like 'Don't worry, things will pass off,’ ‘It is all quite natural,’
‘Things will soon turn out to be better’ ‘It is all for your good,’ and ‘In any case it is a valuable experience
for you’ will indicate that you are supportive of the client. Just telling that you support the client need not be
a supportive response.

I had been interviewing some heart patients who had actually been snatched from death by the
timely intervention of doctors. While they were talking to me, I asked them what in their opinion was
facilitating, and what they did not like people telling them. All of them unanimously said (though they were
interviewed separately) that whenever either the people or the doctors spoke to them supportive responses,
they liked it, and wanted to hear such responses only. Even if the condition was worse, they wanted to hear
that the condition was not that serious and it was quite normal in these days, and that there were many people
who had more severe attacks and yet carried on their works normally. Therefore, people who are in extreme
despair would like to hear only supportive responses.

People in crisis will appreciate your supportive responses. Children definitely love to be reassured.
The danger in supportive responses may be that they discount the intensity of the feeling, significance, and
importance of the experience. Perhaps the client thought that a problem was worthwhile to be dealt with, but
you might have brushed it aside telling that the problem was not that important. A little girl had her toy
broken, and was weeping to her daddy showing the broken toy. The daddy told her that she should not weep
for small things. Then came the question from the girl enquiring ‘what are small things?’ For the daddy the
broken toy is a small thing, but not for the girl. For children, a pet animal being lost, or a cherished toy being
broken, is a very serious matter, and they weep inconsolably. You could remember how jealously you
guarded some of the playthings in your younger days! Even a broken marble is worth the world for a small
boy who feels the joy of possessing it. In the same way, a problem presented by the client may look terribly
 Principles and Techniques of Counselling-7 69

serious for the client, though it may look trifling for the counsellor. In any case, if you do reassure, do not do
so to discount the problem.

There is a difference between supportive and discounting responses. In supportive response we

seriously take the problem but we are only concerned about reducing the intensity of the feeling of the client.
In discounting response, we do not take the problem seriously. Here we somehow reduce the seriousness of
the problem. Literally discounting is reducing the value of a thing.

4) PROBING OR QUESTIONING RESPONSES88

In our example of Amar, counsellor D asks a question to know how long Amar is taking drugs. It is
a probing or questioning response.

Whenever you make a response that is meant to elicit further information to understand the
experience, feeling, and behaviour of the client, it is a probing response. Usually questions facilitate the
counsellor to understand the client better so that he/she could facilitate him/her. Whenever appropriate
questions are asked at the proper time, they are facilitative. Considering the types of question and the timing
of the question will be useful.

(1) FACILITATIVE QUESTIONS

a. INFORMATION QUESTIONS

Usually the counsellor is a stranger to the counsellee, and the counsellee is a stranger to the
counsellor. If they were to understand better, they need to know each other well, for which some general
information is to be obtained even before the counselling proper starts. Here the counsellee need not have
the detailed information about the counsellor because it is not for the problem and benefit of the counsellor
that counselling is done. Yet the counsellor should introduce him/herself and give some basic information
about who he/she is. By information questions we mean the details required of the counsellee being elicited
by the type of questions put by the counsellor. In the beginning of the counselling interview, of necessity, the
counsellor is bound to ask a number of questions to get to know the client well. Since asking too many
questions at a stretch might irritate the counsellee, the counsellor is expected to be judicious in timing the
questions and spacing them appropriately.

b. SPECIFIC QUESTIONS

When you ask the client to give you specific information like which, what, who, how, where and
when, you have specific questions: When was it that you quarrelled with your brother? What makes you
angry when you are in the class? When someone criticizes you in public, how do you react? These are all
examples of specific questions. This helps the client to be very concrete in his/her exploration instead of
being vague and hazy. Since specific questions give clarity to the counselling process, this type of question
is to be made use of in counselling interviews.

c. ELABORATE QUESTIONS

Elaborate questions give opportunity for the clients to speak in detail about the problem situations.
The general information you received may not be of very much relevance to the problem, and the specific
questions will not give the whole picture. Only when the client elaborates the problem situation, you get the
total picture. While dealing with the feeling, you could ask like: ‘Can you speak more about your feelings?’
Or in ordinary situations you could ask ‘Is there anything more to add?’ Or ‘Can you give me more details
about the situation?’ These are all elaborate questions that will impel the clients to elaborate on their problem
situations.
 Principles and Techniques of Counselling-7 70

d. PERSONAL AFFECT QUESTIONS

Finally, what matters in a problem situation is the way the client feels. The client is feeling bad
about the problem he/she is facing; and so to know what he/she is feeling, and to what extent, is important
for the counsellor. 'When you were belittled by your colleague, how did you feel?' ‘As you are narrating
these things to me, what are you experiencing within yourself?’ Or simply 'What are you feeling?’ are all
questions that will elicit information about the way the client is feeling about a situation.

(2) NON-FACILITATIVE QUESTIONS

a. CURIOUS QUESTIONS

You need to know information about the client and his/her problem and all that pertains to these. A
client says that he had an illicit relationship with a woman. If you ask him how the woman looks like, that
will be a curious question. The knowledge about how the woman looks like is not necessary for your
counselling process and the client may not want to describe it either.

I remember that in my former practice of counselling I used to be so strict that I would not ask any
question other than the ones absolutely needed for the immediate counselling process. But later I realized
while doing family counselling, that I should ask other questions which need not be curious questions at all.
For example, in family counselling or even in individual counselling, we may ask the client to do the
‘genogram’ (family tree). After doing it we ask the client/s a number of questions connected to the
relationship of the client/s with other members of the family for three generations. Here the questions we ask
are not curious questions. You might ask if someone committed suicide or had mental health issues and the
like. These are meant to understand the client and his/her problems presented. But otherwise, it is good to
restrict ourselves asking questions that pertain to the counselling only.

b. CLOSED QUESTIONS

Closed questions do not give enough room for the client to elaborate on his/her problem. Closed
questions aim at getting a reply in the form of 'yes' or ‘no.’ For example, if you ask the client ‘Do you like
your father?’, he/she might answer either 'yes' or ‘no,’ and then remain quiet. Instead, if you were to ask
him/her open-ended questions like ‘How is your relationship with your father?’ the client might speak in
detail about how he/she relates to his/her father including whether he/she likes him or not. Since your aim is
to make the client talk more, it is good to ask open-ended questions instead of closed questions.

c. TWO QUESTIONS

If you are used to asking two questions at a time, you are confusing the client and he/she will be in a
dilemma to answer your questions. For example, ‘How do you find the film we saw last night, and which
actor/actress did perform well?’ Ask one question at a time, and after getting the answer, ask the second
question. This gives a psychological space for the client to answer you properly without confusion.

d. TOO MANY QUESTIONS

If your counselling were to be filled with plenty of questions, that will deprive the client of the
opportunity to explore, and understand the problem. All the essential questions are to be asked, while
prudently avoiding too many questions.
 Principles and Techniques of Counselling-7 71

e. CONTINUOUS QUESTIONS

Even if you are asking too many questions, these questions need not be asked at a stretch, one after
another, as that might jeopardize the psychological space the client requires for understanding, assimilating,
and answering. After putting a probe, wait for the answer; and on receiving the answer, make an empathetic
statement instead of making another probe. An empathetic statement makes the client feel accepted, and
keeps him/her ready for the next question you may need to ask. It is advisable that you make an empathetic
response between your questions. This also gives the client psychological space to take a breath and start
talking.

f. WHY QUESTIONS

A word considered anathema in counselling is ‘why.’ There are reasons why 'why' questions are not
usually asked in counselling. In fact ‘why’ question will elicit information from the client, but it would also
block the real exploration of the client. The why type questions will make the client find out reasons,
whereas 'how’ questions will elicit description. By making the client give reasons, you may be making the
condition still worse. The client is likely to become defensive and justify or rationalize his/her actions
without owning his/her problem and responsibility for change. Again 'why' questions will indicate your
disapproval of the problem of the client. If you ask a client ‘Why did you lose your temper with your class
teacher?' you are communicating by this question that the client should not have got angry while talking to
his/her class teacher. This is your disapproval of the problem of the client, and it will go against accepting
him/her unconditionally.

g. LEADING QUESTIONS

By leading questions, you invite the client to answer in the way you want. You almost compel the
client to answer as you wish by giving him/her the answer itself clothed in your question. Take for example,
‘You liked the party we had last night, didn't you?’ will somehow pressurize the person to answer ‘Yes, I did
like it.’ In leading questions you may not get the truth about how a client thinks and feels about a problem,
since he/she may be concerned about pleasing you by giving the ‘right answer.’

h. THREATENING QUESTIONS

Self-disclosure will be obviously painful for the client. He/she does reveal to you mostly because
he/she has to deal with his/her problem, and may not be because he/she feels happy about doing it. Intimate
details should rather come out spontaneously, and not extracted. Therefore it is better to avoid too
penetrating questions about one's intimate personal life, unless the situation warrants it. For example, if a
client tells that he/she was sexually abused in his/her childhood, you need not ask how exactly the abuse took
place. You have known the abuse and you need to know how it affects the person right now but not the
details of how it took place unless that information comes spontaneously from the client. The client will feel
more confident and secure to give you intimate information about him/herself and his/her problems if you do
not go after it.

i. AMBIGUOUS QUESTIONS

Questions with double meanings will make the client doubt your motivation. Your questions need to
be simple, straightforward, and easily understandable. Usually ambiguous questions have two meanings, one
innocent apparently and another wicked underneath. It is likely that the client intuits that you are conveying
a wicked meaning. Therefore, let your questions be open and frank.

j. POORLY TIMED QUESTIONS

 Principles and Techniques of Counselling-7 72

What should be asked at the end of the session must not be asked in the beginning of the session.
For example, to ask a client ‘What steps do you think will be useful in getting rid of laziness’ is poorly timed,
if you had not first dealt with the problem of laziness itself. Or a client had undergone a terrible crisis in
his/her life. You ask him/her whether the bitter experience was not a good lesson in his/her life before you
could make the client accept and assimilate the experience itself and find meaning in it.

k. QUIZ PROGRAMME QUESTIONS

One need not engage the clients with a question-and-answer session as in a quiz programme. The
reason is very evident; you are not allowing the client to explore enough, reflect on the awareness, and take
appropriate decisions. Let your probing be to the minimum.

5) UNDERSTANDING OR PARAPHRASING RESPONSES 89

In the case of Amar, Counsellor E reflected the message of Amar in terms of feelings. The dominant
feelings that he/she found in the narration of Amar are: worry and upset. Whenever you pick out the
feeling of the client and reflect it to his/her satisfaction, you are making an understanding response. In
fact, real capturing of the content of the message of the client automatically implies picking up the feeling,
whether that floats on the surface or remains buried underneath. The criterion to know whether you are
making an understanding response is to see if your reflecting has any feeling word, one that depicts the affect
of the client accurately.

(1) INTERNAL AND EXTERNAL FRAME OF REFERENCE

A concept very intimately connected to understanding responses is ‘internal frame of reference.’ To

understand what is ‘internal frame of reference’ we need to know what is ‘frame of reference’ and from there
we shall proceed to ‘internal frame of reference’ and ‘external frame of reference.’

‘A frame of reference’ is a cognitive map, which is a consistent view of oneself in relation to one’s
environment, that is essential for guiding one’s behaviour. A frame of reference is based on the three
assumptions: 1) reality assumption, 2) possibility assumption, and 3) value assumption. These provide an
individual with his/her phenomenal field. This phenomenal field is his/her ‘personal frame of reference’
through which he/she interacts with the world. These three assumptions are fundamental to the functioning
of the self-system (individual).

This ‘frame of reference’ can be either ‘external frame of reference’ or ‘international frame of
reference’ (personal frame of reference). Now let us consider what are they.

The client as an individual has his/her own world-view about him/herself, others and the rest of the
world. For example, his/her view of him/herself is an internal frame of reference. A drunkard who had come
to a psychiatric clinic for a de-toxification, and whom I happened to meet, was lamenting that he drinks to
forget his worries and especially that he has no issue. Every drunkard has some lame excuses for drinking.
They blame others, or the situations that cause them to drink, and rationalize in a way that they are not
responsible. Had the problem not been there they would not have taken to drinking, they say. For a
drunkard, to view his/her drinking habit as the result of the worries he/she has, is his/her internal frame of
reference. Your telling the drunkard that he/she takes to drinks and does not give up that habit because
he/she does not want to, is an external frame of reference to him/her. It is your view that he/she does not
want to give it up, whereas his/her view is that he/she wants to give it up but only the situation somehow
forces him/her to drink.

Thus your view about him/her forms the external frame of reference for the client, and his/her view
about him/herself is the internal frame of reference. Here we are not speaking of the objective fact, but
 Principles and Techniques of Counselling-7 73

rather understanding the subjective fact of the client. To get into the shoes of the other, crawl into his/her
skin, see the world with his/her eyes, and to feel the sensation with his/her senses, is understanding the client
in his/her internal frame of reference. Internal frame of reference may not be the correct picture of the
reality. A drunkard giving a lame excuse is cheating him/herself and others. But ‘understanding’ means that
you understand the subjective feelings of the client, and convey this, so that the client feels understood.

(2) USEFULNESS OF UNDERSTANDING RESPONSES

For what issues or concerns one should use an understanding response in a counselling process is a
question that addresses you.

i. First of all the client wants to be understood, understood in his/her internal frame of reference.
People are judgemental, and see him/her from their point of view only. The client who is vulnerable
pleads to be understood. This understanding that the client begs for, can be shown only when you
pick up the feelings of the client.

ii. You too cannot be cocksure whether you understood the client as he/she is. Your understanding
needs to be checked with him/her; and the way you do that is by reflecting his/her feeling and seeing
if he/she confirms or denies it. In either case, you are helped with a feedback as to your
understanding of the client’s internal frame of reference.

iii. The client speaks a lot, sometimes things that are connected, and at other times things that are not
related. It could be also in the form of confused statements. You as the second person listening to
him/her can neatly organize the thought and feeling of the client, and present them to him/her for
further self-exploration. If he/she remains in his/her confused state, he/she will remain in the same
state repeating what he/she has been saying without proceeding further. For this, you need to reflect
the feeling of the client. In a way, you are directing the client in a focused way.

Let us summarize what we have hitherto seen. Here you attend and the client gets involved
and automatically expresses him/herself. While he/she expresses, you listen attentively after which
you respond reflecting either the content, or the feeling, or both together, and thus you have well
prepared a power-base to continue counselling on a solid foundation, without which the counselling
that will ensue will not be worthwhile. Thus we can chalk out the skills of the counsellor, and the
tasks of the counsellee, as follows:

Counsellor - Counsellee
Attending  Involving

Listening  Expressing

Responding  Exploring

4. REFLECT THE CONTENT

After the client has expressed his/herself, your immediate and evident task is to respond to the very
content of the client. Before you could respond to the sophisticated message in a very skilful way, your
matter-of-fact reporting the content is expected by the client. We differ from one another in our memory
span, as well as our attention span. Depending upon these two things, your reflecting can be either adequate
or inadequate. One way of reflecting the message of the client is to report word by word what the client has
said. This is called ‘verbatim report.’ Though counsellors may be trained for verbatim report, it is not used
in actual counselling. Training in verbatim is to help one capture the message of the client completely. But
 Principles and Techniques of Counselling-7 74

if you use it in counselling, that is, exactly repeating all that the client was saying, it takes an enormous time,
and the client him/herself may not want such a report. Besides, in case of verbatim report, the client will be
deprived of the chances of talking more. This verbatim report is also called parroting. Parrots repeat
whatever they hear. It is a mechanical repetition without understanding the meaning. If the client wants only
the repetition of the very same thing, then a tape recorder will do that job more accurately. Your reflecting
should be enhanced by your skill; in other words, you need to contribute your share to the clarity of the
message. Therefore the idea of paraphrasing comes handy. Paraphrasing is reformulating the very message
of the client in new words that will express the gist of the client's message without distorting the meaning
and the feeling tone. Thus you need to be prepared to respond to the client's statement with your
paraphrasing.

Here certain formulas that counselling psychologists use will be of help to you. You can preface
your paraphrasing with the words like: 'You say,’ ‘You are saying, 'You seem to be saying,’ ‘From what you
say I understand’ and 'You are trying to say.’ This is called ‘you say’ formula. Here purposely you are using
the word ‘you’ to make the statement very personal. What is personal is appealing and makes one feel
understood and wanted.

Whenever you reflect the content, it should be to the satisfaction of the client. Though not verbally,
at least nonverbally, clients approve or disapprove of your paraphrasing. Consider the example of
paraphrasing given below:

Counsellee : I have done badly in the last three exams, and my assignment paper
is not ready, though I am supposed to submit it within four days. I
try to concentrate on my subjects and assignments, but somehow I
am not able to, and I am terribly distracted with a number of
other unimportant works that can actually be done later.

Counsellor : You are saying that you are unable to concentrate on your
subjects, and in fact did poorly in your exams, and are not ready
with your assignments on account of distractions.

Here the counsellor did not reflect the message verbatim, nor did he/she leave out any message, and
there is no distorting of the message. What he/she did was to reformulate the message in fresh words
understandable to the client. Reflecting the content should become quite natural to you, since you will keep
this technique all through the counselling process.

5. Kinds of Responses as per Ego-States90

1) EGO-STATES

The responses of the counsellors could also be categorized or understood from another angle, that is,
from ego states. This is from ‘Transactional Analysis’ point of view. Transactional Analysis (or TA as it is
popularly called) is a theory of human behaviour based upon Dr. Eric Berne’s discovery that a person has
three sets of behaviour. Each set of behaviour is accomplished by its own kind of thoughts, feelings and
actions. He named these sets as Parent, Adult, and Child and called each one an ego state.

EGO-STATES
 Principles and Techniques of Counselling-7 75

(1) Parent Ego State

An ego state is a set of consistent and coherent patterns of thinking, feeling, and behaving. The
parent ego state is a way of thinking, acting, feeling, and believing similar to that of our parents. This state
develops during the first five years or so of life. The Parent is based upon your brain’s recordings of your
real parents (or those who were in the place of your parents). The parent responds immediately and
automatically to childlike behaviour and to various situations requiring a ‘take charge’ response. The parent
ego state can be subdivided into Nurturing Parent and Critical Parent. Nurturing Parent supports and helps
others by reassuring and doing things for them, maintains traditions and rules of culture by teaching,
preaching and giving advice, and protects the weak, fearful, and ignorant by standing up for them. The
Critical Parent establishes rules of conduct and sets limits in a commanding tone of voice, enforces the
rules by quoting them in a confident or demanding tone of voice, teaches manners and socializes by
rewarding and punishing, and judges who or what are right for self, according to the admonitions and
regulations stored in the memory. Hence the content of the parent ego state will be : all that has been taught
to you — opinions, faith, beliefs, customs, manners, morals (right and wrong), culture, traditions,
controlling, nurturing, and protecting.

(2) Child Ego State

The Child Ego State contains a person’s basic desires and needs, and the recordings of the feelings and
reactions one had as a child. This state develops during the same time as the Parent. The child ego state can
be subdivided into Natural Child or Free child and Adapted child. The Adapted child can be again
subdivided into Rebellious Child and Compliant Child or Obedient Child.
The Natural Child is uncensored, apt to break conventions and rules, to act without thinking about
consequences, energetic, always moving, exploring, doing things, sensuous, always feeling, touching, and
smelling things, creative, filled with new ideas and ways of doing things, affectionate, adventurous, and fun–
loving.
The Adapted Child makes its response when others are acting like a parent to self. It is filled with
feeling in its response to people, objects, and events.

The Compliant Child conforms to the demands placed on it. Sometimes fears people and things
and seeks protection or nurturing. It asks for permission and for what is the right thing to do. It believes in
magic and feels that some people have magical power over self.

The Rebellions Child rebels against authority, ‘parenting,’ and rules and regulations. Sometimes it
procrastinates when given directions, orders, or deadlines. There are times when it withdraws, sulks, or
harbours a grudge toward people who give orders, make judgments, and ‘parent.’

(3) Adult Ego State

The Adult part of the personality develops later than those of the Parent and the Child. According to
Dr. Berne, it starts at about ten months of age. In a healthy person, the Adult continues to develop
 Principles and Techniques of Counselling-7 76

throughout life. This sets the Adult apart from the Parent and the Child. The Adult is the data processor, the
scientific part of the personality. It processes current and objective information about the world. It does two
things. First, it is responsible for most activity and work, such as driving a car, solving a problem, or
learning a skill. Secondly, it edits the recordings of the Parent and the Child when they contain inaccurate
data. This is the most crucial job because it is often through the Adult that a person roots out old beliefs,
feelings, and behaviours and replaces them with new, more effective ways of behaving, feeling, and
believing that is objective in the present, and for computing and managing new data.

The activities of the Adult Ego State are: It is thoughtful, using the logical processes of analysis and
reflection. It acts in a controlled and measured way based upon consideration of the facts. It gathers
information, sorts it, stores it, and uses it when appropriate and considers alternatives based upon the facts
before deciding. It solves problems in a systematic way. It reacts to situations primarily in the here–and-
now rather than with old feelings or beliefs. It judges after consideration of alternatives and consequences.
It thinks about different possible futures for self and others. It up–dates beliefs in the Parent and the Child.
It turns off feelings of fear, insecurity, and rejection when they are unrealistic. It brings together the beliefs,
feelings and responses of the Parent and the Child. It is in a way creative, seeking new ways to see and
interpret things and events.

2) RESPONSES FROM EGO STATES91

Having known the structure and functions of the various ego states, it would be worthwhile to
consider the responses of the counsellor from the point of view of ego states, to identify from which ego state
the responses proceed. All that we speak proceeds from a particular ego state at a given time. If the
counsellor is able to understand from which ego state he/she is speaking, then he/she can adjust and direct
the response from another ego state if required depending upon the condition of the counsellee. If for
example, a counsellee is speaking from his/her child ego state asking for permission, then the counsellor’s
response has to be from the parent ego state (nurturing). If the counsellee is speaking from his/her child ego
state indicating fun and frolic, then the counsellor is expected to respond from his/her child ego state. If the
counsellee is speaking from his/her adult ego state, then the counsellor should respond from his/her adult ego
state. The ideal would be that eventually we facilitate the counsellee to move to his/her adult ego state so
that he/she is able to see his/her condition objectively and take appropriate steps.

In short, at a time the client speaks from one particular ego state and the counsellor responds from a
particular ego state. If the communication were to flow, then the counsellor has to shift making responses
from one ego state to another so that it is appropriate to the ego states of the client. Hence the importance of
the knowledge of the ego states and the type of responses that will proceed from them. Now let us consider
various types of responses (at least five) arising from different ego states of the counsellor to the one and the
same statement of the counsellee. Since the tone of voice and gestures cannot be seen in a response made on
the paper, the assigning of the responses to particular ego states will be a guess work mostly depending upon
the words.

Counsellor Counsellee
 Principles and Techniques of Counselling-7 77

Counsellee : Oh, I am exhausted with all the household chores. (Here the client is addressing from
his/her Child Ego State).

Counsellor Counsellee

Counsellor : Come on, have a cup of tea and relax a while.

(Here the counsellor is addressing from his/her Nurturing Parent).

Counsellor Counsellee

Counsellor : What kind of work do you have at home that exhausts you so much?
(It is an Adult response, since he/she is asking for information).

Counsellor Counsellee

Counsellor : You should know how to take care of yourself. You are very foolish to
do all the works at a stretch.
(It is a response from the Critical Parent).

Counsellor Counsellee

Counsellor : At least now you are free to do what you want.

(It is a response from the Free or Natural Child).
 Principles and Techniques of Counselling-7 78

Counsellor Counsellee

Counsellor : Do you think that you only did so much work ; see the things that I have been
doing the whole morning.
(It is a response from the sulking Adapted Child).

The above examples illustrate the fact that a counsellor can respond at least from five ego
states to the same situation. Not all the five ways of responding will be useful at the same time, but
they will be useful at various times depending upon the counsellee. Therefore a judiciary use of the
responses is the task of the counsellor.

6. RESPONSES VIEWED FROM EISPU AND EGO STATES

We have seen separately how one can make responses from the point of view of EISPU and
Ego States. Now we shall endeavour to identify one and the same response from EISPU and Ego
States.

Counsellor Counsellee

Counsellee : I am a wreck. I smoke at least 20 cigarettes a day. It is debilitating my health and I am

unable to control myself in this regard.
(Here the client is addressing from his Adult Ego State).

Counsellor Counsellee

Counsellor : You feel helpless with regard to your smoking habit.

(It is an Understanding Response from the Nurturing Parent).

Counsellor Counsellee
 Principles and Techniques of Counselling-7 79

Counsellor : Most men usually smoke. It is not uncommon nowadays. You need not be too much
alarmed about it. There are certainly ways to overcome such a habit.
(It is a Supportive Response from the Nurturing parent).

Counsellor Counsellee

Counsellor : If you smoke like this, do you think you will live longer?
(It is an Evaluative Response from the Critical Parent).

Counsellor Counsellee

Counsellor : You say you are unable to control your smoking habit. Perhaps you have become
addicted to smoking.
(It is an Interpretative Response from the Adult Ego State).

Counsellor Counsellee
 Principles and Techniques of Counselling-7 80

Counsellor : Tell me how long you are having this habit.

(It is a Probing Response from the Adult Ego State.)

Counsellor Counsellee

Counsellor : Vow, you seem to be enjoying life.

(It is an Evaluative Response from the Free Child).

Counsellor Counsellee

Counsellor : I don’t know what is the problem in smoking and I won’t

be able to help you anyway.(It is an Evaluative Response
from the Adapted Child.)

7. RESPONSES SEEN AS TRANSACTIONS92

We have already seen how the responses do proceed from particular ego states. Whatever the client
says or expresses comes from one of his/her particular ego states, and in the same way what you respond
also proceeds from a particular ego state of yours. It is not only enough to know from which ego states
yours and those of the client’s responses proceed but it is much more important from which ego states
your responses are to proceed so that your responses are facilitative. Eric Berne has a whole range of
Transactional Analysis in this regard, which is in place for our consideration.

1) Complementary Transactions

We talk to someone and feel we are understood then it is a complementary transaction. If you
express something from a particular ego state, for example adult ego state and you direct this message to
the adult ego state of the other person and when you receive a reply from the adult ego state of the other
 Principles and Techniques of Counselling-7 81

person addressed to your adult ego state then it is a complementary transaction. The complementary
transactions that are conventionally used are :
1.

Parent to Parent (1) : See the way the young girls dress nowadays !
Parent to Parent (2) : It is not the way we were taught when we were young.

2.

Adult to Adult (1) : Where is the Government Hospital ?

Adult to Adult (2) : Go straight and turn to the first cut on the left and at the end you will
find the sign board.
3.

Child to Child (1) : Why not go for a movie ?

Child to Child (2) : In fact I was looking for a companion.

4.
 Principles and Techniques of Counselling-7 82
1

Parent to Child (1) : Why don’t you pay attention to your homework?
Child to Parent (2) : I shall try to do it well, Sir.
5.

Child to Parent (1) : Will you please find the meaning for the word ‘persevere?’
Parent to Child (2) : Of course, I shall certainly do it for you, my child.

2) Crossed Transaction :

You talk to someone and receive a reply which is cutting, and after which you do not feel
like continuing your conversation. You feel misunderstood or surprised. This is called a crossed
transaction. In a crossed transaction you address your message, for example, from your Adult to the
Adult of the client and you receive a reply from any ego state other than the adult ego state of the client.
It could be either from Parent to Child or Child to Parent. The crossed transactions that are normally used
in conversations are :
1.

2
 Principles and Techniques of Counselling-7 83

Parent to Parent (1) : See how her children are roaming about in the street.
Parent to Child (2) : I don’t think your children are much better.

OR

Parent to Parent (1) : See how her children are roaming about in the street.
Child to Parent (3) : What is wrong in that ? (In a rebellious tone).

2.

Adult to Adult (1) : What is the time now ?

Parent to Child (2) : Why
2 don’t you use your watch ?

OR

1 is the time now ?

Adult to Adult (1) : What
Child to Parent (3) : The whole time you pester me asking for time.
3

3.

Child to Child (1) : Let us have some ice cream today.

 Principles and Techniques of Counselling-7 84

Child to Parent (2) : My mother doesn’t like me eating ice cream.

OR

Child to Child (1) : Let us have some ice cream today.

Parent to Child (3) : Who will eat ice cream during the rainy season ?

4.

1 2

Parent to Child (1) : Lilly, fetch me some water to drink.

Parent to Child (2) : You are becoming lazy, fetch it for yourself.

OR

Parent to Child (1) : Lilly, fetch me some water to drink.

Child to Parent (3) : I am tired and I can’t.

3) Ulterior Transaction :
 Principles and Techniques of Counselling-7 85

Sometimes you say something openly; however, by your body language and tone of voice you mean
something else, and you get a secret message back. It is called ulterior transaction. Socially you are
speaking from one ego state addressing a particular ego state of another, and you openly get a reply from
the expected ego state, but the psychological message has been sent from your another ego state and so
you get a reply from another ego state of the other person.

A sales clerk exhibiting a piece of cloth says :

Adult to Adult (Apparent) : It is too expensive.

Child to Child (Hidden) : If you are really rich, you would buy it.
It is an Adult Transaction openly but psychologically he/she is speaking from his/her Child to attract
the Child in you and boost up your image.

A girl addressing a boy says :

Adult to Adult (Apparent) : I am all alone at home this evening.

Child to Child (Hidden) : Come, let us have some fun.

What is evident is Adult to Adult transaction, but the Child to Child transaction is ulterior or hidden.

When transactions are complementary, communication remains open. When transactions are
crossed, communion ceases. When in the ulterior, the outcome is predictable only at the psychological level.
In counselling, only the complementary transactions are helpful, the crossed ones may not be helpful, and the
ulterior transactions will confuse the client. Ulterior transactions are part of psychological game. As far as
possible, keep the transactions complementary.
Beginners usually worry about the type of responses they are making. This concern is really helpful
for the one who is concerned about the accuracy and appropriateness of the responses and he/she will take
the necessary steps to master the skill. In the beginning you are not going to be very accurate. Everybody
 Principles and Techniques of Counselling-7 86

learns the hard way and through trial and error. If your responses are not helpful, then you get a feedback as
to the effectiveness of your responses and then you can improve your future responses. On the average, what
type of responses you have made will indicate to some extent your effectiveness. The counsellors who make
a good number of understanding responses usually succeed in helping the client help themselves.
Understanding responses automatically do not lead the client to solution of the problem. But it is at least half
way through, for, the client is confident with the feeling of being understood. The counsellors who are not
making sufficient number of understanding responses may be having difficulty in understanding, or at least
they have failed to express their understanding of the client’s thoughts and feelings. In making
understanding responses you are not likely to be misunderstood by the client.
The responses you make are only a means in the counselling process. Your real concern should be
the client. At times counsellors cling to such formulae and methods that they easily miss the client. What
does it matter what method one employs provided the client is facilitated. At the same time this does not
take away one’s responsibility to go in a focused way with skills which are mostly accepted as helpful, unless
the situation warrants something different.
Let there be your own stamp in everything you do. You can never be another person
metaphysically. Express yourself in your own unique way and feel happy about it. Imitating others
is good but the imitation should not be mere mimicking, but an exercise of an internalised set of
skills. I have known persons without any formal training in counselling doing real and effective
counselling because the persons were trying to be themselves rather than being somebody else.

8. SPACING RESPONSES

Your responding is essential, but not so fast that the client has not fully completed expressing
him/herself. It is wise to pause for a fraction of a second after the client has spoken, lest the client should
desire to talk more. If you are too fast, the client has to suppress what he/she wants to say fully. In the
beginning, your responding could be paced according to the speed of the client’s conversation; later perhaps
you could lead the client, in which case you could be quicker in responding; and at all times you should
make sure that the client has fully expressed him/herself before you respond. Not fully waiting for the others
to complete the sentence is a common mistake committed by most of us. Too hurried a response conveys to
the client the message that you did not listen to him/her properly. It is good to remember that whenever the
client speaks, you should immediately fall silent, even if you are half way through your responding or
enquiring. You will find this very rewarding in your counselling sessions or even otherwise in any
conversation when others speak.93
 Principles and Techniques of Counselling-7 87

6
REFLECT THE FEELING OF THE CLIENT

Reflect the feeling of the client using the formula ‘You feel….because…..’

1. FEELING – EMOTION

We generally do not make the fine distinction between feeling and emotion. Usually a
layman will identify ‘feeling’ with ‘emotion.’ In our popular parlance also it is so. But scientifically they are
different. In fact, feeling is part of emotion and not the whole of emotion. Let us consider this in detail.
There are many definitions of feeling and emotion. However, I am restricting myself to the description of
feeling/emotion by Aaron Ben-Ze’ev. Therefore, this is not the only explanation nor the exhaustive one. 94

Emotion is a complex state of the organism, involving bodily changes of a widespread character – in
breathing, pulse, and gland secretion – and, on the mental side, a state of excitement or perturbation, marked
by strong feeling, and usually an impulse towards a definite form of behaviour. If the emotion is intense
there is some disturbance of the intellectual functions, a measure of dissociation, and a tendency towards
action of an ungraded or protopathic character. An emotion is experienced as a feeling that motivates,
organizes, and guides perception, thought, and action.

By the term ‘emotion’ we mean a class of elicitors, behaviours, states, and experiences. Change of
highly personal significance causes emotions. Hot emotions have four characteristics namely 1. high
instability, 2. great intensity, 3. a partial perspective, and 4. relative brevity. They mean:

(1) When people are in the grip of an emotion, they are in a transition in which the preceding context
has changed, but no new context has yet been stabilized. Thus there is instability.
 Principles and Techniques of Counselling-7 88

(2) One of the basic evolutionary functions of emotions is that of immediate mobilization of
resources for which a great intensity of emotion is required. Emotions usually impel people to action and
thus by nature emotions are given great intensity in order to mobilize all available resources.

(3) Our emotions are focused on one or a few persons. Emotions are partial since our attention is
focused on a narrow target or they express a personal and interested perspective.

(4) The typical temporal structure of emotions involves a swift rise-time, taking less than half minute
in most cases, followed by a relatively slow decline. Typically emotion takes place within approximately
half a second to four seconds.

Now let us see the components of emotions. The basic components of emotion are intentionality
(which is understood by its subdivisions 1. cognition, 2. evaluation, and 3. motivation), and feeling. Thus
we have four components of emotion namely cognition, evaluation, motivation and feeling.

Whereas intentionality refers to a subject-object relation, feeling refers to the subject’s own state of
mind. For example, when you encounter a thief at night, you are afraid, which is a feeling dimension; the
knowledge of the thief (cognition), the evaluation of the attributes of the thief that he would be harmful
(evaluative) and the desire to run away (motivational) go along with the feeling dimension.

Thus, feeling is one of the basic components of emotion. Therefore, feeling and emotion are not
identical. Yet in ordinary use, we understand them as one. In this book we use the words ‘feeling’ and
‘emotion’ interchangeably.

The word ‘feeling’ was first used in the English language to describe the physical sensation of touch
(kinaesthetic experience) either through experience or perception. It can also indicate physical sensation
apart from touch like ‘a feeling of warmth.’ As we have seen above, in psychology, it is usually used to refer
to the conscious subjective experience of emotion. Many psychotherapy schools insist that the therapists
achieve some kind of understanding of the client’s feelings. Thus, our counselling process too strongly
recommends that we elicit the feeling of the client, make the client aware of it and express it externally. 95

Counsellee : For some ten years we are living in this city. I had a reasonably
good health and a decent job. During the last six months my health has deteriorated
with acute stomach-ache that does not respond to any treatment. For the last two
months, I have not gone to my job on account of my health problem. Financially, I
have spent everything I had for my treatment, and now my whole family is starving.

Counsellor : You feel helpless with your deteriorating physical condition and
your inability to look after your family.

Here the counsellor has first of all picked up the feeling of the client and connected it with the
content. It is a further step in your responding. The first step is to paraphrase and reflect the content, and the
second step is to find out the feeling, and express it along with the content. Whenever you express the
feeling you will communicate it along with the content, because content gives meaning to the feeling, and
feeling alone will not make sense. What made the client feel the way he/she feels is explained by the
content. The content will be sterile without the feeling. Hence a reflection of both the content and the
feeling is required.

The formula one uses in expressing the feeling along with the content is like this: "You
feel……….because …………." ‘You feel’ is followed by the feeling word, and ‘because’ is followed by the
content, which is the reason for the client to have the particular feeling he/she is experiencing.

Very many times the feelings of the client may not be evident from the verbal narration of the client.
In such cases, the counsellor will have to rely on the body language of the client. For example, while
narrating an incident, the client is full of tears in his/her eyes. He/she might not have expressed any word
 Principles and Techniques of Counselling-7 89

about his/her feelings. In such a situation, you know for certain that he/she is sad about the incident. At
times both the verbal and the nonverbal expressions may not evidently speak of the feeling; or you are at a
loss to identify the feeling of the client. Then, imagine yourself in the situation of the client, and see what
you would be feeling if you were he/she. It is seeing the situation from the client's point of view. Still if you
find it difficult to trace the feeling, then plainly put a question to the client, asking him/her what she is
feeling while she is narrating the incident. It is likely that the clients are not familiar with feeling words.
Whenever you ask for the feeling, they will tell you what they are thinking. They express their thoughts
rather than the feelings. They could be coached to name their feeling.

With regard to feelings, they can be understood in terms of families and intensities. There are four
major families of feelings. They are gladness, sadness, madness and sacredness. Some psychologists
categorize them into more than four types. In one and the same family of feelings, we have different levels
of intensity. A feeling can be felt weak, like saying that one is ‘satisfied.’ If the level of satisfaction
increases, one will say ‘cheerful.’ This is somewhat a medium level of intensity. If the satisfaction reaches
its highest level of intensity, one will say ‘excited.’ Sometimes we can have interchangeable feeling words
like ‘happy’ and ‘joyful.’ These two words express identical experiences. For an interchangeable feeling
word, you need to find out a feeling word in the same family with the same intensity. For example,
‘hopeless’ and ‘bad’ belongs to the same family but with different intensities. You cannot substitute the word
‘hopeless’ with the word ‘bad.’ You may substitute ‘hopeless’ with ‘despairing,’ because they are
interchangeable. They belong to the same family with the same intensity of feeling.

While picking up the feeling, you need to name the correct family of feeling and also the exact
intensity of the feeling. If the client him/herself has provided you with a feeling word, then you could use an
interchangeable better feeling word that would capture the feeling more accurately. This is your contribution
to the expression and clarification of the feeling of the client. 96

2. THE FEELINGS CHART

Here below is a feelings chart. 97 Some of the feelings are categorized according to their intensities as
high, medium, and low. Sometimes the intensity of any feeling word depends upon the person with whom it
is used. Therefore, the counsellor may need to visualize the typical counsellee with whom he/she is working
in order to understand the intensity.

Level of Categories of Feelings

Intensity
Happy Sad Angry Scared Confused Strong Weak
elated hurt superior fearful bewildered potent overwhelmed
overjoyed hopeless furious panicky trapped super impotent
proud sorrowful seething afraid troubled powerful small
High together depressed enraged distraught torn/split trusting useless
complete rejected victimized miserable disorganized competent incapable
free/joy unwanted drained frightened mixed-up energetic insecure
grief jealous threatened foggy confident inferior
cheerful ashamed remorseful insecure disoriented capable defensive
up upset annoyed uneasy uncertain attracted shaky
good distressed frustrated very divided sure unsure
Medium strained
hopeful down agitated shy don’t know secure soft
where
peaceful defeated tense timid to stand durable shy
loving beaten strained unsure bothered safe
glad lonely fed-up nervous uncomfortable
content sorry uptight strained undecided
satisfied lost dismayed reluctant tired
positive bad put out
relieved guilty nervous
warm inside embarrassed inconvenienced
 Principles and Techniques of Counselling-7 90

feel safe disappointed tired of

feel secure inferior put upon
Low
accepted repulsed repulsed
affectionate remorse competitive
a sense of frightened
belonging
respected defensive
aggressive
suspicious

For a keen listener and observer, the feeling words are not missing. The dominant feeling word will
come up every now and then during the conversation. All the major feelings are to be reflected in
counselling. I have observed in counselling skills practice that when the client's often repeated feeling word
is not picked up by the counsellor and reflected, the client keeps bringing it up every now and then, because
he/she will find satisfaction only when the uppermost feeling is dealt with and taken care of.

7
REFLECT THE DEEPER FEELING

It is easier to find the uppermost feeling that is obvious either to the counsellor, or to both the
counsellor and the counsellee. Perhaps what is more difficult is the underlying feeling or the deeper feeling.
If you are satisfied with dealing only with the surface feeling, then the client may not feel very much
relieved; you also need to search for anything lurking underneath. If there is any, you need to bring it up to
the surface to be known and accepted by the client. For example, a person overly criticizing a colleague of
hers for her lack of sound morality, may be feeling jealous of her for the many boyfriends she is enjoying.
The reprimand that comes in the name of feeling responsible for her colleague is in reality the feeling of
jealousy. A word of caution is required here. The client may not be ready to accept the deeper feeling, in
which case it is prudent not to go for it until the client is ready. Whenever a realization of a negative nature
comes upon us, we instinctively deny it. For instance, if I am diagnosed as having a dreadful sickness by
medical examinations, my first reaction to such a news is to deny the existence of that awful sickness, saying
that the medical tests were not accurate, and the doctor did not know to diagnose properly. You can expect
this kind of reaction from clients when you bring home the existence of a feeling of a disagreeable nature. In
group therapies, I have observed that when the facilitator brings to the awareness of a participant some
hidden motive, the participant denies it vehemently. The quickness with which he/she denies, and the
vehemence he/she uses, are indications that what he/she denies is true of him/her. In fact, surfacing a
submerged feeling is a skill about which we will speak in great detail in the step on Reframing. Suffice it
now to mention about the task of the counsellor to deal with the submerged feeling if there is any.

As a general rule, you will reflect the content first and wait for the feeling word, using the ‘you say’
formula. When the client is ready for the awareness and acceptance of the feeling, you will reflect the
feeling using an interchangeable feeling word with the same level of intensity with the formula ‘you feel
…..because…..’ Just because such an awareness is threatening to the client, the client may avoid facing a
realization of the feeling, in which case you shall fall back on the previous step of reflecting the content only,
 Principles and Techniques of Counselling-7 91

until such time that the client is ready. When the client is readily accepting the feeling, then see if there is
any deeper feeling, and bring it up to the surface by reflecting it. This too may be disturbing to the client, in
which case fall back on the step of reflecting the content and surface feeling only using the formula ‘you feel
…. because….’ When the client has been prepared to face the hidden feeling, then attempt to bring it to the
notice of the client using tentative statements which are leads, since you are not sure about the deeper
feeling. By being tentative, you give ample room for the client either to confirm or to deny the existence of
such a feeling.98

LEADS — MANNER OF COMMUNICATING RESPONSES

Every person is so unique and his/her experience, the subjective understanding of the reality is also
unique. Psychologists speak of internal frame of reference or personal frame of reference. It refers to the
way one looks at reality. It is a distinctive way of looking at reality. Here the surety we have about having
understood the client varies depending upon many factors. Therefore, it is safe to consider all our
judgements as tentative and not as final with regard to its accuracy. Therefore, how wise it is to be humble
enough to be very tentative in proposing or reflecting to the client. If your understanding of the client is
accepted by the client as accurate, well and good, and if not, you could always modify it to the satisfaction of
the client. There are times when you trust that your perceptions are correct and in such circumstances you
can start the responses as ‘You feel.......’, ‘ What I hear you saying.......’, ‘ You mean......’, ‘ You think....... ‘
etc. You could use such leads to respond to the client.

When you are not pretty sure about your perception, then you need to be open-minded and cautious
in appraising and expressing. Perhaps you could use such leads as the following : ‘Could it be that....’,
‘Perhaps you are feeling.....’, ‘I guess that you are.....’, ‘You appear to be feeling.....’, ‘how does it sound if I
say that you are feeling.....’, ‘My hunch is that you are experiencing.....’, ‘I have an inkling that.....’, ‘I
somehow sense.....’, ‘You seem.....’ ‘I am wondering if it is ….what you are experiencing.’ Such leads are
useful when you are not quite sure about your perceptions.
 Principles and Techniques of Counselling-7 92

8
ALLOW THE CLIENT TO SPEAK SUFFICIENTLY ON
THE FEELING
In this chapter or step I would like to underline just one idea, an idea most important for the success
of the counselling and for the welfare of the client. It is dealing sufficiently with the feeling to the
satisfaction of the client.

One of the mistakes beginners make is to rush through the counselling process. Especially when it is
the question of dealing with the feeling at length, the counsellors hurry up, may be due to the want of the
skill of being comfortable with dealing with persons who are emoting. When the counselling skills practice
starts, I would have told the counsellor trainee that he/she should after reflecting the feeling of the client ask
the client to speak more on it. In most cases they just forget about it and rush to the next step. When the
feelings are sufficiently dealt with, the way is clear for further progress; otherwise the way will be fogged to
the extent that the clients feel that something is lacking when the counselling is terminated. Here I would
like to bring to your notice that when a strong negative feeling is cherished by the client, the counselling will
not be effective for the simple reason that the strong negative feeling comes in the way of the closure of the
counselling process. There is some ‘unfinished business,’ to quote Fritz Perls. Unfinished business keeps
cropping up whenever there is an association with the uncompleted work. I shall take up this theme in the
next chapter.

As I said earlier there are clients who just want to come to counselling to pour out their feelings and
go away. They are in no way prepared to deal with their issues further. All that they wanted was to have a
release. One need not presume that the clients by all means want counselling. Therefore, one need not rush
through the steps to complete the session. Here what one needs to keep in mind is the need to deal with the
feeling. Dealing with feeling does not suffice just to mention or reflect it and leave it. Often I have noticed
in my own counselling practice and in the counselling practice sessions that whenever the counsellor does
not permit the client to deal with the dominant feelings sufficiently, then the client keeps mentioning it quite
often. The feeling desperately needs to be addressed.
 Principles and Techniques of Counselling-7 93

First and foremost, the counsellor should note all the feeling words the client speaks of. Then he/she
should reflect those feeling words to the client to her satisfaction. When a client hears from the counsellor
the very feeling he/she is experiencing that gives the assurance that the counsellor understood the client. It is
more particularly needed with regard to feelings. This reflecting of the feeling by the counsellor not only
gives the impression that the counsellee is understood but also it gives the sense of being accepted and in a
way healed.

One can go on enumerating all kinds of theories why clients keep repeating the feeling words until
they are addressed. Instead we note the fact that the clients somehow want to communicate how much they
have been affected by the feeling they experience and they want to have an assurance from the counsellor.

As a first step having reflected the feeling of the client which you do along with the content, you
could ask the client to express all the feelings he/she experiences right now with regard to the issue he/she is
presenting. The counsellor needs to reflect all of them without fail. Even if you miss other things narrated
by the client, one thing we should never miss is the feelings expressed by the client.

Clients might express a few feelings and keep quiet. At this moment, you can ask the client if there
are any other feelings so that the client exhausts expressing the feelings he/she experiences. Now comes the
point that you should deal with the feelings sufficiently. All the dominant feelings are to be dealt with. At a
time one feeling may be predominant. Ask the client to speak more on the feeling. It is an elaborate
question. You are asking the client to elaborate on how he/she experiences the feeling. According to me this
has to be done until the client has nothing more to speak. From now onwards you are free to proceed in your
counselling session. Otherwise you can notice the client repeatedly speaking of a particular feeling until the
session gets over.

Here you have not yet resolved the issue. The feeling may be connected with the issue. But by now
the way is cleared to proceed further. It is imperative for the counsellor to ask the client to speak more on the
feeling he/she is experiencing.

Not to have picked up the feeling of the client and reflected it and not to have asked the client to
speak more on the feeling are connected to the skill of empathy about which we shall see later. Therefore,
not to have allowed the client to express sufficiently on the feeling is a sign that the counsellor is not
sufficiently empathetic. Lack of empathy is a serious setback in counselling. Hence, there is a great need to
deal sufficiently with the feeling of the client to his/her satisfaction. That is why I have made it a special
skill lest this task of the counsellor is overlooked. 99
 Principles and Techniques of Counselling-7 94

9
FACILITATE THE CLIENT TO RELEASE STRONG
NEGATIVE FEELINGS

Dealing with the feelings, the counsellor should do. The counsellor may come across certain
feelings which are negative and strong that unless they are dealt with or released properly by therapeutic
methods they will not permit the counselling to proceed. This has been my experience and also I have
observed the same in the counselling sessions of others. Not all the negative feelings need to be released
before counselling continues. There are only three and more particularly two of them. They are 1. grief, 2.
anger, and 3. guilt. I have not seen so far a successful counselling completed when there had been a strong
grief or anger lurking behind without being released. Therefore, I speak of them.

1. GRIEF

Grief is a profound form of sadness. Usually it is concerned with death, the most substantial misfortune
we experience. In the death of someone very close to us and whom we value very much, we experience the
irrevocable loss. Since death has a profound impact on us, grief is focused on the same issue for a long
period of time. Thus grief typically develops into a sentiment and in extreme cases into depression. Grief is
not limited to death alone, it may concern misfortunes, which do not involve death but nevertheless are
considered as grim as death. Losses can happen through separation and divorce, both of which have their
own psychological costs. Losses can also be less tangible, for example, the loss of an ideal, the loss of a
limb, or the loss of capacities through chronic illness. Such examples highlight that although we consider the
interpersonal context in which losses occur, reactions to losses that are not interpersonal must also be
considered. The implication they may have are similar to the loss of death. Grief is an emotion towards the
bad fortune of others. But in fact, it has so much to do with our own misfortune as well. A great deal of
concern in grief is that of our own misfortune or feeling of loss. When we grieve the death of someone, it is
not that the dead person is suffering now or missing something of our present life, but we feel something in
us has died, that our life has lost a valuable aspect.
 Principles and Techniques of Counselling-7 95

Clients have the right to feel the ruin fully. Sadness or grief needs to be felt at least for sometime,
before it can be dealt with. Attempting to deal with it as soon as it occurred may not be fruitful. Visu had
lost his father, and he was inconsolable when he came for counselling. In fact, he did not have the mood
even to talk to the counsellor. He was in a dazed state, being stunned by the shock of the death of his
beloved father. The counsellor was keeping a careful watch over him, and after some days of mourning Visu
wanted to talk to the counsellor. As Visu was busy with the arrangement of the funeral rites, he could hardly
weep and mourn the loss. The counsellor immediately used the Gestalt method of having a dialogue with his
father, which ended on a happy note, both Visu and his father taking leave of each other. If the counsellor
attempted to deal with the mourning right at the very beginning, it would not work. And now that Visu has
mourned his father's death, he was prepared to look into the business his father has left and the household
management, for which the counsellor’s intervention was essential in the form of counselling.

When sad, people weep. Weeping is such a sweet relief. Culturally we are conditioned to think that
weeping is the prerogative of women. If a man weeps, others remark 'Why do you weep like a woman?’ as
though it is wrong for men to weep. Weeping is one of the simplest ways of easing oneself of a great burden.
Sometimes clients are quite content with weeping in the presence of a counsellor who understands them.
How salutary it is that we weep! But the fact is that people on finding themselves unable to control their tears
feel embarrassed. Certain skills on the part of the counsellor will definitely facilitate weeping in the client.
If you find your client starting to weep, keep away all interruptions by way of asking questions. You can
resume your enquiry or responding, once the weeping subsides. Maintaining an active silence with full of
care and concern is well appreciated. When we visit our friends and relatives who are mourning, they do not
expect us to give a verbal report of how much we feel with them. All they need is that we be present to them
understandingly. If it is culturally allowed, holding the hand, stroking the shoulders, an embrace, a touch on
the head, will nonverbally soothe the client. Verbally supportive statements are very facilitating. Once one
of my companions came to my room to share something personal and devastating. I saw his moistened eyes
and realizing what was going on within him I said: ‘It is hurting,’ at which he burst into tears. You could
make statements like: ‘You feel so miserable that you would weep it out.’ Or you could say ‘something is
hurting you.’ While weeping is going on do not keep yourself busy with other activities or looking away
through the window. Attending to the client while he/she weeps is necessary. 100

2. ANGER
Anger is directed towards the action of another person. Anger involves a negative evaluation, but
this evaluation is of the specific action of another rather than a global attitude. One of the causes of
anger is the feeling of being either physically or psychologically restrained from doing what you
intensely desire to do. The restraints could be anything such as physical barriers, rules, regulations, or
personal insult, everyday frustrations, interruption of interest or joy, being taken advantage of, and being
compelled to do something against one’s wish. Prolonged and unrelieved distress is known to be the
inborn activator of anger. One of the causes of anger is in relation to a person’s desired direction or goal.
So anything that deflects a person from his/her path to the goal can trigger anger. Aversive stimulus is a
sufficient cause of anger and aggressive inclinations. Physical pain is a direct and immediate cause of
anger. Thus, discomfort from any source like hunger, fatigue, or mental stress can make us angry while
we are unaware of the causes. Mild discomfort, when prolonged, can make us more irritable and thus
lower our anger threshold. It is an offence that arouses anger. That offence should be specific and
undeserved.

Anger is another strong emotion that needs special care like sadness or grief. Love (sex), grief, and
anger have orgasm in the sense that they rise to a level, beyond which they cannot rise, and then they explode
and decline. Naturally a grief-stricken individual remains for some days in his/her grief which reaches its
height and then it declines. Anger too builds itself up and finally explodes. When strong anger is bottled up
and not given a release, then it comes in the way of the closure of an unfinished business. A lady came to me
for counselling. Her husband was working in the market. He had developed an illicit relationship with
another woman working in the same market. When she knew this fact, she could contain herself no longer.
She was literally fuming, but was unable to express her anger towards her husband. Then I facilitated her to
vent her feeling of anger through beating a pillow, as per Gestalt method, and then made her dialogue with
her husband in fantasy. Because she took out her anger first she could understand the market situation, and
how frail her husband would have been in such a vulnerable situation, even though he might not have wanted
 Principles and Techniques of Counselling-7 96

to be unfaithful to his wife. This realization through counselling could come about, just because she first
took care of her anger towards her husband. Hence attempting to counsel a person who is boiling with a
strong negative feeling like anger is mere waste of time, unless you make room for the release of the anger. 101

3. GUILT

Guilt also is a strong negative feeling. But it is not as paralyzing as grief or as devastating as anger.
Guilt refers to a specific deed (or omission). In guilt our focus of concern is a deed, which has violated
certain norms. Guilt emerges when we have done something, which is forbidden. The forbidden thing in
guilt may involve some harm to a person or it might have merely violated a certain norm without doing harm
to anyone. Emotions are mostly concerned with those who are close to us. In guilt, as well, the relationship
to our intimates is also central. Guilt-inducing situations often highlight the neglect of a partner or of other
intimates, or failure to live up to the conventional standards of interpersonal relationships. Guilt is
concerned with the action of an agent — not the agent as a whole. Guilt involves being associated with what
is morally wrong. We do not feel guilty of the deeds of others. To feel guilty I should have done an act over
which I had a certain causal responsibility. Therefore, there should be a clear causal connection between the
deed done and the feeling of guilt.102

First of all clarify with the client whether the guilt is legitimate or illegitimate. In legitimate guilt
you are responsible for a commission or omission but in illegitimate guilt you are not. You did not provide
enough medical facility for the one under your care and so the person died. Here you will have a legitimate
guilt. You could not provide more than your means to care for your aging parents. But you have done all
that you could really do. Yet if you feel guilty of not having cared for them, then it is illegitimate guilt. In
many cases, a mere clarification will help a lot. Then appropriate dialogue with the persons concerned will
ease the burden of guilt.

Guilt can be dealt with through Gestalt method. Make the client dialogue in fantasy with the
individual towards whom he/she feels guilty. In the dialogue he/she can express how he/she feels and ask
pardon of the person. Thus the dialogue will continue and come to a happy ending. If he/she feels guilty
that he/she did not live up to a standard behaviour, then make two parts of the client in fantasy, one part of
the client that committed the mistake and the other person who is righteous. Let there be a dialogue which
ends peacefully. If the person feels guilty towards God, let him/her dialogue with God and reach the end of
the dialogue.
 Principles and Techniques of Counselling-7 97

10
PINPOINT THE PROBLEM AND ASK FOR
A RECENT EVENT
DIAGNOSING

A. PINPOINTNG THE PROBLEM

Counsellees come to the counsellor and speak a lot about the problem they face. Not all the
clients are clear about what they speak. In fact, some of the clients are not able to speak pointedly about
the problem. They give you a jumble of information, mostly confused, and apparently disconnected; or
there is a connection within themselves, but it is not evident to the counsellor. Even the psychotic
person acts according to the perception he/she has, which is not clear to the bystanders. In the same
way, whatever the client speaks has a certain connection. The counsellor needs to know the real
problem. I have seen a number of counsellor trainees who proceed with counselling without realizing
that they have not yet identified the problem the client speaks of. The client may be meaning one thing,
and the counsellor understands it differently; and the counselling proceeds parallelly as though they are
operating on two wavelengths. In order to lead the client to the goal, the counsellor as well as the
counsellee need to know the problem they are going to deal with. In diagnosing, the counsellor
pinpoints the problem so that it becomes clear to him/her as well as to the client. In training sessions I
usually do not allow the counsellor to proceed with the counselling unless he/she has pointed out the
client’s problem that was presented, and both the counsellor and the counsellee have the same
understanding of the problem.

PINPOINTING THE PROBLEM

Problems can be from many fields. It can be from the situation like children being bought up in
a slum situation where stealing and other unethical practices are taken as normal expected behaviour.
Problems can be developmental as one goes through various stages of development. It could be from
one’s type of personality. It could be from within a person in the sense of faulty thinking, faulty feeling,
and faulty behaviour. It could be from interpersonal relationship. It can be also from any of the mental
disorders. In short it could be from anything intrapersonal to interpersonal, and to situational. Since the
spectrum of mental disorders covers a wide range of problems, I have chosen to deal with them using
the Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition (DSM-IV).
 Principles and Techniques of Counselling-7 98

Sometimes pinpointing the problem is not so easy, and the problem may not lend itself to be
identified. In such situations you plainly ask the client if he/she could describe in short what his/her
problem is. Perhaps at this level he/she is able to enunciate the problem. Or else you could tell him/her
what you understand to be his/her problem, and wait for confirmation or denial. Once you both agree
what the problem is, then you are ready to proceed further.

If you realize that the problem is beyond your competence, then take the appropriate steps to
refer the client to the competent person who would deal with his/her problem. In counselling skills
practice, I often see counsellor trainees taking for granted what the problem is and proceeding further.
In some cases the client understands his/her problem to be one, the counsellor understands it to be
another; and thus they proceed parallelly without a meeting point, and finally arrive at something that
has nothing to do with the problem presented. Even after pinpointing the problem the understanding of
the problem by the counsellor and the counsellee may not be the same. Consequently let there be a
concrete discussion about what both of them understand as the problem.

To pinpoint the problem in the client one needs to know what are the problem areas and what are
the problems themselves in order to pinpoint them in the client. In the world we have two types of
classification of mental illnesses. One is by the American Psychiatric Association (APA) with its
Diagnostic and Statistical Manual of Mental Disorders (DSM) and the other by the World Health
Organization (WHO) with its International Classification of Diseases (ICD). At present the latest
versions of these classifications are: DSM-IV (Fourth Edition of 1994 with a "text revision" produced
in 2000) for USA, and ICD-10 (Tenth Edition, 1992) for Europe.

Though DSM-IV was primarily meant for use in the United States of America, it had
considerable influence internationally. Besides, many of its basic features like specified diagnostic
criteria, were adopted for inclusion in the mental disorders chapter of ICD-10 of the World Health
Organization. ICD-10 is the official classification system used in Europe. All the categories used in
DSM-IV are found in ICD-10, but not all ICD-10 categories are in DSM-IV.

DSM-IV is a categorical model rather than a dimensional model. In a dimensional model

clinical presentations are based on quantification of attributes rather than on the assignment to
categories which is followed by categorical model.

The fine distinction we had formerly before the arrival of DSM-IV as psychosis and neurosis is
not used currently. With the latest development in mental disorders classifications we understand
psychotic as grossly impaired in reality testing, i.e. persons incorrectly evaluate the accuracy of their
perceptions and thoughts and make incorrect inferences about external reality, even in the face of
contrary evidence. Direct evidence of psychotic behaviour is the presence of either delusion or
hallucinations without insight into their pathological nature. A neurosis is a chronic or recurrent
nonpsychotic disorder, characterized mainly by anxiety, that is experienced or expressed directly or is
altered through defence mechanism; neurosis appears as a symptom, such as an obsession, a
compulsion, a phobia, or sexual dysfunction. Though not used in DS-IV, many clinicians consider the
following diagnostic categories as neuroses: anxiety disorders, somatoform disorders, dissociative
disorders, sexual disorders, and dysthymic disorder. The term ‘neurosis’ signifies that the person’s
gross reality testing and personality organization are intact though the person is impaired in a
number of areas. Now let us consider each problem separately.

In the treatment of mental disorders, I have purposely left out symptoms due to the direct
physiological effects of a substance (e.g., drug of abuse, a medication, or other treatment) or a general
medical condition (e.g., hyperthyroidism) or as a manifestation/consequence of another mental disorder.
These categories may not concern a counsellor directly; they are of concern to a physician. We need to
keep in mind that most of the mental illnesses or symptoms dealt with in the following pages (1) could
 Principles and Techniques of Counselling-7 99

be also due to a general medical condition or due to the direct physiological effects of a substance (e.g.,
a drug of abuse, a medication) or a manifestation/consequence of another mental disorder; (2) they
should cause significant distress or impairment in social, occupational, or other important areas of
functioning. Since we take these for granted, I mostly avoid adding them in the diagnostic criteria of
every mental illness.

1. DEVELOPMENTAL PROBLEMS

First let us take developmental problems. In normal individuals, we could also expect
developmental problems according to the ten developmental stages.

1) Prenatal — From conception to birth, 270 or 280 days, or 9 calendar months.

2) Infancy — From birth to the end of the second week. Here Partunate refers to the time between the
emergence of the foetus from the mother's body till the umbilical cord is cut and tied; and Neonate
denotes the time between the cutting of the umbilical cord and the end of the second week.

3) Babyhood — From the end of the second week to the end of second year.

4) Early childhood — From two to six years.

5) Late childhood — From six to ten or twelve years.

6) Puberty or Preadolescence — From ten or twelve to thirteen or fourteen years.

7) Adolescence — From thirteen or fourteen years to eighteen years.

8) Early adulthood — From eighteen years to forty years.

9) Middle age or Middle adulthood — From forty to sixty years.

10) Old age or senescence or late adulthood — From sixty years to death.

Now each of these stages has its own problems, and the very transition from one stage to another
has its own problem. A counsellor needs to distinguish whether a particular problem is a neurotic or
developmental. For example, in late childhood children are known to steal, cheat, lie and use vulgar
words. These misdemeanours are likely to be there in a child. Once a college professor came and
complained to me about his son (in his late childhood) that he was telling lies for silly things. The
professor could not accept that it is a developmental problem (specific to the stage) that his son was
facing. Some parents are shocked to observe their children in early childhood, especially from 3 to 6
years, engaged in manipulation of their genitals, and their adolescent sons or daughters experimenting
with sex.103

2. PERSONALITY DISORDERS

In this part we shall consider various types of personality disorders. They are thirteen in all. Let
us take them one by one. Before that, let us see how a personality disorder is to be identified and later
we shall apply it to specific personality disorder.

GENERAL DIAGNOSTIC CRITERIA FOR A PERSONALITY DISORDER

 Principles and Techniques of Counselling-7 100

A. An enduring pattern of inner experience and behaviour that deviates markedly from the
expectations of the individual’s culture. This pattern is manifested in two (or more) of the
following areas:
(1) cognition (i.e., ways of perceiving and interpreting self, other people, and events)
(2) affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response)
(3) interpersonal functioning
(4) impulse control
B. The enduring pattern is inflexible and pervasive across a broad range of personal and social
situations.
C. The enduring pattern leads to clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
D. The pattern is stable and of long duration and its onset can be traced back at least to adolescence
or early adulthood.104

The first three Paranoid, Schizoid, and Schizotypal personality disorders are considered as odd
and eccentric types.105

1) PARANOID PERSONALITY DISORDER

A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent,
beginning by early adulthood and present in a variety of contexts as indicated by four (or more) of the
following:
(1) suspects, without sufficient basis, that others are exploiting, harming, or deceiving
him/her
(2) is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or
associates
(3) is reluctant to confide in others because of unwarranted fear that the information will be
used maliciously against him/her
(4) reads hidden demeaning or threatening meanings into benign remarks or events
(5) persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
(6) perceives attacks on his/her character or reputation that are not apparent to others and is
quick to react angrily or to counterattack
(7) has recurrent suspicions, without justification, regarding fidelity of spouse or sexual
partner.

2) SCHIZOID PERSONALITY DISORDER

A pervasive pattern of detachment from social relationships and a restricted range of expression
of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts,
as indicated by four (or more) of the following:
(1) neither desires nor enjoys close relationships, including being part of a family
(2) almost always chooses solitary activities
(3) has little, if any, interest in having sexual experiences with another person
(4) takes pleasure in few, if any, activities
(5) lacks close friends or confidants other than first degree relatives
(6) appears indifferent to the praise or criticism of others
(7) shows emotional coldness, detachment, or flattened affectivity.

3) SCHIZOTYPAL PERSONALITY DISORDER

 Principles and Techniques of Counselling-7 101

A pervasive pattern of social and interpersonal deficit marked by acute discomfort with, and
reduced capacity for, close relationships as well as by cognitive or perceptual distortions and
eccentricities of behaviour, beginning by early adulthood and present in a variety of contexts, as
indicated by five (or more) of the following:
(1) ideas of reference (excluding delusions of reference)
(2) odd beliefs or magical thinking that influences behaviour and is inconsistent with
subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or ‘sixth
sense’; in children and adolescents, bizarre fantasies or preoccupations)
(3) unusual perceptual experiences, including bodily illusions
(4) odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or
stereotyped)
(5) suspiciousness or paranoid ideation
(6) inappropriate or constricted affect
(7) behaviour or appearance that is odd, eccentric, or peculiar
(8) lack of close friends or confidants other than first-degree relatives
(9) excessive social anxiety that does not diminish with familiarity and tends to be
associated with paranoid fears rather than negative judgements about self.

The next four Antisocial, Borderline, Histrionic, and Narcissistic personality disorders are
considered as dramatic, emotional, and erratic types.106

4) ANTISOCIAL PERSONALITY DISORDER

There is a pervasive pattern of disregard for and violation of the rights of others occurring since
age 15 years, as indicated by three (or more) of the following;
(1) failure to conform to social norms with respect to lawful behaviours as indicated by
repeatedly performing acts that are grounds for arrest
(2) deceitfulness, as indicated by repeated lying, use of aliases, or conning others for
personal profit or pleasure
(3) impulsivity or failure to plan ahead
(4) irritability and aggressiveness, as indicated by repeated physical fights or assaults
(5) reckless disregard for safety of self or others
(6) consistent irresponsibility, as indicated by repeated failure to sustain consistent work
behaviour or honour financial obligations
(7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt,
mistreated, or stolen from another.

5) BORDERLINE PERSONALITY DISORDER

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and

marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by
five (or more) of the following:
(1) frantic efforts to avoid real or imagined abandonment
(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between
extremes of idealization and devaluation
(3) identity disturbance: markedly and persistently unstable self-image or sense of self
(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance
abuse, reckless driving, binge eating)
(5) recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria,
irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
(7) chronic feeling of emptiness
 Principles and Techniques of Counselling-7 102

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper,
constant anger, recurrent physical fights)
(9) transient, stress-related paranoid ideation or severe dissociative symptoms.

6) HISTRIONIC PERSONALITY DISORDER

A pervasive pattern of excessive emotionality and attention seeking, beginning by early

adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1) is uncomfortable in situations in which he or she is not the centre of attention
(2) interaction with others is often characterized by inappropriate sexually seductive or provocative
behaviour
(3) displays rapidly shifting and shallow expression of emotions
(4) consistently uses physical appearance to draw attention to self
(5) has a style of speech that is excessively impressionistic and lacking in detail
(6) shows self-dramatization, theatricality, and exaggerated expression of emotion
(7) is suggestible, i.e., easily influenced by others or circumstances
(8) considers relationships to be more intimate than they actually are.

7) NARCISSISTIC PERSONALITY DISORDER

A pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, and lack of
empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or
more) of the following:
(1) has grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be
recognized as superior without commensurate achievements)
(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
(3) believes that he or she is ‘special’ and unique and can only be understood by, or should associate
with, other special or high-status people (or institutions)
(4) requires excessive admiration
(5) has a sense of entitlement, i.e., unreasonable expectations of especially favourable treatment or
automatic compliance with his or her expectations
(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
(8) is often envious of others or believes that others are envious of him or her
(9) shows arrogant, haughty behaviours or attitudes.

The next three Avoidant, Dependent, and Obsessive-compulsive personality disorders are
considered as anxious, and fearful types.107

8) AVOIDANT PERSONALITY DISORDER

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative

evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or
more) of the following:
(1) avoids occupational activities that involve significant interpersonal contact, because of fears of
criticism, disapproval, or rejection
(2) is unwilling to get involved with people unless certain of being liked
(3) shows restraint within intimate relationships because of the fear of being shamed or ridiculed
(4) is preoccupied with being criticized or rejected in social situations
(5) is inhibited in new interpersonal situations because of feelings of inadequacy
 Principles and Techniques of Counselling-7 103

(6) views self as socially inept, personally unappealing, or inferior to others

(7) is usually reluctant to take personal risks or to engage in any new activities because they
may prove embarrassing.

9) DEPENDENT PERSONALITY DISORDER

A pervasive and excessive need to be taken care of that leads to submissive and clinging
behaviour and fears of separation, beginning by early adulthood and present in a variety of contexts, as
indicated by five (or more) of the following:
(1) has difficulty making everyday decisions without an excessive amount of advice and
reassurance from others
(2) needs others to assume responsibility for most major areas of his or her life
(3) has difficulty expressing disagreement with others because of fear of loss of support or approval
Note: Do not include realistic fears of retribution
(4) has difficulty initiating projects or doing things on his or her own (because of a lack of self-
confidence in judgement or abilities rather than a lack of motivation or energy)
(5) goes to excessive lengths to obtain nurturance and support from others, to the point of
volunteering to do things that are unpleasant
(6) feels uncomfortable or helpless when alone because of exaggerated fears of being unable to
care for himself or herself
(7) urgently seeks another relationship as a source of care and support when a close relationship
ends
(8) is unrealistically preoccupied with fears of being left to take care of himself or herself.

10) OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and

interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early
adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
(1) is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the
major point of the activity is lost
(2) shows perfectionism that interferes with task completion (e.g., is unable to complete a project
because his or her own overly strict standards are not met)
(3) is excessively devoted to work and productivity to the exclusion of leisure activities and
friendships (not accounted for by obvious economic necessity)
(4) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not
accounted for by cultural or religious identification)
(5) is unable to discard worn-out or worthless objects even when they have no sentimental value
(6) is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way
of doing things
(7) adopts a miserly spending style toward both self and others; money is viewed as something to
be hoarded for future catastrophes
(8) shows rigidity and stubbornness.

11) DEPRESSIVE PERSONALITY DISORDER (RESEARCH CRITERIA)

A pervasive pattern of depressive cognitions and behaviours beginning by early adulthood and
present in a variety of contexts, as indicated by five (or more) of the following:
(1) usual mood is dominated by dejection, gloominess, cheerlessness, joylessness,
unhappiness
 Principles and Techniques of Counselling-7 104

(2) self-concept centres around beliefs of inadequacy, worthlessness, and low self-esteem
(3) is critical, blaming, and derogatory toward self
(4) is brooding and given to worry
(5) is negativistic, critical, and judgmental toward others
(6) is pessimistic
(7) is prone to feeling guilty or remorseful. 108

12) PASSIVE-AGGRESSIVE PERSONALITY DISORDER (RESEARCH CRITERIA)

A pervasive pattern of negativistic attitudes and passive resistance to demands for adequate
performance, beginning by early adulthood and present in a variety of contexts, as indicated by four (or
more) of the following:
(1) passively resists fulfilling routine social and occupational tasks
(2) complains of being misunderstood and unappreciated by others
(3) is sullen and argumentative
(4) unreasonably criticizes and scorns authority
(5) expresses envy and resentment toward those apparently more fortunate
(6) voices exaggerated and persistent complaints of personal misfortune
(7) alternates between hostile defiance and contrition. 109

13) SELF-DEFEATING PERSONALITY DISORDER (RESEARCH CRITERIA)

(1) A pervasive pattern of self-defeating behaviour that does not occur only in response to, or in
anticipation of, physical, sexual, or psychological abuse.
(2) Feel unworthy of being treated well and, as a result, treat themselves poorly and unwittingly
encourage others to make them suffer.
(3) They may for example, reject opportunities for pleasure, choose people or situations that lead to
mistreatment or failure, and incite others to become angry with them or reject them.
(4) If things do go well for them, they attempt to undermine themselves by, for example, becoming
depressed or causing themselves pain. 110

So far we have seen what are personality disorders considered separately by each one of them.
We now are about to consider psychoses (psychotic disorders). In doing this, first we shall deal the
schizophrenia proper111 with its subtypes112 and secondly we shall deal with other psychotic disorders
which are seven.

3. SCHIZOPHRENIA (PSYCHOSIS)

1) SCHIZOPHRENIA

A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion
of time during a 1-month period (or less if successfully treated):
(1) delusions
(2) hallucinations
(3) disorganized speech (e.g., frequent derailment or incoherence)
(4) grossly disorganized or catatonic behaviour
(5) negative symptoms, i.e., affective flattening, alogia (poverty of speech), or avolition
 Principles and Techniques of Counselling-7 105

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a
voice keeping up a running commentary on the person’s behaviour or thoughts, or two or more voices
conversing with each other.
B. Social/occupation dysfunction: For a significant portion of the time since the onset of the
disturbance, one or more major areas of functioning such as work, interpersonal relations, or
self-care are markedly below the level achieved prior to the onset (or when the onset is in
childhood or adolescence, failure to achieve expected level of interpersonal, academic, or
occupational achievement).
C. Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period
must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A
(i.e., active-phase symptoms) and may include periods of prodromal (an early or premonitory
sign or symptom of a disorder) or residual (the phase of an illness that occurs after remission of
the florid symptoms or the full syndrome) symptoms. During these prodromal or residual
periods, the signs of the disturbance may be manifested by only negative symptoms or two or
more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual
perceptual experiences).

Characteristic symptoms (Criterion A) may be understood as falling into two broad categories
— positive and negative. The positive symptoms appear to reflect an excess or distortion of normal
functions, whereas the negative symptoms appear to reflect a diminution or loss of normal functions.

The positive symptoms include distortions or exaggerations of inferential thinking (delusion),

and behavioural monitoring (grossly disorganized or catatonic behaviour). Negative symptoms include
restrictions in the range and intensity of emotional expression (affective flattening), in the fluency and
productivity of thought and speech (alogia), and in the initiation of goal-directed behaviour (avolition).

(1) PARANOID TYPE

A type of schizophrenia in which the following criteria are met:

A. Preoccupation with one or more delusions or frequent auditory hallucinations.
B. None of the following is prominent: disorganized speech, disorganized or catatonic
behaviour, or flat or inappropriate affect

(2) DISORGANIZED TYPE

A type of schizophrenia in which the following criteria are met:

A. All of the following are prominent:
(1) disorganized speech
(2) disorganized behaviour
(3) flat or inappropriate affect
B. The criteria are not met for catatonic type.

(3) CATATONIC TYPE

A type of schizophrenia in which the clinical picture is dominated by at least two of the
following:
(1) motoric immobility as evidenced by catalepsy (including waxy flexibility) or stupor
(2) excessive motor activity (that is apparently purposeless and not influenced by external
stimuli)
 Principles and Techniques of Counselling-7 106

(3) extreme negativism (an apparently motiveless resistance to all instructions or maintenance
of a rigid posture against attempts to be moved) or mutism
(4) peculiarities of voluntary movement as evidenced by posturing (voluntary assumption of
inappropriate or bizarre postures) stereotyped movements, prominent mannerisms, or
prominent grimacing
(5) echolalia or echopraxia.

4. OTHER PSYCHOTIC DISORDERS113

1) SCHIZOPHRENIFORM DISORDER

A. Criterion A, D, and E of schizophrenia are met.

B. An episode of the disorder (including prodromal, active, and residual phases) lasts at least 1
month but less than 6 months. (When the diagnosis must be made without waiting for recovery,
it should be qualified as ‘provisional.’)
Specify if:
Without Good Prognostic Features
With Good Prognostic Features: as evidenced by two (or more) of the following:
(1) onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in
usual behaviour or functioning
(2) confusion or perplexity at the height of the psychotic episode
(3) good premorbid social and occupational functioning
(4) absence of blunted or flat affect

2) SCHIZOAFFECTIVE DISORDER

A. An uninterrupted period of illness during which, at some time, there is either a Major
Depressive Episode, a Manic Episode, or a Mixed Episode concurrent with symptoms that meet
Criterion A for Schizophrenia.
Note: The Major Depressive Episode must include Criterion A1: depressed mood.
B. During the same period of illness, there have been delusions or hallucinations for at least 2
weeks in the absence of prominent mood symptoms.
C. Symptoms that meet criteria for a mood episode are present for a substantial portion of the total
duration of the active and residual periods of the illness.

3) DELUSIONAL DISORDER

A. Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed,
poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of
at least 1 month’s duration.
B. Criterion A for Schizophrenia has never been met. Note: Tactile and olfactory hallucinations
may be present in delusional disorder if they are related to the delusional theme.
C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly
impaired and behaviour is not obviously odd or bizarre.
D. If mood episodes have occurred concurrently with delusions, their total duration has been brief
relative to the duration of the delusional periods.
Specify type (the following types are assigned based on the predominant delusional theme):
1. Erotomanic Type: delusions that another person, usually of higher status, is in love
with the individual
2. Grandiose Type: delusions of inflated worth, power, knowledge, identity or special
relationship to a deity or famous person
 Principles and Techniques of Counselling-7 107

3. Jealous Type: delusions that the individual’s sexual partner is unfaithful

4. Persecutory Type: delusions that the person (or someone to whom the person is close)
is being malevolently treated in some way
5. Somatic Type: delusions that the person has some physical defect or general medical
condition
6. Mixed Type: delusions characteristic of more than one of the above types but no one
theme predominates

4) BRIEF PSYCHOTIC DISORDER

A. Presence of one (or more) of the following symptoms:

(1) delusions
(2) hallucinations
(3) disorganized speech (e.g., frequent derailment or incoherence)
(4) grossly disorganized or catatonic behaviour
Note: Do not include a symptoms if it is a culturally sanctioned response pattern. For example, in some
religious ceremonies, an individual may report hearing voices, but these do not generally persist and are
not perceived as abnormal by most members of the person’s community.
B. Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual
full return to premorbid level of functioning.

5) SHARED PSYCHOTIC DISORDER

A. A delusion develops in an individual in the context of a close relationship with another

person(s), who has an already-established delusion.
B. The delusion is similar in content to that of the person who already has the established
delusion.

6) PSYCHOTIC DISORDER DUE A GENERAL MEDICAL CONDITION

A. Prominent hallucinations or delusions.
B. There is evidence from the history, physical examination, or laboratory findings that the
disturbance is the direct physiological consequence of a general medical condition.
C. The disturbance is not better accounted for by another mental disorder.
D. The disturbance does not occur exclusively during the course of a delirium.
Specifiers:
With Delusions: if delusions are the predominant symptom
With Hallucinations: if hallucinations are the predominant symptom

7) SUBSTANCE-INDUCED PSYCHOTIC DISORDER

A. Prominent hallucinations or delusions. Note: Do not include hallucinations if the person has
insight that they are substance induced.
B. There is evidence from the history, physical examination, or laboratory findings of either (1)
or (2):
(1) the symptoms in Criterion A developed during, or within a month of, Substance
Intoxication or Withdrawal
(2) medication use is etiologically related to the disturbance

5. MOOD DISORDERS114
 Principles and Techniques of Counselling-7 108

Mood is a enduring emotional orientation that colours one’s psychology. We make a distinction
between mood episodes and mood disorders. Since mood episodes form part of mood disorders, we
separately study mood episodes first. Otherwise our aim is to understand mood disorders, for which, of
course, we need the definition of mood episodes.

The part that deals with mood disorders has the following plan: 1. First we treat Mood
Episodes (Major Depressive Episode, Manic Episode, Mixed Episode, and Hypomanic Episode). They
actually are not separate entities of illnesses but rather they serve as building blocks for defining Mood
Disorders. 2. Secondly we learn about Mood Disorders proper. They include Depressive Disorders
(Major depressive Disorder, Dysthymic Disorder), and Bipolar Disorders. To define these Mood
Disorders we need the presence or absence of the Mood Episodes described in the first step. (Here I
leave out Mood Disorder due to a General Medical Condition and Substance-Induced Mood Disorder.)

To put this division differently: Mood Disorders are divided into Unipolar Disorders (which
includes Depression, and not ever having had Manic, Mixed, or Hypomanic Episodes) and Bipolar
Disorders (which involve the presence or history of Manic, Mixed, or hypomanic episodes usually
accompanied by Major Depressive Episodes). Thus Unipolar is restricted to Depressive Episodes
alone whereas Bipolar has both Manic Episodes and Depressive Episodes.

Bipolar can be subdivided into Bipolar I (characterized by the occurrence of one or more
Manic Episodes or Mixed Episodes and often with the experience of one or more Major Depressive
Episodes) and Bipolar II (characterized by the occurrence of one or more Major Depressive Episodes
accompanied by at least one Hypomanic Episode but never with Manic Episodes or Mixed Episodes).
These amount to say that:

Bipolar I and Bipolar II have both Manic Episodes and Depressive Episodes. Bipolar I has
Manic Episodes or Mixed Episodes as its main feature and Depressive Episodes as the secondary
features whereas Bipolar II has Depressive Episodes as its main feature and Hypomanic Episodes
(only) as its secondary feature without Manic or Mixed Episodes.

Let us see this division in a table.

Mood Disorders
Unipolar Bipolar
(Depression) (Mania and Depression)
Major Depressive Disorders and Bipolar I Bipolar II
Dysthymic Disorders
Mania as main feature Depression as main feature
Depression as secondary feature Mania as secondary feature
Cyclothymic Disorder
A chronic, fluctuating mood disturbance with numerous periods of
hypomanic symptoms not sufficient for a Manic Episode and
numerous periods of depressive symptoms not sufficient for
Depressive Episode.

1) MOOD EPISODES

(1) MAJOR DEPRESSIVE EPISODE

 Principles and Techniques of Counselling-7 109

A. Five (or more) of the following symptoms have been present during the same 2-week period
and represent a change from previous functioning; at least one of the symptoms is either (1)
depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-
incongruent delusions or hallucinations.
(1) Depressed mood most of the day, nearly every day, as indicated by either subjective
report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
Note: In children and adolescents, can be irritable mood.
(2) Markedly diminished interest or pleasure in all, or almost all, activities most of the
day, nearly every day (as indicated by either subjective account or observation made
by others)
(3) Significant weight loss when not dieting or weight gain (e.g., a change of more than
5% of body weight in a month), or decrease or increase in appetite nearly every day.
Note: In children, consider failure to make expected weight gains.
(4) Insomnia or hypersomnia nearly every day
(5) Psychomotor agitation or retardation nearly every day (observable by others, not
merely subjective feelings of restlessness or being slowed down)
(6) Fatigue or less of energy nearly every day
(7) Feelings of worthlessness or excessive or inappropriate guilt (which may be
delusional) nearly every day (not merely self-reproach or guilt about being sick)
(8) Diminished ability to think or concentrate, or indecisiveness, nearly every day
(either by subjective account or as observed by others)
(9) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
without a specific plan, or a suicide attempt or a specific plan for committing suicide
B. The symptoms do not meet criteria for a Mixed Episode

(2) MANIC EPISODE

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood,

lasting at least 1 week (or any duration if hospitalisation is necessary).
B. During the period of mood disturbance, three (or more) of the following symptoms have
persisted (four if the mood is only irritable) and have been present to a significant degree:
(1) inflated self-esteem or grandiosity
(2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
(3) more talkative than usual or pressure to keep talking
(4) flight of ideas or subjective experience that thoughts are racing
(5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external
stimuli)
(6) increase in goal-directed activity (either socially, at work or school, or sexually) or
psychomotor agitation
(7) excessive involvement in pleasurable activities that have a high potential for painful
consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or
foolish business investments)
C. The symptoms do not meet criteria for a Mixed Episode.
D. The mood disturbance is sufficiently severe to cause marked impairment in occupational
functioning or in usual social activities or relationships with others, or to necessitate
hospitalisation to prevent harm to self or others, or there are psychotic features.

(3) MIXED EPISODE

A. The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for
duration) nearly every day during at least a 1-week period.
 Principles and Techniques of Counselling-7 110

B. The mood disturbance is sufficiently severe to cause marked impairment in occupational

functioning or in usual social activities or relationships with others, or to necessitate
hospitalisation to prevent harm to self or others, or there are psychotic features.

(3) HYPOMANIC EPISODE

A. Criterion B for Manic Episode is met.

B. The episode is associated with an unequivocal change in functioning that is uncharacteristic of
the person when not symptomatic.
C. The disturbance in mood and the change in functioning are observable by others.
D. The episode is not severe enough to cause marked impairment in social or occupational
functioning, or to necessitate hospitalisation, and there are no psychotic features.

2) MOOD DISORDERS PROPER

A. DEPRESSIVE DISORDERS115

(1) MAJOR DEPRESSIVE DISORDER, SINGLE EPISODE

A. Presence of a single Major Depressive Episode.

B. The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is
not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or
Psychotic Disorder Not Otherwise specified.
C. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This
exclusion does not apply if all of the manic-like, mixed-like, or hypomanic-like episodes are
substance or treatment induced or are due to the direct physiological effects of a general
medical condition.

(2) MAJOR DEPRESSIVE DISORDER, RECURRENT

Presence of two or more Major Depressive Episodes.

Note: To be considered separate episodes, there must be an interval of at least 2 consecutive
months in which criteria are not met for a Major Depressive Episode.

(3) DYSTHYMIC DISORDER

A. Depressed mood for most of the day, for more days than not, as indicated either by subjective
account or observation by others, for at least 2 years. Note: In children and adolescents, mood
can be irritable and duration must be at least 1 year.
B. Presence, while depressed, of two (or more) of the following:
(1) Poor appetite or overeating
(2) insomnia or hypersomnia
(3) low energy or fatigue
(4) low self-esteem
(5) poor concentration or difficulty making decisions
(6) feelings of hopelessness
C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has
never been without the symptoms in Criteria A and B for more than 2 months at a time.
D. No Major depressive episode has been present during the first 2 years of the disturbance (1
year for children and adolescents); i.e., the disturbance is not better accounted for by chronic
Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission.
 Principles and Techniques of Counselling-7 111

Note: There may have been a previous major Depressive Episode provided there was a full
remission (no significant signs or symptoms for 2 months) before development of the
Dysthymic Disorder. In addition, there may be superimposed episodes of Major Depressive
Disorder, in which case both diagnoses may be given when the criteria are met for a Major
Depressive Episode.
E. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria
have never been met for Cyclothymic Disorder.
F. The symptoms cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning.

B. BIPOLAR DISORDERS116

(1) BIPOLAR I DISORDER, SINGLE MANIC EPISODE

Presence of only one manic Episode and no past Major Depressive Episodes.
Note: Recurrence is defined as either a change in polarity from depression or an interval of at
least 2 months without manic symptoms.

(2) BIPOLAR I DISORDER, MOST RECENT EPISODE HYPOMANIC

A. Currently (or most recently) in a Hypomanic Episode.

B. There has previously been at least one Manic Episode or Mixed Episode.
C. The mood symptoms cause clinically significant distress or impairment in social, occupational,
or other important areas of functioning.

(3) BIPOLAR I DISORDER, MOST RECENT EPISODE MANIC

A. Currently (or most recently) in a Manic Episode.

B. There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed
Episode.

(4) BIPOLAR I DISORDER, MOST RECENT EPISODE MIXED

A. Currently (or most recently) in a Mixed Episode.

B. There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed
Episode.

(5) BIPOLAR I DISORDER, MOST RECENT EPISODE DEPRESSED

A. Currently (or most recently) in a Major Depressive Episode.

B. There has previously been at least one Manic Episode or Mixed Episode.

(6) BIPOLAR I DISORDER, MOST RECENT EPISODE UNSPECIFIED

A. Criteria, except for duration, are currently (or most recently) met for a Manic, a Hypomanic, a
Mixed, or a Major Depressive Episode.
B. There has previously been at least one Manic Episode or Mixed Episode.

(7) BIPOLAR II DISORDER (Recurrent Major Depressive Episodes with Hypomanic

Episodes)
 Principles and Techniques of Counselling-7 112

A. Presence (or history) of one or more Major Depressive Episodes.

B. Presence (or history) of at least one Hypomanic Episode.
C. There has never been a manic Episode or a Mixed Episode.

C. CYCLOTHYMIC DISORDER

A. For at least 2 years, the presence of numerous periods with hypomanic symptoms and
numerous periods with depressive symptoms that do not meet criteria for a Major
Depressive Episode. Note: In children and adolescents, the duration must be at least 1 year.
B. During the above 2-year period (1 year in children and adolescents), the person has not
been without the symptoms in Criterion A for more than 2 months at a time.
C. No Major Depressive Episode, Manic Episode, or Mixed Episode has been present during
the first 2 years of the disturbance.
Note: After the initial 2 years (1 year in children and adolescents) of Cyclothymic Disorder,
there may be superimposed Manic or Mixed Episodes (in which case both Bipolar I
Disorder and Cyclothymic Disorder may be diagnosed) or Major Depressive Episodes (in
which case both Bipolar II disorder and Cyclothymic Disorder may be diagnosed).

6. ANXIETY DISORDERS

When anxiety is appropriate to the circumstance, it is considered normal. When it is not

related to the realistic circumstances and become a frequent or repeated response, then it is
pathological. Anxiety disorders are the most common of all psychiatric illnesses and result in
considerable functional impairment and distress. Sometimes it is difficult to separate anxiety from
depression.

Tracing the history of anxiety disorders, we find that the ‘anxiety neurosis’ of Freud (1895)
was divided into ‘panic disorder’ and ‘generalized anxiety disorder.’ Again DSM-IV divided panic
disorder into panic disorder with and panic disorder without agoraphobia, depending on whether
there is any secondary phobic avoidance.

Panic attacks are known to occur not only in panic disorder but in other anxiety disorders as
well.

Agoraphobia can occur in the context of Panic Disorder With Agoraphobia and Agoraphobia
Without History of Panic Disorder. We consider Panic Attack and Agoraphobia first since they are
part of Panic Disorder.

1) PANIC DISORDER117

(1) PANIC ATTACK

Note: A Panic Attack is not a codable disorder. Code the specific diagnosis in which the
Panic Attack occurs.
A discrete period of intense fear or discomfort, in which four (or more) of the following
symptoms developed abruptly and reached a peak within 10 minutes:
1. palpitations, pounding heart, or accelerated heart rate
2. sweating
 Principles and Techniques of Counselling-7 113

3. trembling or shaking
4. sensations of shortness of breath or smothering
5. feeling of choking
6. chest pain or discomfort
7. nausea or abdominal distress
8. feeling dizzy, unsteady, light-headed, or faint
9. derealisation (feelings of unreality) or depersonalisation (being detached from oneself)
10. fear of losing control or going crazy
11. fear of dying
12. paresthesias (numbness or tingling sensations)
13. chills or hot flushes

(2) AGORAPHOBIA

Note: Agoraphobia is not a codable disorder. Code the specific disorder in which the Agoraphobia
occurs.
A. Anxiety about being in places or situations from which escape might be difficult (or
embarrassing) or in which help may not be available in the event of having an unexpected or
situationally predisposed Panic Attack or panic-like symptoms. Agoraphobic fears typically
involve characteristic clusters of situations that include being outside the home alone; being in
a crowd or standing in a line; being on a bridge; and travelling in a bus, train, or automobile.
Note: Consider the diagnosis of Specific Phobia if the avoidance is limited to one or only a few specific
situations, or Social Phobia if the avoidance is limited to social situations.
B. The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or
with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a
companion.

(3) PANIC DISORDER PROPER

a. PANIC DISORDER WITHOUT AGORAPHOBIA

A. Both (1) and (2)

(1) recurrent unexpected Panic Attacks
(2) at least one of the attacks has been followed by 1 month (or more) of one (or more)
of the following:
(a) persistent concern about having additional attacks
(b) worry about the implications of the attack or its consequences (e.g., losing
control, having a heart attack, ‘going crazy’)
(c) a significant change in behaviour related to the attacks
B. Absence of Agoraphobia

b. PANIC DISORDER WITH AGORAPHOBIA

A. Criterion A for Panic Disorder without Agoraphobia is met.

B. The presence of Agoraphobia.

(4) AGORAPHOBIA WITHOUT HISTORY OF PANIC DISORDER

A. The presence of Agoraphobia related to fear of developing panic-like symptoms (e.g.,

dizziness or diarrhoea).
 Principles and Techniques of Counselling-7 114

B. Criteria have never been met for Panic Disorder.

(5) SPECIFIC PHOBIA (FORMERLY SIMPLE PHOBIA)

A. Marked and persistent fear that is excessive or unreasonable, cued by the presence or
anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an
injection, seeing blood).
B. Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response,
which may take the form of a situationally bound or situationally predisposed Panic Attack.
Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.
(Fears are very common, particularly in childhood, but they do not warrant a diagnosis of
specific phobia unless there is significant interference with social, educational, or
occupational functioning or marked distress about having the phobia).
C. The person recognizes that the fear is excessive or unreasonable. Note: In children, this
feature may be absent.
D. The phobic situation(s) is avoided or else is endured with intense anxiety or distress.
E. The avoidance, anxious anticipation, or distress in the feared situation(s) interferes
significantly with the person’s normal routine, occupational (or academic) functioning, or
social activities or relationships, or there is marked distress about having the phobia.
F. In individuals under age 18 years, the duration is at least 6 months.

Animal Type: This subtype should be specified if the fear is cued by animals or insects. This
subtype generally has a childhood onset.

Natural Environment Type: This subtype should be specified if the fear is cued by objects in
the natural environment, such as storms, heights, or water. This subtype generally has a childhood
onset.

Blood-Injection-Injury Type: This subtype should be specified if the fear is cued by seeing
blood or an injury or by receiving an injection or other invasive medical procedure. This subtype is
highly familial and is often characterized by a strong vasovagal response.

Situational Type: This subtype should be specified if the fear is cued by a specific situation
such as public transportation, tunnels, bridges, elevators, flying, driving, or enclosed places. This
subtype has a bimodal age-at-onset distribution, with one peak in childhood and another peak in the
mid-20s. This subtype appears to be similar to Panic Disorder With Agoraphobia in its characteristic
sex ratios, familial aggregation pattern, and age at onset.

Other Type: This subtype should be specified if the fear is cued by other stimuli. These stimuli
might include the fear or avoidance of situations that might lead to choking, vomiting, or contracting an
illness; ‘space’ phobia (i.e., the individual is afraid of falling down if away from walls or other means of
physical support); and children’s fear of loud sounds or costumed characters.

(6) SOCIAL PHOBIA (SOCIAL ANXIETY DISORDER)

A. A marked and persistent fear of one or more social or performance situations in which the
person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears
that he or she will act in a way (or show anxiety symptoms) that will be humiliating or
embarrassing. Note: In children, there must be evidence of the capacity for age-appropriate
social relationships with familiar people and the anxiety must occur in peer settings, not just in
interactions with adults.
 Principles and Techniques of Counselling-7 115

B. Exposure to the feared social situation almost invariably provokes anxiety, which may take the
form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the
anxiety may be expressed by crying, tantrum, freezing, or shrinking from social situations with
unfamiliar people.
C. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature
may be absent.
D. The feared social or performance situations are avoided or else are endured with intense anxiety
or distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s)
interferes significantly with the person’s normal routine, occupational (academic) functioning,
or social activities or relationships, or there is marked distress about having the phobia.
F. In individuals under age 18 years, the duration is at least 6 months.

2) OBSESSIVE-COMPULSIVE DISORDER118

One might wonder why Obsessive-Compulsive Disorder (OCD) is classified among the Anxiety
Disorders. It is done because 1. anxiety is often associated with obsessions and resistance to
compulsions, 2. anxiety or tensions is often immediately relieved by yielding to compulsions, and 3.
OCD often occurs in association with other Anxiety Disorders. However the nature of anxiety in OCD
is distinct from that in other Anxiety Disorders.

OBSESSIVE-COMPULSIVE DISORDER

A. Either obsessions or compulsions:

Obsessions as defined by (1), (2), (3), and (4):
(1) recurrent and persistent thoughts, impulses, or images that are experienced, at some
time during the disturbance, as intrusive and inappropriate and that cause marked
anxiety or distress
(2) the thoughts, impulses, or images are not simply excessive worries about real-life
problems
(3) the person attempts to ignore or suppress such thoughts, impulses, or images, or to
neutralize them with some other thought or action
(4) the person recognizes that the obsessional thoughts, impulses, or images are a
product of his or her own mind (not imposed from without as in thought insertion)
Compulsion as defined by (1) and (2)
(1) repetitive behaviours (e.g., hand washing, ordering, checking) or mental acts (e.g.,
praying, counting, repeating words silently) that the person feels driven to perform
in response to an obsession, or according to rules that must be applied rigidly
(2) the behaviours or mental acts are aimed at preventing or reducing distress or
preventing some dreaded event or situation; however, these behaviours or mental
acts either are not connected in a realistic way with what they are designed to
neutralize or prevent or are clearly excessive
B. At some point during the course of the disorder, the person has recognized that the obsessions
or compulsions are excessive or unreasonable. Note: This does not apply to children.
C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1
hour a day), or significantly interfere with the person’s normal routine, occupational (or
academic) functioning, or usual social activities or relationships.

3) POSTTRAUMATIC STRESS DISORDER (PTD)119

A. The person has been exposed to a traumatic event in which both of the following were present:
 Principles and Techniques of Counselling-7 116

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or
threatened death or serious injury, or a threat to the physical integrity of self or others
(2) the person’s response involved intense fear, helplessness, or horror. Note: In children, this may be
expressed instead by disorganized or agitated behaviour
B. The traumatic event is persistently reexperienced in one (or more) of the following ways:
(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or
perceptions. Note: In young children, repetitive play may occur in which themes or aspects
of the trauma are expressed.
(2) Recurrent distressing dreams of the event. Note: In children, there may be frightening
dreams without recognizable content.
(3) Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the
experience, illusions, hallucinations, and dissociative flashback episodes, including those
that occur on awakening or when intoxicated). In young children trauma-specific
reenactment may occur.
(4) Intense psychological distress at exposure to internal or external cues that symbolize or
resemble an aspect of the traumatic event.
(5) Physiological reactivity on exposure to internal or external cues that symbolize or resemble
an aspect of the traumatic event.
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness
(not present before the trauma), as indicated by three (or more) of the following:
(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to have loving feelings)
(7) sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a
normal life span)
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or
more) of the following:
(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response
E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other
important areas of functioning.
Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more
Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

4) ACUTE STRESS DISORDER120

A. The person has been exposed to a traumatic event in which both of the following were present:
(1) the person experienced, witnessed, or was confronted with an event or events that involved
actual or threatened death or serious injury, or a threat to the physical integrity of self or
others
(2) the person’s response involved intense fear, helplessness, or horror
 Principles and Techniques of Counselling-7 117

B. Either while experiencing or after experiencing the distressing event, the individual has three (or
more) of the following dissociative symptoms:
(1) a subjective sense of numbing, detachment, or absence of emotional responsiveness
(2) reduction in awareness of his or her surroundings (e.g., ‘being in a daze’)
(3) derealisation
(4) depersonalisation
(5) dissociative amnesia (i.e., inability to recall an important aspect of the trauma)
C. The traumatic event is persistently reexperienced in at least one of the following ways: recurrent
images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or
distress on exposure to reminders of the traumatic event.
D. Marked avoidance of stimuli that arouse recollections of the trauma (e.g., thoughts, feelings,
conversations, activities, places, people).
E. Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor
concentration, hypervigilance, exaggerated startle response, motor restlessness).
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other
important areas of functioning or impairs the individual’s ability to pursue some necessary task,
such as obtaining necessary assistance or mobilizing personal resources by telling family
members about the traumatic experience.
G. The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4
weeks of the traumatic event.

5) GENERALIZED ANXIETY DISORDER

Generalized anxiety disorder (GAD) is the main diagnostic category for prominent and chronic
anxiety in the absence of panic disorder. The essential feature of this syndrome is persistent anxiety
lasting at least 6 months. The symptoms of this type of anxiety fall within two broad categories:
apprehensive expectation and physical symptoms.

Patients with GAD are constantly worried over trivial matters, fearful, and anticipating the
worst. Muscle tension, restlessness, feeling keyed up (hypervigilance), difficulty concentrating,
insomnia, irritability, and fatigue are symptoms for GAD. Motor tension and hypervigilance better
differentiate GAD from anxiety states than does autonomic hyperactivity.

7. DISSOCIATIVE DISORDER121

1) DISSOCIATIVE AMNESIA

A. The predominant disturbance is one or more episodes of inability to recall important personal
information, usually of a traumatic or stressful nature, that is too extensive to be explained by
ordinary forgetfulness.
B. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder,
Dissociative Fugue, Posttraumatic Stress Disorder, Acute Stress Disorder, or Somatisation
Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse,
a medication) or a neurological or other general medical condition (e.g., Amnesic Disorder
Due to Head Trauma).

2) DISSOCIATIVE FUGUE

A. The predominant disturbance is sudden, unexpected travel away from home or one’s customary
place of work, with inability to recall one’s past.
B. Confusion about personal identity or assumption of a new identity (partial or complete).
 Principles and Techniques of Counselling-7 118

3) DISSOCIATIVE IDENTITY DISORDER

A. The presence of two or more distinct identities or personality states (each with its own
relatively enduring pattern of perceiving, relating to, and thinking about the environment and
self).
B. At least two of these identities or personality states recurrently take control of the person’s
behaviour.
C. Inability to recall important personal information that is too extensive to be explained by
ordinary forgetfulness.

4) DEPERSONALISATION DISORDER

A. Persistent or recurrent experiences of feeling detached from, and as if one is an outside

observer of, one’s mental processes or body (e.g., feeling like one is in a dream).
B. During the depersonalisation experience, reality testing remains intact.

5) DISSOCIATIVE TRANCE DISORDER (RESEARCH CRITERIA)

A. Either (1) or (2):

(1) Trance, i.e., temporary marked alteration in the state of consciousness or loss of
customary sense of personal identity without replacement by an alternate identity,
associated with at least one of the following:
(a) narrowing of awareness of immediate surroundings, or unusually
narrow and selective focusing on environmental stimuli
(b) stereotyped behaviours or movements that are experienced as being
beyond one’s control
(2) possession trance, a single or episodic alteration in the state of consciousness
characterized by the replacement of customary sense of personal identity by a new
identity. This is attributed to the influence of a spirit, power, deity, or other person,
as evidenced by one (or more) of the following:
(a) stereotyped and culturally determined behaviours or movements that are
experienced as being controlled by the possessing agent
(b) full or partial amnesia for the event
B. The trance or possession trance state is not accepted as a normal part of a collective cultural or
religious practice.

(This dissociative trance disorder should not be considered in individuals who enter trance or
possession states voluntarily and without distress or impairment in the context of cultural and religious
practices.)

8. IMPULSE CONTROL DISORDERS122

1) THE COMMON FEATURES OF ALL IMPULSE DISORDERS

1. Failure to resist an impulse, drive, or temptation to perform some act that is harmful to the
person or others
2. An increasing sense of tension or arousal before committing the act
3. A sense of pleasure, gratification, or release at the time of committing the act, or shortly
thereafter
 Principles and Techniques of Counselling-7 119

2) INTERMITTENT EXPLOSIVE DISORDER

A. Several discrete episodes of failure to resist aggressive impulses that result in serious
assaultive acts or destruction of property.
B. The degree of aggressiveness expressed during the episodes is grossly out of proportion to
any precipitating psychological stressors.

3) KLEPTOMANIA

A. Recurrent failure to resist impulses to steal objects that are not needed for personal use or for
their monetary value.
B. Increasing sense of tension immediately before committing the theft.
C. Pleasure, gratification, or relief at the time of committing the theft.
D. The stealing is not committed to express anger or vengeance and is not in response to a
delusion or a hallucination.

4) PYROMANIA

A. Deliberate and purposeful fire setting on more than one occasion.

B. Tension or affective arousal before the act.
C. Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts
(e.g., paraphernalia, uses, consequences).
D. Pleasure, gratification, or relief when setting fires, or when witnessing or participating in their
aftermath.
E. The fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to
conceal criminal activity, to express anger or vengeance, to improve one’s living
circumstances, in response to a delusion or hallucination, or as a result of impaired judgment
(e.g., in dementia, Mental Retardation, Substance Intoxication).

5) PATHOLOGICAL GAMBLING

`Persistent and recurrent maladaptive gambling behaviour as indicated by five (or more) of the
following:
(1) is preoccupied with gambling (e.g., preoccupied with reliving past gambling
experiences, handicapping or planning the next venture, or thinking of ways to get
money with which to gamble)
(2) needs to gamble with increasing amounts of money in order to achieve the desired
excitement
(3) has repeated unsuccessful efforts to control, cut back, or stop gambling
(4) is restless or irritable when attempting to cut down or stop gambling
(5) gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g.,
feelings of helplessness, guilt, anxiety, depression)
(6) after losing money gambling, often returns another day to get even (‘chasing’ one’s
loses)
(7) lies to family members, therapist, or others to conceal the extent of involvement with
gambling
(8) has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance
gambling
 Principles and Techniques of Counselling-7 120

(9) has jeopardized or lost a significant relationship, job, or educational or career

opportunity because of gambling
(10) relies on others to provide money to relieve a desperate financial situation caused by
gambling

6) TRICHOTILLOMANIA

A. Recurrent pulling out of one’s hair resulting in noticeable hair loss.

B. An increasing sense of tension immediately before pulling out the hair or when attempting to
resist the behaviour.
C. Pleasure, gratification, or relief when pulling out the hair.

9. SOMATOFORM DISORDERS123

1) SOMATIZATION DISORDER

A. A history of many physical complaints beginning before age 30 years that occur over a period
of several years and result in treatment being sought or significant impairment in social,
occupational, or other important areas of functioning.
B. Each of the following criteria must have been met, with individual symptoms occurring at any
time during the course of the disturbance:
(1) four pain symptoms: a history of pain related to at least four different sites or
functions (e.g., head, abdomen, back, joints extremities, chest, rectum, during
menstruation, during sexual intercourse, or during urination)
(2) two gastrointestinal symptoms: a history of at least two gastrointestinal symptoms
other than pain (e.g., nausea, bloating, vomiting other than during pregnancy,
diarrhoea, or intolerance of several different foods)
(3) one sexual symptom: a history of at least one sexual or reproductive symptoms other
than pain (e.g., sexual indifference, erectile or ejaculatory dysfunction, irregular
menses, excessive menstrual bleeding, vomiting throughout pregnancy)
(4) one pseudoneurological symptom: a history of at least one symptom or deficit
suggesting a neurological condition not limited to pain (conversion symptoms such
as impaired coordination or balance, paralysis or localized weakness, difficulty
swallowing or lump in throat, aphonia, urinary retention, hallucinations, loss of
touch or pain sensation, double vision, blindness, deafness, seizures; dissociative
symptoms such as amnesia; or loss of consciousness other than fainting)
C. Either (1) or (2):
(1) after appropriate investigation, each of the symptoms in Criteria B cannot be fully
explained by a known general medical condition or the direct effects of a substance
(e.g., a drug of abuse, a medication)
(2) when there is a related general medical condition, the physical complaints or
resulting social or occupational impairment are in excess of what would be expected
from the history, physical examination, or laboratory findings
D. The symptoms are not intentionally produced or feigned (as in Factitious Disorder or
Malingering).

2) UNDIFFERENTIATED SOMATOFORM DISORDER

A. One or more physical complaints (e.g., fatigue, loss of appetite, gastrointestinal or urinary
complaints).
B. Either (1) or (2):
 Principles and Techniques of Counselling-7 121

(1) after appropriate investigation, the symptoms cannot be fully explained by a known
general medical condition or the direct effects of a substance (e.g., a drug of abuse, a
medication)
(2) when there is a related general medical condition, the physical complaints or
resulting social or occupational impairment is in excess of what would be expected
from the history, physical examination, or laboratory findings
C. The symptoms cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning.
D. The duration of the disturbance is at least 6 months.
E. The symptom is not intentionally produced or feigned (as in Factitious Disorder or
Malingering).

3) CONVERSION DISORDER
A. One or more symptoms or deficits affecting voluntary motor or sensory function that suggest a
neurological or other general medical condition.
B. Psychological factors are judged to be associated with the symptom or deficit because the
initiation or exacerbation of the symptom or deficit is preceded by conflicts or other stressors.
C. The symptom or deficit is not intentionally produced or feigned (as in Factitious Disorder or
Malingering).
D. The symptom or deficit cannot, after appropriate investigation, be fully explained by a general
medical condition, or by the direct effects of a substance, or as a culturally sanctioned
behaviour or experience.
E. The symptom or deficit causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning or warrants medical evaluation.

4) PAIN DISORDER

A. Pain in one or more anatomical sites is the predominant focus of the clinical presentation and is
of sufficient severity to warrant clinical attention.
B. The pain causes clinically significant distress or impairment in social, occupational, or other
important areas of functioning.
C. Psychological factors are judged to have an important role in the onset, severity, exacerbation,
or maintenance of the pain.
D. The symptom or deficit is not intentionally produced or feigned (as in Factitious Disorder or
Malingering).

5) HYPOCHONDRIASIS

A. Preoccupation with fears of having, or the idea that one has, a serious disease based on the
person’s misinterpretation of bodily symptoms.
B. The preoccupation persists despite appropriate medical evaluation and reassurance.
C. The belief in Criterion A is not of delusional intensity (as in Delusional Disorder, Somatic
Type) and is not restricted to a circumscribed concern about appearance (as in Body
Dysmorphic Disorder).
D. The preoccupation causes clinically significant distress or impairment in social, occupational,
or other important areas of functioning.
E. The duration of the disturbance is at least 6 months.

6) BODY DYSMORPHIC DISORDER

 Principles and Techniques of Counselling-7 122

Preoccupation with an imagined defect in appearance. If a slight physical anomaly is

present, the person’s concern is markedly excessive.

10. SLEEP DISORDERS

Sleep Disorders can be organized into four major sections according to the presumed aetiology.
They are 1. Primary Sleep Disorders which arise from endogenous abnormalities in sleep-wake
generating or timing mechanisms, often complicated by conditioning factors with its subdivisions as a.
Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep and b.
Parasomnias (characterized by abnormal behavioural or physiological events occurring in association
with sleep, specific sleep stages, or sleep-wake transitions). 2. Sleep Disorder Related to Another
Mental Disorder. 3. Sleep Disorder Due to a general Medical Condition. 4. Substance-Induced Sleep
Disorder. However, in this book we shall consider only the first one — Primary Sleep Disorders.

PRIMARY SLEEP DISORDERS

A. DYSSOMNIAS124

1) PRIMARY INSOMNIA

The predominant complaint is difficulty initiating or maintaining sleep, or nonrestorative sleep,

for at least 1 month.

2) PRIMARY HYPERSOMNIA

The predominant complaint is excessive sleepiness for at least 1 month (or less if recurrent) as
evidenced by either prolonged sleep episodes or daytime sleep episodes that occur almost daily.

3) NARCOLEPSY

A. Irresistible attacks of refreshing sleep that occur daily over at least 3 months
B. The presence of one or both of the following:
(1) cataplexy (i.e., brief episodes of sudden bilateral loss of muscle tone, most often in
association with intense emotion)
(2) recurrent intrusions of elements of rapid eye movement (REM) sleep into the
transition between sleep and wakefulness, as manifested by either hypnopompic or
hypnagogic hallucinations or sleep paralysis at the beginning or end of sleep
episodes

4) BREATHING-RELATED SLEEP DISORDER

Sleep disruption, leading to excessive sleepiness or insomnia, that is judged to be due to a sleep-
related breathing condition (e.g., obstructive or central sleep apnea syndrome or central alveolar
hypoventilation syndrome).

5) CIRCADIAN RHYTHM SLEEP DISORDER

A persistent or recurrent pattern of sleep disruption leading to excessive sleepiness or insomnia

that is due to a mismatch between the sleep-wake schedule required by a person’s environment and his
or her circadian sleep-wake pattern.
 Principles and Techniques of Counselling-7 123

B. PARASOMNIAS125

1) NIGHTMARE DISORDER

A. Repeated awakenings from the major sleep period or naps with detailed recall of extended and
extremely frightening dreams, usually involving threats to survival, security, or self-esteem.
The awakenings generally occur during the second half of the sleep period.
B. On awakening from the frightening dreams, the person rapidly becomes oriented and alert (in
contrast to the confusion and disorientation seen in Sleep Terror Disorder and some forms of
epilepsy).
C. The dream experience, or the sleep disturbance resulting from the awakening, causes clinically
significant distress or impairment in social, occupational, or other important areas of
functioning.

2) SLEEP TERROR DISORDER

A. Recurrent episodes of abrupt awakening from sleep, usually occurring during the first third of
the major sleep episode and beginning with a panicky scream.
B. Intense fear and signs of autonomic arousal, such as tachycardia, rapid breathing, and sweating,
during each episode.
C. Relative unresponsiveness to efforts of others to comfort the person during the episode.
D. No detailed dream is recalled and there is amnesia for the episode.

3) SLEEPWALKING DISORDER

A. Repeated episodes of rising from bed during sleep and walking about, usually occurring during
the first third of the major sleep episode.
B. While sleepwalking, the person has a blank, staring face, is relatively unresponsive to the
efforts of others to communicate with him or her, and can be awakened only with great
difficulty.
C. On awakening (either from the sleepwalking episode or the next morning), the person has
amnesia for the episode.
D. Within several minutes after awakening from the sleepwalking episode, there is no impairment
of mental activity or behaviour (although there may initially be a short period of confusion or
disorientation).

11. SEXUAL AND GENDER IDENTITY DISORDERS

1) SEXUAL DESIRE DISORDERS126

(1) HYPOACTIVE SEXUAL DESIRE DISORDER

Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity.
The judgement of deficiency or absence is made by the clinician, taking into account factors that affect
sexual functioning, such as age and the context of the person’s life.

(2) SEXUAL AVERSION DISORDER

Persistent or recurrent extreme aversion to, and avoidance of, all (or almost all) genital sexual
contact with a sexual partner.
 Principles and Techniques of Counselling-7 124

2) SEXUAL AROUSAL DISORDERS127

(1) FEMALE SEXUAL AROUSAL DISORDER

Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity,
an adequate lubrication-swelling response of sexual excitement.

(2) MALE ERECTILE DISORDER

Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity,
an adequate erection.

3) ORGASMIC DISORDERS128

(1) FEMALE ORGASMIC DISORDER

Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement
phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The
diagnosis of Female Orgasmic Disorder should be based on the clinician’s judgement that the woman’s
orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of
sexual stimulation she receives.

(2) MALE ORGASMIC DISORDER

Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement
phase during sexual activity that the clinician, taking into account the person’s age, judges to be
adequate in focus, intensity, and duration.

(3) PREMATURE EJACULATION

Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after
penetration and before the person wishes it. The clinician must take into account factors that affect
duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent
frequency of sexual activity.

4) SEXUAL PAIN DISORDERS129

(1) DYSPAREUNIA

Recurrent or persistent genital pain associated with sexual intercourse in either a male or a
female.

(2) VAGINISMUS

Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that
interferes with sexual intercourse.

5) PARAPHILIAS130
 Principles and Techniques of Counselling-7 125

(1) EXHIBITIONISM

Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges,
or behaviours involving the exposure of one’s genitals to an unsuspecting stranger.

(2) FETISHISM

Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or
behaviours involving the use of nonliving objects (e.g., female undergarments).

The fetish objects are not limited to articles of female clothing used in cross-dressing (as in
Transvestic Fetishism) or devices designed for the purpose of tactile genital stimulation (e.g., a
vibrator).

(3) FROTTEURISM

Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges,
or behaviours involving touching and rubbing against a nonconsenting person.

(4) PEDOPHILIA

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges,
or behaviours involving sexual activity with a prepubescent child or children (generally age 13
years or younger).
B. The person is at least age 16 years and at least 5 years older than the child or children in
Criterion A.
Note: do not include an individual in late adolescence involved in an ongoing sexual relationship with a
12- or 13-year-old.

(5) SEXUAL MASOCHISM

Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges,
or behaviours involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise
made to suffer.

(6) SEXUAL SADISM

Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges,
or behaviours involving acts (real, not simulated) in which the psychological or physical suffering
(including humiliation) of the victim is sexually exciting to the person.

(7) TRANSVESTIC FETISHISM

Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing
fantasies, sexual urges, or behaviours involving cross-dressing.

(8) VOYEURISM
 Principles and Techniques of Counselling-7 126

Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges,
or behaviours involving the act of observing an unsuspecting person who is naked, in the process of
disrobing, or engaging in sexual activity.

6) GENDER IDENTITY DISORDERS131

A. A strong and persistent cross-gender identification (not merely a desire for any perceived
cultural advantages of being the other sex).
In Children, the disturbance is manifested by four (or more) of the following:
(1) Repeatedly stated desire to be, or insistence that he or she is, the other sex
(2) In boys, preference for cross-dressing or simulating female attire; in girls, insistence
on wearing only stereotypical masculine clothing
(3) Strong and persistent preferences for cross-sex roles in make-believe play or
persistent fantasies of being the other sex
(4) Intense desire to participate in the stereotypical games and pastimes of the other sex
(5) Strong preference for playmates of the other sex
In adolescents and adults, the disturbance is manifested by symptoms such as a stated desire to be the
other sex, frequent passing as the other sex, desire to live or be treated as the other sex, or the conviction
that he or she has the typical feelings and reactions of the other sex.
B. Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that
sex.
In children, the disturbance is manifested by any of the following: in boys, assertion that his penis or
testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion
toward rough-and-tumble play and rejection of male stereotypical toys, games, and activities; in girls,
rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that
she does not want to grow breasts or menstruate, or marked aversion toward normative feminine
clothing.
In adolescents and adults, the disturbance is manifested by symptoms such as preoccupation with
getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other
procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she
was born the wrong sex.
C. The disturbance is not concurrent with a physical intersex condition.

12. EATING DISORDERS132

1) ANOREXIA NERVOSA

A. Refusal to maintain body weight at or above a minimally normal weight for age and height
(e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or
failure to make expected weight gain during period of growth, leading to body weight less than
85% of that expected).
B. Intense fear of gaining weight or becoming fat, even though underweight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of
body weight or shape on self-evaluation, or denial of the seriousness of the current low body
weight.
D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive
menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only
following hormone, e.g., estrogen administration.)
Specify type:
 Principles and Techniques of Counselling-7 127

Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged
in binge-eating or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or
enemas)
Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly
engaged in binge-eating or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives,
diuretics, or enemas)

2) BULIMIA NERVOSA

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the
following:
(1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of
food that is definitely larger than most people would eat during a similar period of
time and under similar circumstances
(2) a sense of lack of control over eating during the episode (e.g., a feeling that one
cannot stop eating or control what or how much one is eating)
B. Recurrent inappropriate compensatory behaviour in order to prevent weight gain, such as self-
induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or
excessive exercise.
C. The binge eating and inappropriate compensatory behaviours both occur, on average, at least
twice a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
Specify type:
Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-
induced vomiting or the misuse of laxatives, diuretics, or enemas
Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other
inappropriate compensatory behaviours, such as fasting or excessive exercise, but has not regularly
engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

13. ADJUSTMENT DISORDERS133

A. The development of emotional or behavioural symptoms in response to an identifiable

stressor(s) occurring within 3 months of the onset of the stressor(s).
B. These symptoms or behaviours are clinically significant as evidenced by either of the
following:
(1) marked distress that is in excess of what would be expected from exposure to the
stressor
(2) significant impairment in social or occupational (academic) functioning
C. The symptoms do not represent Bereavement.
D. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more
than an additional 6 months.
Specify if:
Acute: if the disturbance lasts less than 6 months
Chronic: if the disturbance lasts for 6 months or longer

14. FACTITIOUS DISORDERS134

1) FACTITIOUS DISORDER
 Principles and Techniques of Counselling-7 128

A. Intentional production or feigning of physical or psychological signs or symptoms.

B. The motivation for the behaviour is to assume the sick role.
C. External incentives for the behaviour (such as economic gain, avoiding legal responsibility, or
improving physical well-being, as in Malingering) are absent.

2) FACTITIOUS DISORDER BY PROXY (RESEARCH CRITERIA)

A. Intentional production or feigning of physical or psychological signs or symptoms in another

person who is under the individual’s care.
B. The motivation for the perpetrator’s behaviour is to assume the sick role by proxy.
C. External incentives for the behaviour (such as economic gain) are absent.

15. SUBSTANCE RELATED DISORDERS135

1) SUBSTANCE DEPENDENCE

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as

manifested by three (or more) of the following, occurring at any time in the same 12-month period:

(1) tolerance, as defined by either of the following:

(a) a need for markedly increased amounts of the substance to achieve intoxication or
desired effect
(b) markedly diminished effect with continued use of the same amount of the substance
(2) withdrawal, as manifested by either of the following;
(a) the characteristic withdrawal syndrome for the substance
(b) the same (or a closely related) substance is taken to relieve or avoid withdrawal
symptoms
(3) the substance is often taken in larger amounts or over a longer period than was intended
(4) there is a persistent desire or unsuccessful efforts to cut down or control substance use
(5) a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting
multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or
recover from its effects
(6) important social, occupational, or recreational activities are given up or reduced because of
substance use
(7) the substance use is continued despite knowledge of having a persistent or recurrent physical
or physiological problem that is likely to have been caused or exacerbated by the substance
(e.g., current cocaine use despite recognition of cocaine-induced depression, or continued
drinking despite recognition that an ulcer was made worse by alcohol consumption)

Specify if:

With Physiological Dependence: evidence of tolerance or withdrawal (i.e., either Item 1 or 2 is present)
or Without Physiological Dependence: no evidence of tolerance or withdrawal (i.e., neither Item 1 nor 2
is present)

2) SUBSTANCE ABUSE

A. A maladaptive pattern of substance use leading to clinically significant impairment or distress,

as manifested by one (or more) of the following, occurring within a 12-month period:
 Principles and Techniques of Counselling-7 129

(1) recurrent substance use resulting in a failure to fulfil major role obligations at work,
school, or home (e.g., repeated absences or poor work performance related to
substance use; substance-related absences, suspensions, or expulsions from school;
neglect of children or household)
(2) recurrent substance use in situations in which it is physically hazardous (e.g., driving
an automobile or operating a machine when impaired by substance use)
(3) recurrent substance-related legal problems (e.g., arrests for substance-related
disorderly conduct)
(4) continued substance use despite having persistent or recurrent social or interpersonal
problems caused or exacerbated by the effects of the substance (e.g., arguments with
spouse about consequences of intoxication, physical fights)
B. The symptoms have never met the criteria for Substance Dependence for this class of
substance.

3) SUBSTANCE INTOXICATION

A. The development of a reversible substance-specific syndrome due to recent ingestion of (or

exposure to) a substance. Note: Different substances may produce similar or identical
syndromes.
B. Clinically significant maladaptive behavioural or psychological changes that are due to the
effect of the substance on the central nervous system (e.g., belligerence, mood lability,
cognitive impairment, impaired judgement, impaired social or occupational functioning) and
develop during or shortly after use of the substance.

4) SUBSTANCE WITHDRAWAL

The development of a substance-specific syndrome due to the cessation of (or reduction in)
substance use that has been heavy and prolonged.

5) ALCOHOL INTOXICATION

A. Recent ingestion of alcohol.

B. Clinically significant maladaptive behavioural or psychological changes (e.g., inappropriate
sexual or aggressive behaviour, mood lability, impaired judgement, impaired social or
occupational functioning) that developed during, or shortly after, alcohol ingestion.
C. One (or more) of the following signs, developing during, or shortly after alcohol use:
(1) slurred speech
(2) incoordination
(3) unsteady gait
(4) nystagmus
(5) impairment in attention or memory
(6) stupor or coma.

6) ALCOHOL WITHDRAWAL

A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged.
B. Two (or more) of the following, developing within several hours to a few days after Criterion
A:
(1) autonomic hyperactivity (e.g., sweating or pulse rate greater than 100)
(2) increased hand tremor
 Principles and Techniques of Counselling-7 130

(3) insomnia
(4) nausea or vomiting
(5) transient visual, tactile, or auditory hallucinations or illusions
(6) psychomotor agitation
(7) anxiety
(8) grand mal seizures

16. DELIRIUM, DEMENTIA AND AMNESTIC AND OTHER COGNITIVE DISORDERS

This section includes three disorders namely Delirium, Dementia, and Amnestic Disorders.
The predominant disturbance is a clinically significant deficit in cognition or memory that
represents a significant change from a previous level of functioning. For each disorder in this
section, the aetiology is either a general medical condition (although the specific general medical
condition may not be identifiable) or a substance (i.e., a drug of abuse, medication, or toxin), or a
combination of these factors.

1) DELIRIUM136

The delirium disorders share a common symptom presentation of a disturbance in

consciousness and cognition, but are differentiated based on aetiology and thus we have: Delirium
Due to a General Medical Condition, Substance-induced Delirium (including medication and side
effects), and Delirium Due to Multiple Aetiologies.

Delirium is one of the first mental disorders described in medicine and the most common
psychiatric syndrome found in clinical setting. It is mostly common among elderly people. People
with dementia or brain damage have a lower threshold for developing delirium and with greater
frequency. A variety of physiological insults (e.g., infectious, withdrawal, metabolic, trauma, CNS
pathology, hypoxemia, deficiencies, endocrinopathies, vascular, toxins/drugs and metals) can
produce the delirium syndrome. It can express itself as hypoactive state (i.e., decreased arousal and
psychomotor activity), hyperactive state (i.e., increased arousal and psychomotor activity), or a
mixed form with fluctuations between hypoactive and hyperactive states.

DIAGNOSTIC CRITERIA

Clinical features of delirium are 1. prodrome (restlessness, anxiety, sleep disturbance,

irritability) and rapid onset, 2. rapid fluctuating course, 3. attention decreased (easily distractible), 4.
altered arousal and psychomotor abnormality, 5. Disturbance of sleep-wake cycle, 6. impaired
memory (cannot register new information), 7. disorganized thinking and speech, 8. disorientation
(to time, place but rarely to person), 8. perception altered (misperceptions, illusions, delusions
poorly formed, hallucinations), 9. neurological abnormalities, and 10. other features (sadness,
irritability, anger, or euphoria).

(1) DELIRIUM DUE TO A GENERAL MEDICAL CONDITION

A. Disturbance of consciousness (i.e., reduced clarity of awareness of the environment) with

reduced ability to focus, sustain, or shift attention.
 Principles and Techniques of Counselling-7 131

B. A change in cognition (such as memory deficit, disorientation, language disturbance) or

the development of a perceptual disturbance that is not better accounted for by a
preexisting, established, or evolving dementia.
C. The disturbance develops over a short period of time (usually hours to days) and tends to
fluctuate during the course of the day.
D. There is evidence from the history, physical examination, or laboratory findings that the
disturbance is caused by the direct physiological consequences of a general medical
condition.

(2) SUBSTANCE INTOXICATION DELIRIUM

A. Criteria A, B, C of delirium due to a General Medical Condition are met.

B. There is evidence from the history, physical examination, or laboratory findings of either
(1) or (2):
(1) the symptoms in Criteria A and B developed during Substance Intoxication
(2) medication use is etiologically related to the disturbance

(3) SUBSTANCE WITHDRAWAL DELIRIUM

A. Criteria A, B, C of delirium due to a General Medical Condition are met.

B. There is evidence from the history, physical examination, or laboratory findings that the
symptoms in Criteria A and B developed during, or shortly after, a withdrawal syndrome.

(4) DELIRIUM DUE TO MULTIPLE AETIOLOGIES

A. Criterion A for Dementia of the Alzheimer’s type is met.

B. There is evidence from the history, physical examination, or laboratory findings that the
delirium has more than one aetiology (e.g., more than one etiological general medical
condition, a general medical condition plus Substance Intoxication or medication side
effect).

2) DEMENTIA137

Dementia is a syndrome of acquired, persistent intellectual impairment with compromised

function in multiple spheres of mental activity, such as memory, language, visuospatial skills,
emotion or personality, and cognition. It affects 5%-8% of individuals older than age 65, 15%-20%
of individuals older than age 75, and 25%-50% of individuals older than age 85. The dementing
disorders can be categorized into cortical and subcortical types. The cortical dementias reflect
dysfunction of the cerebral cortex and are characterized by amnesia, aphasia, apraxia, and agnosia.
For example, Alzheimer’s disease is a cortical dementia. The subcortical dementias are caused by
dysfunction of the deep grey and deep white matter structures, including the basal ganglia,
thalamus, brain stem nuclei, and frontal lobe projections of these structures. Injury to subcortical
structures often disrupts arousal, attention, motivation, and the rate of information processing; and
this is seen as psychomotor retardation, defective recall, poor abstraction and strategy formation,
and mood and personality alterations such as depression and apathy. Subcortial dementias include
human immunodeficiency virus (HIV) disease, Huntington’s disease, and Parkinson’s disease.
 Principles and Techniques of Counselling-7 132

DIAGNOSTIC CRITERIA

It is not normal aging that we find in patients with dementia but the impact of significant
brain pathology. Therefore there is a difference in memory decline in normal aging and in dementia.
The diagnostic criteria for age-associated memory impairment (AAMI) are: 1. patients at least 50
years of age, 2. subjective complaints of gradual onset of memory dysfunction in daily life activities
(e.g., difficulty remembering names, misplacing objects, forgetting phone numbers), 3.
psychometric evidence of memory failure, as measured by a performance at least one standard
deviation below the mean established for young adults on a well-standardized test, 4. intact global
intellectual function, 5. absence of dementia, 6. absence of any current or past medical,
neurological, or psychiatric illness known to produce cognitive impairment, including the effects of
psychotrophic or other medications, drug or alcohol use, and any history of head trauma resulting in
a period of unconsciousness for 1 hour or more.

(1) DEMENTIA OF THE ALZHEIMER’S TYPE

A. The development of multiple cognitive deficits manifested by both

(1) memory impairment (impaired ability to learn new information or to recall
previously learned information)
(2) one (or more) of the following cognitive disturbances:
(a) aphasia (language disturbance)
(b) apraxia (impaired ability to carry out motor activities despite intact
motor function)
(c) agnosia (failure to recognize or identify objects despite intact sensory
function)
(d) disturbance in executive functioning (i.e., planning, organizing,
sequencing, abstracting)
B. The cognitive deficits in Criteria A1 and A2 each cause significant impairment in social
or occupational functioning and represent a significant decline from a previous level of
functioning.
C. The course is characterized by gradual onset and continuing cognitive decline.

(2) VASCULAR DEMENTIA

Vascular dementia (VaD) is the diagnostic term used when cerebral injury from vascular disease
leads to multiple cognitive impairments.

A. Criterion A for Dementia of the Alzheimer’s type is met.

B. Focal neurological signs and symptoms (e.g., exaggeration of deep tendon reflexes, extensor
plantar response, pseudobulbar palsy, gait abnormalities, weakness of an extremity) or
laboratory evidence indicative of cerebrovascular disease (e.g., multiple infarctions
involving cortex and underlying white matter) that are judged to be etiologically related to
the disturbance.

(3) DEMENTIA DUE TO OTHER GENERAL MEDICAL CONDITIONS

A. Criterion A for Dementia of the Alzheimer’s type is met.

 Principles and Techniques of Counselling-7 133

B. There is evidence from the history, physical examination, or laboratory findings that
the disturbance is the direct physiological consequence of one of the general medical
conditions listed below.

a. DEMENTIA DUE TO HIV DISEASE

Infection with the human immunodeficiencyvirus-type 1 (HIV-1) produces a dementing

illness initially called the AIDS dementia complex. A more recent designation is HIV-1-associated
cognitive/motor complex.

b. DEMENTIA DUE TO HEAD TRAUMA

It is a dementia that is judged to be the direct pathophysiological consequence of head

trauma. The degree and type of cognitive impairments or behavioural disturbances depend on the
location and extent of the brain injury.

c. DEMENTIA DUE TO PARKINSON’S DISEASE

Parkinson’s disease (PD) is characterized by progressive loss of dopaminergic neurons in the

substantia nigra and other pigmented brain stem nuclei.
Parkinson’s disease is a slowly progressive neurological condition, characterized by tremor, rigidity, bradykinesia, and postural instability.
20%-60% of the individuals with Parkinson’s disease do have dementia and dementia is more likely to be present in older individuals or those with
more severe or advanced disease. Patients have cognitive and motoric slowing, executive dysfunction, and impairment in memory retrieval.

d. DEMENTIA DUE TO HUNTINGTON’S DISEASE

Huntington’s disease (HD) is an idiopathic neurodegenerative disorder inherited as an

autosomal dominant trait with complete penetrance.

It is a dementia that is judged to be the direct pathophysiological consequence of

Huntington’s disease. Huntington’s disease is an inherited progressive degenerative disease of
cognition, emotion, and movement. The disease affects men and women equally and is transmitted
by a single autosomal dominant gene on the short arm of chromosome 4. The disease is usually
diagnosed in the late 30s to early 40s but may begin as early as age 4 years or as late as age 85
years. It is heralded by insidious changes in behaviour and personality, including depression,
irritability, and anxiety.

e. DEMENTIA DUE TO PICK’S DISEASE

It is a dementia that is judged to be the direct pathophysiological consequence of

Pick’s disease. Pick’s disease is a degenerative disease of the brain that particularly affects the
frontal and temporal lobes. It is characterized by changes in personality early in the course,
deterioration of social skills, emotional blunting, behavioural disinhibition, and prominent language
abnormalities. Difficulties with memory, apraxia, and other features of dementia usually follow later
in the course. As it progresses, it may be accompanied by either apathy or extreme agitation. Pick’s
disease often cannot be distinguished with certainty from atypical cases of Alzheimer’s disease or
from other dementias that affect the frontal lobes.

f. DEMENTIA DUE TO CREUTZFELDT-JAKOB DISEASE

 Principles and Techniques of Counselling-7 134

It is a dementia that is judged to be the direct pathophysiological consequence of

Creutzfeldt-Jakob (CJD) disease. It is one of the subacute spongiform encephalopathies, a group of
central nervous system diseases caused by transmissible agents known as ‘slow viruses’ or prions.
Typically, patients with Creutzfeldlt-Jakob disease manifest the clinical triad of dementia,
involuntary movements (particularly myoclonus), and periodic EEG activity.

(4) SUBSTANCE-INDUCED PERSISTING DEMENTIA

A. Criterion A for Dementia of the Alzheimer’s type is met.

B. There is evidence from the history, physical examination, or laboratory findings that the
deficits are etiologically related to the persisting effects of substance use (e.g., a drug of
abuse, a medication).

(5) DEMENTIA DUE TO MULTIPLE AETIOLOGIES

A. Criterion A for Dementia of the Alzheimer’s type is met.

B. There is evidence from the history, physical examination, or laboratory findings that the
disturbance has more than one aetiology (e.g., head trauma plus chronic alcohol use,
Dementia of the Alzheimer’s Type with the subsequent development of Vascular
Dementia).

3) AMNESTIC DISORDERS138

DIAGNOSTIC CRITERIA

Amnestic disorders are characterized by an inability to learn new information despite normal
attention and an ability to recall extremely remote information, with no other cognitive deficits. The
principal causes of amnesia include head trauma, Wernicke-Korsakoff syndrome, stroke, neoplasm,
herpes encephalitis, anoxia, hypoglycemia, and surgical procedures that disrupt medial temporal
structures. Causes of transient amnesia include epileptic convulsions, ischemic episodes, and the
syndrome known as transient global amnesia.
(1) AMNESTIC DISORDER DUE TO A GENERAL MEDICAL CONDITION

A. The development of memory impairment as manifested by impairment in the ability to

learn new information or the inability to recall previously learned information.
B. There is evidence from the history, physical examination, or laboratory findings that the
disturbance is the direct physiological consequence of a general medical condition
(including physical trauma).
Specify if:
Transient: if memory impairment lasts for 1 months or less
Chronic: if memory impairment lasts for more than 1 month

(2) SUBSTANCE-INDUCED PERSISTING AMNESTIC DISORDER

A. The development of memory impairment as manifested by impairment in the ability to learn
new information or the inability to recall previously learned information.
 Principles and Techniques of Counselling-7 135

B. There is evidence from the history, physical examination, or laboratory findings that the
disturbance is etiologically related to the persisting effects of substance use (e.g., a drug of
abuse, a medication).

17. DISORDERS USUALLY FIRST DIAGNOSED IN INFANCY, CHILDHOOD, OR

ADOLESCENCE

1) MENTAL RETARDATION139

A. Significantly subaverage intellectual functioning: an IQ of approximately 70 or below on an

individually administered IQ test (for infants, a clinical judgement of significantly subaverage
intellectual functioning).
B. Concurrent deficits or impairments in present adaptive functioning (i.e., the person’s
effectiveness in meeting the standards expected for his or her age by his or her cultural group)
in at least two of the following areas: communication, self-care, home living,
social/interpersonal skills, use of community resources, self-direction, functional academic
skills, work, leisure, health, and safety.
C. The onset is before the age 18 years.
Severity reflecting level of intellectual impairment:
Mild Mental Retardation: IQ level 50-55 to approximately 70
Moderate Retardation: IQ level 35-40 to 50-55
Severe Mental Retardation: IQ level 20-25 to 35-40
Profound Mental Retardation: IQ level below 20-25

2) LEARNING DISORDERS (FORMERLY ACADEMIC SKILLS DISORDERS)140

(1) READING DISORDER

A. Reading achievement, as measured by individually administered standardized tests of reading

accuracy or comprehension, is substantially below that expected given the person’s
chronological age, measured intelligence, and age-appropriate education.
B. The disturbance in Criterion A significantly interferes with academic achievement or
activities of daily living that require reading skills.
C. If a sensory deficit is present, the reading difficulties are in excess of those usually
associated with it.

(2) MATHEMATICS DISORDER

A. Mathematical ability, as measured by individually administered standardized tests, is

substantially below that expected given the person’s chronological age, measured
intelligence, and age-appropriate education.
B. The disturbance in Criterion A significantly interferes with academic achievement or
activities of daily living that require mathematical ability.
C. If a sensory deficit is present, the difficulties in mathematical ability are in excess of those
usually associated with it.
 Principles and Techniques of Counselling-7 136

(3) DISORDER OF WRITTEN EXPRESSION

A. Writing skills, as measured by individually administered standardized tests (or functional

assessments of writing skills), are substantially below those expected given the person’s
chronological age, measured intelligence, and age-appropriate education.
B. The disturbance in Criterion A significantly interferes with academic achievement or activities
of daily living that require the composition of written texts (e.g., writing grammatically correct
sentences and organized paragraphs).
C. If a sensory deficit is present, the difficulties in writing skills are in excess of those usually
associated with it.

3) MOTOR SKILLS DISORDER141

DEVELOPMENTAL COORDINATION DISORDER

A. Performance in daily activities that require motor coordination is substantially below that
expected given the person’s chronological age and measured intelligence. This may be
manifested by marked delay in achieving motor milestones (e.g., walking, crawling, sitting),
dropping things, ‘clumsiness,’ poor performance in sports, or poor handwriting.
B. The disturbance in Criterion A significantly interferes with academic achievement or activities
of daily living.

4) COMMUNICATION DISORDER142

(1) EXPRESSIVE LANGUAGE DISORDER

A. The scores obtained from standardized individually administered measures of expressive

language development are substantially below those obtained from standardized measures of
both nonverbal intellectual capacity and receptive language development. The disturbance
may be manifest clinically by symptoms that include having a markedly limited vocabulary,
making errors in tense, or having difficulty recalling words or producing sentences with
developmentally appropriate length or complexity.
B. The difficulties with expressive language interfere with academic or occupational
achievement or with social communication.

(2) MIXED RECEPTIVE-EXPRESSIVE LANGUAGE DISORDER

A. The scores obtained from a battery of standardized individually administered measures of

both receptive and expressive language development are substantially below those obtained
from standardized measures of nonverbal intellectual capacity. Symptoms include those for
Expressive Language Disorder as well as difficulty understanding words, sentences, or
specific types of words, such as spatial terms.
B. The difficulties with receptive and expressive language significantly interfere with academic
or occupational achievement or with social communication.

(3) PHONOLOGICAL DISORDER

A. Failure to use developmentally expected speech sounds that are appropriate for age and dialect
(e.g., errors in sound production, use, representation, or organization such as, but not limited
 Principles and Techniques of Counselling-7 137

to, substitutions of one sound for another [use of/t/for target /k/ sound] or omissions of sounds
such as final consonants).
B. The difficulties in speech sound production interfere with academic or occupational
achievement or with social communication.

(4) STUTTERING

A. Disturbance in the normal fluency and time patterning of speech (inappropriate for the
individual’s age), characterized by frequent occurrences of one or more of the following:
(1) sound and syllable repetitions
(2) sound prolongations
(3) interjections
(4) broken words (e.g., pauses within a word)
(5) audible or silent blocking (filled or unfilled pauses in speech)
(6) circumlocutions (word substitutions to avoid problematic words)
(7) words produced with an excess of physical tension
(8) monosyllabic whole-word repetitions (e.g., ‘I-I-I-I see him’)
B. The disturbance in fluency interferes with academic or occupational achievement or with social
communication.

5) PERVASIVE DEVELOPMENTAL DISORDER143

(1) AUTISTIC DISORDER

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from
(2) and (3):
(1) qualitative impairment in social interaction, as manifested by at least two of the
following:
(a) marked impairment in the use of multiple nonverbal behaviours such as
eye-to-eye gaze, facial expression, body postures, and gestures to regulate
social interaction
(b) failure to develop peer relationships appropriate to developmental level
(c) a lack of spontaneous seeking to share enjoyment, interests, or
achievements with other people (e.g., by a lack of showing, bringing, or
pointing out objects of interest)
(d) lack of social or emotional reciprocity
(2) qualitative impairments in communication as manifested by at least one of the
following:
(a) delay in, or total lack of, the development of spoken language (not
accompanied by an attempt to compensate through alternative modes of
communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to
initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play
appropriate to developmental level
(3) restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as
manifested by at least one of the following:
(a) encompassing preoccupation with one or more stereotyped and restricted
patterns of interest that is abnormal either in intensity or focus
 Principles and Techniques of Counselling-7 138

(b) apparently inflexible adherence to specific, non-functional routines or

rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping
or twisting, or complex whole-body movements)
(d) persistent preoccupation with parts of objects
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3
years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or
imaginative play.

(2) RETT’S DISORDER

A. All of the following:

(1) apparently normal prenatal and perinatal development
(2) apparently normal psychomotor development through the first 5 months after birth
(3) normal head circumference at birth
B. Onset of all of the following after the period of normal development:
(1) deceleration of head growth between ages 5 and 48 months
(2) loss of previously acquired purposeful hand skills between ages 5 and 30 months
with the subsequent development of stereotyped hand movements (e.g., hand-writing
or hand washing)
(3) loss of social engagement early in the course (although often social interaction
develops later)
(4) appearance of poorly coordinated gait or trunk movements
(5) severely impaired expressive and receptive language development with severe
psychomotor retardation

(3) CHILDHOOD DISINTEGRATIVE DISORDER

A. Apparently normal development for at least the first 2 years after birth as manifested by the
presence of age-appropriate verbal and nonverbal communication, social relationships, play,
and adaptive behaviour.
B. Clinically significant loss of previously acquired skills (before age 10 years) in at least two of
the following areas:
(1) expressive or receptive language
(2) social skills or adaptive behaviour
(3) bowel or bladder control
(4) play motor skills
C. Abnormalities of functioning in at least two of the following areas:
(1) qualitative impairment in social interaction (e.g., impairment in nonverbal
behaviours, failures to develop peer relationships, lack of social or emotional
reciprocity)
(2) qualitative impairments in communication (e.g., delay or lack of spoken language,
inability to initiate or sustain a conversation, stereotyped and repetitive use of
language, lack of varied make-believe play)
(3) restricted, repetitive, and stereotyped patterns of behaviour, interests, and activities,
including motor stereotypies and mannerisms

(4) ASPERGER’S DISORDER

A. Qualitative impairment in social interaction, as manifested by at least two of the following:

 Principles and Techniques of Counselling-7 139

(1) marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye
gaze, facial expression, body postures, and gestures to regulate social interaction
(2) failure to develop peer relationships appropriate to developmental level
(3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with
other people (e.g., by a lack of showing, bringing, or pointing out objects of interests
to other people)
(4) lack of social or emotional reciprocity
B. Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as
manifested by at least one of the following:
(1) encompassing preoccupation with one or more stereotyped and restricted patterns of
interest that is abnormal either in intensity or focus
(2) apparently inflexible adherence to specific, non-functional routines or rituals
(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or
twisting, or complex whole-body movements)
(4) persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairment in social, occupational, or other
important areas of functioning.
D. There is no clinically significant general delay in language (e.g., single words used by age 2
years, communicative phrases used by age 3 years).
E. There is no clinically significant delay in cognitive development or in the development of
age-appropriate self-help skills, adaptive behaviour (other than in social interaction), and
curiosity about the environment in childhood.

6) ATTENTION-DEFICIT AND DISRUPTIVE BEHAVIOUR DISORDERS144

(1) ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

A. Either (1) or (2):
(1) six (or more) of the following symptoms of inattention have persisted for at least 6
months to a degree that is maladaptive and inconsistent with developmental level:
Inattention
(a) often fails to give close attention to details or makes careless mistakes in
schoolwork, work, or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish
schoolwork, chores, or duties in the workplace (not due to oppositional
behaviour or failure to understand instructions)
(e) often has difficulty organizing tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require
sustained mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school
assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities
(2) six (or more) of the following symptoms of hyperactivity-impulsivity have persisted
for at least 6 months to a degree that is maladaptive and inconsistent with
developmental level:
Hyperactivity
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining
seated is expected
 Principles and Techniques of Counselling-7 140

(c) often runs about or climbs excessively in situations in which it is

inappropriate (in adolescents or adults, may be limited to subjective
feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often ‘on the go’ or often acts as if ‘driven by a motor’
(f) often talks excessively
Impulsivity
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or
games)
B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present
before age 7 years.
C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or
work] and at home).

(2) CONDUCT DISORDER

A. A repetitive and persistent pattern of behaviour in which the basic rights of others or major
age-appropriate societal norms or rules are violated, as manifested by the presence of three (or
more) of the following criteria in the past 12 months, with at least one criterion present in the
past 6 months:
Aggression to people and animals
(1) often bullies, threatens, or intimidates others
(2) often initiates physical fights
(3) has used a weapon that can cause serious physical harm to others (e.g., a bat, brick,
broken bottle, knife, gun)
(4) has been physically cruel to people
(5) has been physically cruel to animals
(6) has stolen while confronting a victim (e.g., mugging, purse snatching, extortion,
armed robbery)
(7) has forced someone into sexual activity
Destruction of property
(8) has deliberately engaged in fire setting with the intention of causing serious damage
(9) has deliberately destroyed others’ property (other than by fire setting)
Deceitfulness or theft
(10) has broken into someone else’s house, building, or car
(11) often lies to obtain goods or favours or to avoid obligations (i.e., ‘cons’ others)
(12) has stolen items of nontrivial value without confronting a victim (e.g., shoplifting,
but without breaking and entering; forgery)
Serious violations of rules
(13) often stays out at night despite parental prohibitions, beginning before age 13 years
(14) has run away from home overnight at least twice while living in parental or parental
surrogate home (or once without returning for a lengthy period)
(15) is often truant from school, beginning before age 13 years
B. If the individual is age 18 years or older, criteria are not met for Antisocial Personality
Disorder.

(3) OPPOSITIONAL DEFIANT DISORDER

 Principles and Techniques of Counselling-7 141

A pattern of negativistic, hostile, and defiant behaviour lasting at least 6 months, during which
four (or more) of the following are present:
(1) often loses temper
(2) often argues with adults
(3) often actively defies or refuses to comply with adults’ requests or rules
(4) often deliberately annoys people
(5) often blames others for his or her mistakes or misbehaviour
(6) is often touchy or easily annoyed by others
(7) is often angry and resentful
(8) is often spiteful or vindictive
Note: Consider a criterion met only if the behaviour occurs more frequently than is typically observed in
individuals of comparable age and developmental level

7) FEEDING AND EATING DISORDERS OF INFANCY OR EARLY CHILDHOOD145

(1) PICA

A. Persistent eating of non-nutritive substance for a period of at least 1 month.

B. The eating of non-nutritive substance is inappropriate to the developmental level.
C. The eating behaviour is not part of a culturally sanctioned practice.

(2) RUMINATION DISORDER

Repeated regurgitation and rechewing of food for a period of at least 1 month following a period
of normal functioning.

(3) FEEDING DISORDER OF INFANCY OR EARLY CHILDHOOD

A. Feeding disturbance as manifested by persistent failure to eat adequately with significant
failure to gain weight or significant loss of weight over at least 1 month.
B. The onset is before age 6 years.

8) TIC DISORDERS146

(1) TOURETTE’S DISORDER

A. Both multiple motor and one or more vocal tics have been present at some time during the
illness, although not necessarily concurrently. (a ‘tic’ is a sudden, rapid, recurrent,
nonrhythmic, stereotyped motor movement or vocalization.)
B. The tics occur many times a day (usually in bouts) nearly every day or intermittently
throughout a period of more than 1 year, and during this period there was never a tic-free
period of more than 3 consecutive months.
C. The onset is before age 18 years.

(2) CHRONIC MOTOR OR VOCAL TIC DISORDER

A. Single or multiple motor or vocal tics (i.e., sudden, recurrent, nonrhythmic, stereotyped motor
movements or vocalizations), but not both, have been present at some time during the illness.
 Principles and Techniques of Counselling-7 142

B. The tic occur many times a day nearly every day or intermittently throughout a period of more
than 1 year, and during this period there was never a tic-free period of more than 3 consecutive
months.
C. The onset is before age 18 years.

(3) TRANSIENT TIC DISORDER

A. Single or multiple motor and/or vocal tics (i.e., sudden, recurrent, nonrhythmic, stereotyped
motor movements or vocalizations)
B. The tics occur many times a day, nearly every day for at least 4 weeks, but for no longer than
12 consecutive months.
C. The onset is before age 18 years.

9) ELIMINATION DISORDERS147

(1) ENCOPRESIS

A. Repeated passage of faeces into inappropriate places (e.g., clothing or floor) whether
involuntary or intentional
B. At least one such event a month for at least 3 months.
C. Chronological age is at least 4 years (or equivalent developmental level).

(2) ENURESIS

A. Repeated voiding of urine into bed or clothes (whether involuntary or intentional).

B. The behaviour is clinically significant as manifested by either a frequency of twice a week for
at least 3 consecutive months or the presence of clinically significant distress or impairment in
social, academic (occupational), or other important areas of functioning.
C. Chronological age is at least 5 years (or equivalent developmental level).

10) OTHER DISORDERS OF INFANCY, CHILDHOOD, OR ADOLESCENCE148

(1) SEPARATION ANXIETY DISORDER

A. Developmentally inappropriate and excessive anxiety concerning separation from home or

from those to whom the individual is attached, as evidenced by three (or more) of the
following:
(1) recurrent excessive distress when separation from home or major attachment figures
occurs or is anticipated
(2) persistent and excessive worry about losing, or about possible harm befalling, major
attachment figures
(3) persistent and excessive worry that an untoward event will lead to separation from a
major attachment figure (e.g., getting lost or being kidnapped)
(4) persistent reluctance or refusal to go to school or elsewhere because of fear of
separation
(5) persistently and excessively fearful or reluctant to be alone or without major
attachment figures at home or without significant adults in other settings
 Principles and Techniques of Counselling-7 143

(6) persistent reluctance or refusal to go to sleep without being near a major attachment
figure or to sleep away from home
(7) repeated nightmares involving the theme of separation
(8) repeated complaints of physical symptoms (such as headaches, stomach-aches,
nausea, or vomiting) when separation from major attachment figures occurs or is
anticipated
B. The duration of the disturbance is at least 4 weeks.
C. The onset is before age 18 years.

(2) SELECTIVE MUTISM

A. Consistent failure to speak in specific social situations (in which there is an expectation for
speaking, e.g., at school) despite speaking in other situations.
B. The disturbance interferes with educational or occupational achievement or with social
communication.
C. The duration of the disturbance is at least 1 month (not limited to the first month of school).
D. The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken
language required in the social situation.

(3) REACTIVE ATTACHMENT DISORDER OF INFANCY OR EARLY CHILDHOOD

A. Markedly disturbed developmentally inappropriate social relatedness in most contexts,
beginning before age 5 years, as evidenced by either (1) or (2):
(1) persistent failure to initiate or respond in a developmentally appropriate fashion to
most social interactions, as manifest by excessively inhibited, hypervigilant, or
highly ambivalent and contradictory responses (e.g., the child may respond to
caregivers with a mixture of approach, avoidance, and resistance to comforting, or
may exhibit frozen watchfulness)
(2) diffuse attachments as manifest by indiscriminate sociability with marked inability
to exhibit appropriate selective attachments (e.g., excessive familiarity with relative
strangers or lack of selectivity in choice of attachment figures)
B. The disturbance in Criterion A is not accounted for solely by developmental delay (as in
Mental Retardation) and does not meet criteria for a Pervasive Developmental Disorder.
C. Pathogenic care as evidenced by at least one of the following:
(1) persistent disregard of the child’s basic emotional needs for comfort, stimulation,
and affection
(2) persistent disregard of the child’s basic physical needs
(3) repeated changes of primary caregiver that prevent formation of stable attachments
(e.g., frequent changes in foster care)
D. There is a presumption that the care in Criterion C is responsible for the disturbed behaviour in
Criterion A (e.g., the disturbances in Criterion A began following the pathogenic care in
Criterion C).

(4) STEREOTYPIC MOVEMENT DISORDER

A. Repetitive, seemingly driven, and non-functional motor behaviour (e.g., hand shaking or
waving, body rocking, head banging, mouthing of objects, self-biting, picking at skin or
bodily orifices, hitting own body).
B. The behaviour markedly interferes with normal activities or results in self-inflicted bodily
injury that requires medical treatment or would result in an injury if preventive measures were
not used).
 Principles and Techniques of Counselling-7 144

C. The behaviour persists for 4 weeks or longer.

B. ASKING FOR A RECENT EVENT

Illustrations and examples drive home the idea better than mere explanation of the idea you want
to inculcate. In the same way, you can know what the problem is, its exact nature, and the contribution
of the client to it, by asking the client to give an instance of the problem he/she faced quite recently.

I thought of making this ‘asking for a recent event’ into a step or chapter for obvious reasons.
Usually I get a clearer picture of a problematic situation when I have an example. All of us are assisted
in our understanding of a subject when the professor give us examples. In the same way to understand
the problem of the client it is worthwhile to know a recent occurrence of the problematic situation. This
is the main reason for making it into a step.

First of all, the client could be vague in what he/she is presenting and if he/she were to tell a
recent event connected with the problem, he/she becomes clear about what he/she speaks.

Secondly, the client becomes concrete with the details, which will give clues to the nature of the
problem.

Thirdly, the role of the client in the problem situation can be assessed by a recent event. When a
teenager says that his father keeps yelling at him, you could ask him to give an instance of his father’s
yelling. Perhaps you will find out that the teenager was coming home late at night everyday which was
the reason for his dad to yell at him. This knowledge you would arrive at only after listening to the
teenager's narration of a recent event.

Fourthly, while narrating an incident the client is in touch with his/her feeling, and in some cases
it could be an emotional discharge for the client. Remembering past painful events people emote.

At times I have noticed that my asking the client to narrate a recent event of the problem triggers
off a lot of talking on the part of the client. After all what is more useful is the talking of the client not
your monopolizing the conversation. Since some of the incidents are vivid in the memory of the clients
they narrate with many details. This in a way gives you enough information about the dynamics of the
clients’ role in the problem. It might help you to facilitate the client personalize the problem since you
are rather pretty sure of the involvement of the client in the problem situation.

There are also problems for which there is no need of asking for a recent event. The nature of
the problem does not warrant such a one. For example, a client met with an accident and is discussing
about the accident and the pain he undergoes. Therefore it is not necessary that you should ask for a
recent event of an accident. There are certain things that keep recurring. For them it is good to ask for a
recent event. If one quarrels whenever the family members gather together, then you can ask for a
recent event of quarrelling when the family members gathered together.

By now you are reaching the end of the pacing Phase. You have prepared the client to work on
the problem; all the above steps have been a preparation to the ensuing task that awaits both the
counsellee and the counsellor. No doubt that you have been building a rapport with the client right from
the very beginning; as you were dealing with him/her you also observed his/her non-verbal behaviour
very keenly to know more of the client. Then you started to do some ground work (laying the
foundation) for the type of work you are undertaking with the client by your attending, listening,
reflecting the content, and reflecting the feeling. In a way you helped the client to deal with strong
negative feelings; you pinpointed the problem, and finally to understand the dynamics of the problem,
 Principles and Techniques of Counselling-7 145

you asked for a recent event. By now you have a certain grasp of the situation, where the client stands,
and where he/she needs to go. With this you are now ready to enter into the reframing phase. 149

II. REFRAMING

ACTION-ORIENTED DIMENSION

When we think of the relative importance of the different steps, the ones for which I give greater
value are Pacing, Personalizing and Reframing. Of these three I give more weight to Reframing, for, on
this the success of the counselling depends. Even if you had not been competent in other steps, you will
not cut a poor figure if only you are able to do well at the reframing step.

What is this reframing all about? So far the client who has come to you was looking at the
reality from one angle, but now he/she will see the same reality from another angle. The word
'reframing' is taken from Neuro-Linguistic Programming (NLP). To understand what reframing is, it is
good to think of a frame through which as it were we are seeing the reality. We go about looking at the
reality through that frame which we put around our eyes. In reframing, we remove that old frame and
substitute it with a new one. It is like wearing different glasses. If you are using red glasses, you see
everything red; and when you remove these and put on green glasses, you see the reality as green.

In NLP, reframing is divided into ‘content reframing’ and ‘non-content reframing.’ Content
reframing is divided into ‘meaning reframing’ and ‘context reframing.’ For our counselling purpose
we could take the content reframing alone with its sub-divisions of meaning reframing and context
reframing. We know the content of ‘content reframing’ whereas we do not know the content of ‘non-
content reframing’ which is a form of therapy to treat psychosomatic illnesses.

There are three realities in our experience: 1. stimulus that which impinges on any one of the
five senses, 2. the meaning of the stimulus, and 3. the context in which the experience takes place.
Now you can keep the stimulus (behaviour), and the context constant and change only the meaning.
This is one way of reframing which is called meaning reframing. Or you can keep the stimulus
(behaviour), and the meaning constant and change the context. It is another way of reframing which is
called context reframing. So among the three realities of Stimulus – Meaning – Context, keeping the
stimulus always constant, you can change any one of the other two — meaning or context. Stimulus is
the undesirable behaviour pattern or the problem.

A. REFRAMING

1. MEANING REFRAMING

In meaning reframing, the stimulus and context remain the same and constant, but the meaning
they had is changed and that is why the name 'meaning reframing.' In connection with a behaviour, that
which was considered negative is now seen as something positive. Earlier it was invested with a
negative meaning but now it is being invested with a new meaning. A stimulus is neutral and it has no
inherent power to make one happy or unhappy, but it is the way you perceive that stimulus that makes
you happy or unhappy. In other words it is not the stimulus and the sensory experience of the stimulus
 Principles and Techniques of Counselling-7 146

that is negative, but it is your perception of that particular stimulus that makes you feel negative. Your
response depends upon the meaning that the stimulus and the sensory experience have for you. If for
you the stimulus has a positive meaning your response also is positive, but if it has a negative meaning
your response is negative. Therefore instead of changing the stimulus and the sensory experience, just
change the meaning, and that is exactly what is called meaning reframing. Here only the meaning
changes not the behaviour or the context. For example, an enquiry form a colleague of yours may be
taken as a sign of concern or a sign of inquisitiveness and unnecessary interference depending upon
which of the two meanings you invest the enquiry with. This only proclaims loudly that we need not be
condemned to look at a behaviour only from one angle and we have the option to look at it differently
also. In other words we are capable of reframing. Let us see an example for the meaning reframing.

Counsellee: People make fun of me when I weep. They say only women weep and I
should not weep as a man, they say. I hate myself for being so sentimental.
Counsellor: I am wondering if you are not a person very sensitive to the feelings of others
and that you can be so very consoling to people in crisis with your empathic
understanding.

The counsellee thought that his being sentimental was something negative, but the counsellor
made him realize that it only meant that he was a person capable of feeling for others. Here both the
behaviour (stimulus) and the context are not changed, but only the meaning of it is changed. The
behaviour which was considered 'sentimental' is changed into 'sensitive' and it makes a world of
difference to the client. Here the counsellor has made use of meaning reframing.

2. CONTEXT REFRAMING

Context reframing refers to keeping the same meaning and the stimulus but only you change to
context. A stimulus and meaning which were inappropriate in a particular context may be most
appropriate in another context. Finding out a different context in which a behaviour (which is a
stimulus with a meaning) will be appropriate is called context reframing. Let us see an example for
context reframing.

Counsellee: My parents scold me for being too outspoken.

Counsellor: Your outspokenness can also bring about justice in many situations.

Here outspokenness is considered as something negative by the client’s parents and that disturbs
the client. The counsellor is finding a context where such outspokenness will be very appropriate and
welcome. There are situations of injustice and in such situations, outspokenness is considered positive
since that will pave the way for justice. This is an example of context reframing.

Counsellors are supposed to reframe the clients who come to them so that they go back to their
own old situation (which includes the same stimulus and the same context) with a new meaning or to the
old situation (which includes the same stimulus and the same meaning) in a new context. 150

3. ADVANTAGES OF REFRAMING

Reframing has many advantages in the counselling situations. We know that change is the aim
of counselling, roughly speaking. It is precisely change that is called for in reframing. Instead of
getting rid of an unwanted behaviour, you are teaching him/her to make use of the same behaviour for
something good. The unwanted behaviour was not appropriate just because the meaning given or the
context in which it is exercised is considered negative. Therefore instead of destroying the habit, find
out how best it can be made use of for your own well-being. Reframing opens up a vast number of
 Principles and Techniques of Counselling-7 147

choices; instead of being tied down to one particular mode of reaction, you teach a client to react in
different ways. It is also true that the unwanted, when accepted, becomes positive for the client. What
was negative was the non-acceptance, and when one is prepared to accept it, it becomes something
positive. In psychology, a pain that is integrated (accepted) is no more a pain.

B. SKILLS

In this action-oriented dimension you are supposed to be equipped with certain skills. The
format you follow is procedure and the skills are techniques which you need to use. There are eight
skills you need to master. They are:

1. genuineness, 2. respect, 3. basic empathy, 4. advanced empathy, 5. concreteness, 6. caring

confrontation (challenging or feedback), 7. self-disclosure, and 8. immediacy. Let us take each one of
them separately for our consideration.

1. GENUINENESS151
Genuineness is the non-denial of oneself and the acceptance of oneself as one is . When we
were born, we were naked both physically and psychologically. But through a process of socialization
we learn as children that we can no longer continue to be naked physically and also psychologically.
We begin to put on masks which we remove when we are by ourselves and put on when we are with
others. At times, we remove them if we are sure that the people close to us will not reject our true self.
Genuineness results in being comfortable with oneself and being comfortable with others. You might
have noticed your own behaviour of being nervous when someone is critical of you which means that
you are not comfortable with the person who criticises you. Being comfortable with oneself demands
acceptance of oneself with all the strengths and weaknesses. We are made up of strength and weakness;
these are two sides of our personality. As we accept our strength it is also necessary to accept our
weakness. Some are not even ready to accept their own strength!

You are a counsellor and it is a role. Either you put on the role or others identify you in that
role. Genuineness here will mean that you are free of that role. This attitude of genuineness is known
by different names. Sidney M. Jourard calls it transparency. The clients should be able to see your
real self not a put-on self. You become a see-through person. Another psychological term is
congruence; you are not a piecemeal but an integrated person with no dichotomy between various
aspects of your personality and that self is called congruent self, whereas if there is some discrepancy
between various dimensions of your personality then it is incongruence. What you appear to be outside,
is the same inside of you. It is non-pretentious. It will mean sincerity of relationship, a certain
reliability and predictability. The one who trusts you will not be deceived.

The counsellor should be relatively more genuine than the counsellee. Clients seem to be
preferring a counsellor who is more genuine than skilled. Genuineness evokes thrust in the other since
there is no deception and that will facilitate the client to speak more about him/herself. To have come
into contact with a genuine person is in itself a healing for the client. In counselling situation you do not
take the attitude of being better than the client. You as well as the client are struggling with your
problems of life and now in a given situation you are facilitating a client and that should never make
you think that you are in a way holier than the client. This does not mean that there is no hiddenness in
you, which is required to be an independent personality, but you will endeavour to be just the self you
are without being affected by any role. The attitude of genuineness may be expressed in various ways.

1) UNFEIGNING UNDERSTANDING
 Principles and Techniques of Counselling-7 148

Carl came to a counsellor who was looking very tired after a heavy session with a few
counsellees. Because of his tiredness the counsellor could not concentrate on what Carl was telling and
yet kept up with his nods and 'Unhum' even when he missed the client without clarifying and getting the
correct information. It is fake understanding which goes against genuineness. If you have missed the
client, ask him/her to explain to you once again. May be you are attentive but could not understand the
message, and here too your genuineness should prompt you to ask for clarification.

2) EXPRESSING DIRECTLY

When Siva counsels a girl he has a terrible headache and his whole comportment betrays that he
is feeling uncomfortable. It would be welcome to accept that he is not comfortable on account of his
headache.

3) RESPONDING IMMEDIATELY

Punitha is generally cautious. She wants to use the right word at the right time. In her
responding there should not be any extra word, she thinks. She would make the whole counselling
miserable for the counsellee for want of being ready to respond with whatever words she is able to
address the client. At the same time you should not rush in such a way that before the client could
complete the sentence you are ready with your response. Readiness without being impulsive will be the
ideal. The clients need 'psychological space' which means to say that the clients after speaking should
have a space before you could respond. This is only to make sure that the client has nothing more to say
at that moment.

4) BEING SPONTANEOUS

Sugirtha has learned the counselling techniques and format so well that she would never deviate
from the format given. Irrespective of what situation presents itself she will stick on to her format.
Formats are only guidelines and they cannot be applied universally to every situation. There should be a
certain originality on your part. Your spontaneity only adds to the beauty of the counselling process.

5) MANIFESTING VULNERABILITY

If you appear to be too holy and exalted, the clients may avoid you because you are too 'holy.'
You have your own deficits like anybody else. You do not have to take extra pain to reveal your
shadow-side of your personality but avoid putting a holy covering over your shadow. You are capable
of experiencing all sorts of negative feelings. It is all right that by chance the clients come to know who
you are because by only showing your real self and accepting the same you invite the client to do the
same with regard to him/herself.

6) CLEARING PIPELINES

Plumbers clean the pipe lines when they are blocked so that water would flow freely. Any
blockade will prevent free flow of water. In the same way if something concerning the client is
bothering the counsellor, unless that is dealt with, the counselling will not be smooth. It is better that the
counsellor expresses it. Once when my residence was nearer to a seminary, a few seminarians used to
come to me for spiritual counselling. All of them would phone me and make an appointment and be on
time to meet me. But one individual would make an appointment and would not turn up before at least
half an hour elapsed. This happened not once, but practically every time he had to meet me. After a
 Principles and Techniques of Counselling-7 149

few visits, I gently brought to his notice how I had been waiting for him leaving aside my other
commitments. For, without this clearing I would not have functioned well with that seminarian. This is
called clearing pipelines.

7) BEING NON-DEFENSIVE

Clients might find out something in you annoys them and they point it out. Or it could be as a
result of negative transference they find fault with you as they did with their authority figures at home.
They may openly express negative feelings towards you. Once while a colleague of mine, a
psychologist was in charge of some seminarians as their director, one of them did not relate to him well
and as far as possible he would avoid the director, and was negative. When asked he said that he
disliked psychologists. That was a hang-up which he would have acquired through a bitter experience
with a psychologist and that he projected on to the director and felt negative. Whether it is a real
problem of yours that is pointed out, or a transference problem that is projected on you, it is worth
dealing patiently with the client. In any case, it might provide you with a feedback as to your dealing
especially with the clients or at least you will come to know your own reaction to the clients when they
are negative.

8) BEING CONSISTENT

Human beings have the knack to pick up messages from body movements. Hidden messages
leak out through the body. All that is most visible is your body. Your words might camouflage your true
experience which manifests itself through your body. Being consistent will mean that you report only
what you experience. Being annoyed and saying that you are happy is inconsistency between what you
are experiencing and what you are saying.

From the foregoing, it becomes evident to us that being genuine will attract the clients.
Genuineness is goodness and as such it would make others like you for your genuineness. A person
who is committed to self-growth will endeavour to be genuine in his/her day-to-day living. It is not the
question of being genuine for a day and give it up on the next day. It should be a habitual attitude. If it
has to be habitual, it has to be practised everyday and at every moment, otherwise it will cease to be
habitual, and consequently it will never be genuineness at all. Even if other skills were lacking that
would not be too much of a disturbance to the client but if genuineness is wanting the whole thing is a
problem for the client.

2. RESPECT152

Respect is the regard we have for the other just because the other is a human person. As Carl R.
Rogers puts it, it is unconditional positive regard for the other. It should be unconditional in the sense
that no condition is put for the acceptance of the other, avoiding all ‘ifs’ and ‘but's.’ The attitude should
be a positive one because the persons are good though their actions may not be good. It is with the
distinction of person and behaviour that you accept the client and since the client is good, your attitude
should be positive. Simply accepting the other as he/she is, is respect. Respect is the appreciation of
the human dignity. Respect is expressed more by action than by words. The way one can perceive
respect could be many:

1) BEING AVAILABLE
 Principles and Techniques of Counselling-7 150

You value the client so much that you would like to spend your time and energy for the client
because he/she is worth more than your time. More than the exterior availability what is required is the
interior availability. Even if you are spending ten minutes you are there totally.

2) PAYING ATTENTION

Along with availability you need to pay attention to the client. The client is so precious that you
will not waste the client's time and energy by your non-attending. Usually we pay attention to the things
we value most. The lack of attention is itself an indication that the client is not worth paying attention
to.

3) BEING FOR THE CLIENT

You are not just there the whole person in front of the client but you are there for the sake of the
client's interest. You will be firm with the problem and benevolent with the client, because you care for
the client. Even if you were to challenge the client you will somehow indicate that you care for the
welfare of the client.

4) PHYSICALLY PRIZING

It is not only the abstract concept of the personality of the other that is to be respected but even
the body of the client is to be respected. Therefore making use of the client for one's own selfish
gratification is out of question in the counselling context. No harm should be done in any way to the
client.

5) VALUING DIVERSITY

Clients might come from cross-cultural background. They need not resemble you, nor should
you expect them to behave the way you behave in your culture, and have the same religious background
as you have. An appreciation of something dissimilar from you is called for.

6) VALUING INDIVIDUALITY

Clients have their own autonomous lives as individuals. It refers to the uniqueness of the client
even at times being queer or freak. Clients being queer need not overwhelm you.

7) ASSUMING GOODWILL

Clients approach a counsellor for working out their problems. When the clients approach you,
you shall take this for granted even with reluctant and resistant clients unless the ill-will is proved. To
presume that the client is not serious enough to work out his/her problem may be distrusting the
goodwill of the client.

8) FAITH IN HIS/HER POTENTIAL

 Principles and Techniques of Counselling-7 151

It is to avoid an attitude of patronizing thinking that the client may not be adequate or does not
have enough of resources and skills to solve his/her problems. Carried to the extreme it is simply giving
advice to the client since the counsellor presumes that the counsellee does not know to solve his/her
own problem. Some people understand counselling as giving advice but it is far from that. Beginners
usually try for a while and give up and land on giving advice.

9) FAITH IN RESPONSIBILITY

The client not only is able to work out his/her problems with your facilitation but he/she is
capable of taking responsibility for his/her own life, functioning, and carrying out the decisions he/she
makes.

10) GIVING FREEDOM

At times it is possible that the clients make decisions which are not in tune with your ethical
standards or the decisions would bring in more problems than the one that is currently faced. Your duty
is to make the client become aware of the consequences of the decisions he/she is making and leave
him/her to him/herself. Does this mean indifference to the wellbeing of the client? If the client's
decisions affect him/her mildly, you could totally leave them to the discretion of the client, having
pointed out the consequences; but if it is a question of life and death, your indifference means lack of
caring, and hence it is not respect but rather disrespect for a human life.

11) REMAINING NEUTRAL

As a rule, no negative behaviour has to be reinforced. A client reports that he had raped five
girls. You need not applaud him for his heroic deed, nor should you reprimand him. You may not
approve of the action, and yet acceptance of the person will demand that you do not blame him either.
You could only bring to his awareness the seriousness of the act and all the social implications it might
have both for him and for the victims. Apart from that, praising or blaming the client for a negative
behaviour may not be appropriate.

12) BEING HONEST

False assurance and support are disrespect to the client, for, the client is duped into thinking that
everything is all right since you have been falsely supporting. For example, a heart patient undertakes
rigorous physical exercises which you perceive are dangerous and yet you would encourage him/her to
continue; here you care less for the health and even for the life of the client.

Having seen what respect is, in attitude as well as in behaviour, one begins to wonder how far
this respect should go. Total respect means acceptance of the other as he/she is. Now how would you
go about with a client who appears to be incompetent to manage by him/herself? It is a question of
whether you are directive or non-directive. Non-directive is the ideal but there may be situations that
warrant a moderately directive method. Without undermining the capabilities of the clients we can
distinguish people at different levels of efficiency. People who are below average in intelligence
function not as well as those who are intelligent; children may not be able to stand on their own for want
of maturity of thought and experience; people in a crisis lose their balance and left to themselves will
only deteriorate all the more; and people after a traumatic experience are so bewildered that they are
immobilized to organize themselves. Such cases will respond favourably to your moderate directive
counselling. Here respect is not violated, for, since you love the person and respect him/her totally, you
 Principles and Techniques of Counselling-7 152

take into account the whole situation and make an assessment as to the effectiveness of his/her effort
and then you venture to be moderately directive.

But to assume at every setback of a client that the client needs only a kind of directive
counselling is a disrespect to the client. Directive counselling in its extreme is smothering and nobody
can grow when smothered. Even in a moderately directive counselling there could be ample freedom
and space for the client to move about and choose between decisions, though it is you who directed the
client to arrive at a specific decision. Non-directive does not mean that you leave the client to
him/herself. Your role as a counsellor will mean that you give direction to be counselling which comes
from your expertise in the counselling field and at the same time as a mark of respect you leave the
client to decide for him/herself. Total respect is not synonymous with no-direction and giving a
direction in a focused way is part of respect and in no way negates such a value as respect. You could
operate from being moderately directive to moderately non-directive.

Respect is an inalienable aspect of human personality. Human beings have become ever more
conscious of their dignity as persons and demand that they be respected for what they are as human
persons. With wonder and awe we look at the uniqueness of the individual with his/her dignity and that
is respect.

3. BASIC EMPATHY153
Empathy is a mode of gathering subjective data about another self through vicarious
introspection. It is the ability to enter into and understand the world (internal frame of reference)
of another person and communicate this to him/her to his/her satisfaction.

A. COMPONENTS OF EMPATHY

Empathy is the accurate understanding of what the client is experiencing within him/herself and
to communicate this understanding either verbally or nonverbally or by both to the satisfaction of the
client. Thus we can find three components of empathy.

1) UNDERSTANDING

First of all it is the correct understanding of the experience of the client. It is your
perceptiveness which comes first. This perceptiveness should be accurate. Metaphysically it is rather
difficult to understand exactly what the other is experiencing within him/herself. All the same, there is
commonness in what you experience and in what I experience. And this understanding should be the
world of the client as experienced by him/her.

2) COMMUNICATING

The second component is to communicate your understanding to the client. It requires certain
skills or know-how techniques. If you do not know the skills of communicating, your understanding is
useless and does not help the client in any way. You should have the know-how, as well as assertiveness
to communicate when called for. Do not leave the client to presume that you understand him/her; it has
to be communicated in one way or other. There are some people who communicate their understanding
of the experience of the client in words; some others will make use of nonverbal languages, and yet
 Principles and Techniques of Counselling-7 153

others may make use of both. What method you employ is not important, and all that matters is that you
somehow communicate to the client your understanding.

3) TO THE SATISFACTION OF THE CLIENT

You might correctly understand the experience of the client and you might have attempted to
communicate the same understanding in some way or other. But you are not sure that what you
communicated went home. That the client understood your understanding is confirmed by his/her
reactions. If the client did not understand your understanding, then empathy is not complete.

At this level we qualify the word empathy with the adjective 'basic' as against 'advanced' about
which we shall see later.

What the client is experiencing can be understood in the following ways: a) It is the experience
proper that which happens to the client as when a lady says that her husband shouted at her and the
children last night after heavy drinking. b) Secondly, the behaviour of the client. What the client does
in response to the event or experience proper. Here in the example, the lady shouted back and pushed
him outside and locked the door from within. Her shouting back and pushing him outside and locking
the room are her behaviour. c) Thirdly, what the client feels about it. Here the lady feels furious at her
husband. Therefore when we say that the counsellor should understand what the client is experiencing,
it would amount to understanding what had happened to the client, what the client did about it and what
the client felt about it.

One is said to be empathetic when one picks up the feelings of the client and expresses them
along with the experience or behaviour of the client using the formula: you feel (affect) because
(experience or behaviour). Thus in the example of the lady we just spoke about, the counsellor could
say like this which might sound empathetic: ‘You feel furious (affect) at your husband for what he has
done to you and your children (experience).' Here feeling and experience of the client are combined.
Supposing she feels guilty for having beaten him up and thrown him out of the house the counsellor
would address like this: 'You regret (affect) because you have beaten up your husband and thrown him
away (behaviour).' Here the feeling and the behaviour of the client are combined. Feeling has to be
expressed by all means, and along with that you could express either the experience or the behaviour
depending upon what makes sense in a particular context. In the first example the counsellor expressed
the feeling and experience of the client and in the second he/she expressed the feeling and the behaviour
of the client. This is what we have already seen with regard to responding to the feeling of the client
using the formula ‘you feel (feeling) because (content).’ In the place of the content, you insert either the
experience or the behaviour of the client to make the empathic statement complete.

A. SYMPATHY-EMPATHY COMPARISON

Usually empathy is identified with sympathy; but they are two different things. Sympathy is
agreement with another person's feeling. For example, if the counsellee feels angry, the counsellor too
feels the same, and if the counsellee feels sad the counsellor too does so. If you go in for emotional
agreement you land up being exhausted, for you would be meeting a number of clients with various
types of feelings. Since sympathy is an emotional identification, your thinking power is lowered
because you are overtaken by the feeling tone. In empathy you have an intellectual identification with
the experience of the client. Emotional agreement in sympathy and intellectual agreement in empathy
are quite different things. What facilitates growth in the client is empathy. Sympathy is identical with
 Principles and Techniques of Counselling-7 154

compassion, pity, and condolence, whereas empathy is identified with understanding and effective
helping out.

Sympathy Empathy
1. Agreement with another’s feelings. 1. An intellectual identification with a person’s
feelings, thoughts and attitudes.
2. Emotional element is predominant. 2. Intellectual and perceptive elements are
predominant.
3. Involved in the overwhelming 3. Understands the client’s frame of reference,
experience of the client and has the context, how he/she feels, and why, and is thus free
same feeling of the client. from the client’s overwhelming experience.
4. Feels as if he/she is the client. 4. Feels as if he/she were the client.

B. BEHAVIOUR MODALITIES

The behaviour modalities of empathy will be as follows:

1) REPORT FEELING AND CONTENT (EXPERIENCE OR BEHAVIOUR)

One of the surest signs of having been empathic is the communication of the understanding of
the feeling of the client along with his/her experience or behaviour. This should be your primary
concern. When feelings are not picked up, in no way can we say that you have been empathic.

2) CHECKING ACCURACY

As we have already seen that empathy will not be complete unless your understanding of his/her
experience is communicated to him/her to his/her satisfaction. The reaction of the client comes as a
confirmation of your empathic understanding. Go on modifying your report until it clicks well with the
client's internal experience.

3) PICKING UP CORE MESSAGES

Clients usually speak a lot and even things that are not relevant to the problem they propose but
your responsibility is to pick up the core and central messages to make the counselling clear avoiding
confusion and ambiguity.

4) KEEP THE CLIENT ON HIS/HER AGENDA

It is another way of asking you to be focused and let not the client escape from important
considerations. Otherwise it is merely a waste of time and energy both for you and for the client.

5) BEING FLEXIBLE
 Principles and Techniques of Counselling-7 155

Your reporting should be tentative so that the client does not feel constrained. The client should
have the freedom to confirm or deny what you report. He/she should not be compelled to accept what
you say even if what you say may be correct. Perhaps the client is not ready to accept your correct
understanding at this particular moment.

6) NOT PARROTING

Your reporting should always add something to what the client has said and thus you enhance
the client's understanding. On the contrary, when you keep repeating what the client was saying then
the counselling cannot proceed further because there is no new insight. You are required to formulate
your report in such a way that it adds to the understanding of the client.

7) NO CRAZY TALK

At times you get clients who go on talking for hours together with little provocation. Client
rambling will take you to a labyrinth and you as well as the client will get lost. Whenever crazy talk
goes on, you summarize the core materials and invite the client to proceed in a focused way.

8) NO DAWDLING

Sometimes the counsellor and the client start with all enthusiasm and goodwill and after a while
they perceive that they remain in the same stage without moving forward and in some cases they
proceed a little further and come back to the same spot like a vicious circle or a merry-go-round.

9) NO LONG-WINDEDNESS

Long-windedness is the counsellor's talking more than necessary. If you have a need to talk,
you better approach another counsellor for your own need and you need not meet your need when
clients come for counselling. You should not be too slow in answering, or totally silent. After the
clients talking you need to respond to him/her nor should you put a question without empathically
responding to him/her. The rule is when the client speaks, respond empathically and then if you want,
put a probe. Your talking should be relatively frequent and trim using short responses.

10) NOT BEING IMPULSIVE

If you are too quick to respond you are likely to make mistakes since you do not have enough
time to think for yourself. If you are too cautious and slow it might indicate indifference or fearfulness.
It is good to strike a balance between these two extremes.

11) NOTING CLIENT RESISTANCE

From the reaction of the client to your empathic response you can make out if the client is free
or resisting. Sometimes the resistance can be due to want of accuracy on your part or at times it could
be too much of accuracy on your part which is threatening. For, empathy at times is threatening. Since
empathy is a kind of intimacy, people who are not comfortable with intimacy may find it difficult to be
comfortable with your empathic responses.
 Principles and Techniques of Counselling-7 156

When clients usually speak of an 'understanding counsellor' they are just talking in their own
language about an empathic counsellor who sees the problem as the clients see it. There are times when
clients come just to pour out their burdens with no intention of working out any of them. In those
moments you need not take up the responsibility to solve their problems, instead, be empathic and that
will heal the clients to a greater extent and if they so desire to work out their problems later, you can be
of service to them.

154
4. ADVANCED EMPATHY

We have already seen in the preceding passages what is basic empathy and now we shall
consider what is advanced empathy. Basic empathy is the reflection of the surface feelings of the client,
whereas advanced empathy is the reflection of the deeper feelings that lie buried underneath, outside the
awareness of the client. In advanced empathy the counsellor is not interpreting the situation of the client
but rather he/she picks up what has been half said, hinted at, said implicitly, lies buried and said in a
confused way. It is bringing to the surface the feelings that lie deep down. It is reading between the
lines. In basic empathy the counsellor makes use of interchangeable feeling-words whereas in advanced
empathy he/she discovers new feeling-words, which are not expressed by the client, but perceived by
the counsellor deep down in the client. In this sense, it is additive to what the client has already stated.

Now let us consider some of the ways in which advanced empathy can be used by the
counsellors. It is at times risky to make use of advanced empathy, for, the client may be threatened by
the revelation of the hidden feelings. Since it brings out something from the bottom and from the
unconscious, it is a challenge which the client might refute or reluctantly admit. There is the possibility
of losing the client because what has come to the surface is not acceptable to the client, and the client
may avoid the counsellor. Therefore it has to be judiciously used by the counsellor.

1) EXPRESSING THE IMPLIED

From the way the counsellee speaks both verbally and non-verbally, the counsellor picks up the
cues of the things that lie hidden and not expressed but are there definitely. If you claim to identify
something that is not there hidden, it is not empathy and much less advanced empathy. That which you
make explicit should have been there in the counsellee implicitly.

Counsellee: Of all my sons the one I loved most was Steve, but the way he was answering me back
and was rebellious made me terribly angry, and I am unable to think that Steve could do
such a thing to me.
Counsellor: Could it be that you are hurt by your son's behaviour?
Counsellee: I would say that it is more a hurt than anger that I feel right now.

What is explicit and evident both for the counsellor and the counsellee at face value is the
feeling of anger, but in situations of this sort when the loved ones turn against us, we normally feel more
hurt than feel angry, for, if an enemy were to be rude with us we might be angry, but with the loved ones
we feel hurt. This feeling of hurt could be picked up by the counsellor from the way the client was
sharing, and the type of experience he/she was narrating.

2) IDENTIFYING THEMES

Clients keep repeating a theme quite often in the conversation. A good listener will readily pick
up the message immediately. One can see a particular theme running constantly like a thread.

Counsellee: Some five years back I loved Sara and we were very steady, but somehow
she felt I am not up to her mark, and she left me; then I was in love with Nita,
 Principles and Techniques of Counselling-7 157

who was studying with me. When I said that I loved her, she seemed happy;
but we parted as friends; and now I have a girl in my mind, but I am afraid that I
might lose her, if I tell that I love her. In spite of my telling very earnestly
that I need their love, they deserted me.
Counsellor: What do you think that made them desert you?
Counsellee: Actually I don’t know. I always remained submissive and in need of their help and
love.
Counsellor: Could there be any game of 'poor me' played in all these situations?

The client's repeated love failure is due to his psychological game of 'poor me' by which he begs
others to love him, and perhaps this psychological game which was detected by the girls unconsciously
had left him alone. In different experiences we find one particular theme that is constant.

3) CONNECTING ISLANDS

Clients normally speak of different episodes and experiences. Apparently they may look
disparate and disconnected, and in fact they are unless someone pieces them together.

Counsellee: When I was in the high school I had quarrelled with a teacher and sure I did
fail in his subjects. In the college too, a lecturer who resembled my
authoritarian father failed me. Last week when I went for a job interview, the
bossy demeanour of the interviewer put me off. Somehow I find myself as a
failure in various situations.
Counsellee: Did you at any time fail in the subjects taught by the teachers whom you
liked?
Counsellee: Not so far.
Counsellor: Is it probable that you do well when you like a person, and do very badly
when you do not like a person?
Counsellee: Oh, it looks like that.

4) CONCLUDING FROM PREMISES

When the clients say a number of things which are somehow connected there is the possibility of
making a conclusion from what they have been talking. The conclusion may not occur to their mind,
but a counsellor could help them make it.

Counsellee: I have been working in a private company as a bus conductor. Of late they have stopped
taking in fresh employees. For the last Diwali they made a lot of fuss to give bonus. It
is difficult to take leave since they have made all stringent measures to curb the
workers.
Counsellor: What do you think that the authorities are aiming at with such measures as
you have narrated?
Counsellee: I am wondering if voluntary retirement is in their mind.

5) LESS TO THE MORE

By the empathic responses of the counsellor, the client is led from less knowledge to more
knowledge about the problem situation or resources.
 Principles and Techniques of Counselling-7 158

Counsellee: I have a flair for music. I listen to music and I do not miss any orchestra. For about
three years I have been learning violin but I am not able to play a piece of music even
now. I am wondering what is wrong with my learning?
Counsellor: What do you think of your aptitude for playing music?
Counsellee: I do not know if aptitude is the one I need.

The counsellee naively thought that he/she had enough aptitude for music, but the counsellor
analysing the situation intuits and finds out that the client may not have the aptitude which he/she claims
to have, and this knowledge is something additive to the client's knowledge.

6) SUMMARIZING

Very many times summarizing adds to the knowledge of not only the client but also the
counsellor in understanding the situation of the client. Things that were not clear become clearer now,
things that stood disconnected get connected, and things that were buried come to the surface as insights
come to the client about the things he/she is dealing with. In any case, summarizing is adding
something new to the materials that have been already expressed.

Usually the counsellor could do the summarizing. At times if the clients are able and clever, the
counsellor could ask the clients themselves to summarize the things they had been sharing up to a
certain point. Since in summarizing the clients hear the problem situation in clear terms, certain insights
are bound to come to them.

Summarizing could be used at various occasions for the benefit of the clients. In fact it serves as
an advanced empathy.

1. At the beginning of a new session: The clients may be coming to you for a number of
sessions. Every time the session has to be started. For some clients that could be an ordeal. To ease the
situation and to make the clients talk freely and get the thread of the previous session, summarizing the
previous session could be done either by the counsellor or by the counsellee.

2. When sessions go nowhere: It might happen that the session started well, and while the client
is talking, he/she may be talking the same thing over and over again, perhaps not realizing it or finding
it difficult to proceed further. At that time, summarizing what went on up to the time the counsellor
intervenes, would be useful for the client to go forward in a focused way.

3. When clients get stuck: At times clients get stuck in the middle of the counselling sessions. It
may not be intentional. Perhaps you could take it as a silence and see if something is forthcoming. If
you realize that the client got stuck and is not able to proceed further, you could make a summary
statement of what went on up to the time of his/her getting stuck. Your summarizing may set the
process moving for the client.

The ways of expressing advanced empathy are not so distinct, and in fact some of them are
overlapping. In any case if you can only add some knowledge and bring something to the
awareness of the client with regard to the materials that were not there in the consciousness, you are
empathic in your responses. In short, picking up the underlying feelings and communicating them
to the client to his/her satisfaction will mean in general advanced empathy. Advanced empathy is
an advanced skill compared to the basic empathy. As counselling proceeds, the counsellor will be
called upon to make use of advanced empathy at the appropriate time in an appropriate way.
 Principles and Techniques of Counselling-7 159

5. CONCRETENESS155

Specific, direct and complete expression of the experiences, feelings, and behaviour by both
the counsellor and counsellee.
counsellee.

You cannot deal with generalities; you need particulars. The problem has to be concrete, the
goal should be concrete and the means to the goal should be concrete. Concreteness gives clarity to
one's thinking and thus moves the process towards the goal in a focused and understandable way.
Clients may not always be concrete and specific. They while talking about their problem may add a lot
of information and leave out the essential ones. It is at those times, concreteness will be of great use to
the counsellor and the counsellee. Concreteness is specifics, particulars and they are in the context of
the communication between the counsellor and the counsellee. It refers to the discussion of the
problems of the counsellee, his/her opportunities that are not used and his/her misused potentials, and in
terms of specific experiences, feelings and behaviour. When translated into behaviour on the part of the
counsellor, concreteness will take the following forms:

1) ONE AT A TIME

At times the clients bring in a number of problems together. It is not possible for you to deal
with all of them at the same time. Therefore, ask the client to choose any one of them for consideration.
This is one way of being concrete.

Counsellee: What is the use of praying to God? Whether you pray or don't pray, things happen
worse. Nowadays I am losing my religious faith. Added to that, my teenage boy has
been found taking drugs and comes home late at night. I am at a loss to deal with him.
As though that is not enough my youngest daughter met with an accident and I do not
know where to go for money.

Counsellor: You feel overwhelmed by a number of crisis coming one after the other and
you are at a loss not knowing what to do. You seem to be having faith crisis,
difficulty in dealing with a drug dependent son and the financial crisis to meet
the expenses of you daughter. Of these three which one would you like to
deal with first?

2) DIRECT QUESTIONS

Whenever you are asking questions of ‘who’ ‘when’ ‘what’ 'which' ‘where' and 'how' to get
specific information, you are concrete in your communication.

Counsellee: When I met my ex-boy-friend I just ignored him purposely and that hurt me.

Counsellor: When did you meet your ex-boy-friend?

3) RECENT EVENT

When problems are narrated, they might remain vague but when you ask the client to illustrate
the problem with a recent occurrence of the problem you are making the client concrete in his/her
expression.
 Principles and Techniques of Counselling-7 160

Counsellee: I tremble all over when I have to give a speech in public. In spite of my
trying to clam myself down I become more nervous.

Counsellor: Could you give me a recent instance when you were nervous before giving a speech in
public?

4) 'I' STATEMENT

Clients may not take self-responsibility for their feelings and behaviours and thus distance
themselves by using words like 'we' 'people' 'you' and the like. For example, a client says: 'No one will
like to be criticized in front of his/her subordinates,' instead of saying 'I don't like to be criticized in front
of my subordinates.' Such situation can be handled by the counsellor by making a 'you' statement like:
You don't like to be criticized in front of your subordinates' and this in all probability will impel the
client to use 'I' statement. But in spite of your using 'you' statement if the client continues to avoid 'I'
statement you could bring to his/her notice the fact that he/she is not making 'I' statement. You could
bring to his/her notice this lapse only when you are quite sure that your pointing out this lapse will not
make him/her more nervous about the way he/she expresses.

5) SPECIFIC GOALS

Counselling may end up being a failure for want of specific goals. The client may have good
intention, but since the goal was vague he/she could not apply him/herself to the goal. Therefore, while
setting a goal, make sure that the client spells it out in concrete terms.

Counsellee: I want to improve in my studies in spite of my previous setbacks.

Counsellor: What do you mean by 'improving in your studies?

Counsellee: Well, I shall spend some time in study both at night and early in the morning
daily.

Here the goal of 'improving one's studies' is specified by a duration of study the client will be
putting in.

6) SPECIFIC MEANS

Specific goals alone will not bring in success. The goal may never be realized because the
means to the goals were not thought out in concrete terms. Let us take the example of the counsellee
who wanted to improve his/her studies by applying him/herself to study every night and morning. Here
the means are not made concrete.

Counsellor: How many hours will you spend at night and early in the morning for studies?

Counsellee: I could spend two hours each time.

Counsellor: Will you tell me from when to when you are going to study?

Counsellee: Perhaps at night from 9 to 11 p.m. and in the morning form 5 to 7 a.m.
 Principles and Techniques of Counselling-7 161

Here the means to the goal are made concrete, and the client is likely to keep up his/her
programme to improve his/her studies.

7) PRESENT FEELING:

In counselling, the present moment is of great value. The feeling currently experienced by the
counsellee is the concretisation of the problem he/she is experiencing. Therefore every now and then
asking for the present feeling he/she is experiencing is worth the trouble to make the client concrete in
his/her communication.

Counsellor: And now that you have worked out your concern, what are you feeling right
now?

Counsellee: I feel really relieved of my anxiety.

6. CHALLENGING (CARING CONFRONTATION OR FEEDBACK)156

Challenging is a responsible and delicate unmasking of the discrepancies, distortions,

games, and excuses the client is using to evade self-understanding and constructive behavioural
change. The counsellor observes something phoney and brings it to the awareness of the client in a
caring manner. High level functioning counsellors usually use challenging, but of course appropriately
and with care. Low level functioning counsellors may not use challenging sufficiently and if they are
obliged to use it, they do it brutally, tearing the client to pieces. There was a time in the history of
psychology around 1960's when counsellors under the pretext of being honest were attacking in
challenging the clients to the extent of people being afraid of counselling or psychotherapy. But now
the times have changed especially with the use of self psychology, and counsellors take benign attitudes
towards challenging. Challenging is not your reaction to the functioning of a client, but a caring act of
sharing your perception of the client and his/her functioning. Challenging is a mature from of caring.

1) CHALLENGING DISCREPANCIES BETWEEN

(1) WHAT HE/SHE SAYS & DOES

The client says that women are equal to men in every respect and he respects women for their
dignity, but at home he treats his wife like a slave.

(2) HIS/HER VIEW OF HIM/HERSELF & OTHERS' VIEW OF HIM/HER

Once I was a participant of a group therapy. A pillow was passed on, and each of us holding the
pillow did to the pillow what we thought was done to us when we were born, and spoke the things that
were supposed to have been spoken to us. When it came to one of my companions, he just pulled the
pillow with his left hand and kept it on his lap and pressed it with both the hands without saying a word
with his face looking grim. When the therapist asked him what he meant by his behaviour, he coolly
said 'I am caring,' to which the whole group shouted in a chorus 'That was not caring but smothering the
child.'

(3) WHAT HE/SHE IS & WHAT HE/SHE WANTS TO BE

 Principles and Techniques of Counselling-7 162

A man was coming to me for counselling over a period of time. He was the father of three
young boys, all of them in their teens. His relationship with his sons was not going well, and he
constantly spoke of that. Every time he spoke to me he stoutly said that he wants to improve his
relationship with his children and be a good father, but he never did it, at least as long as he was coming
to me. There is a vast discrepancy between what he was and what he wanted to be.

(4) VERBAL & NONVERBAL EXPRESSIONS

Once I went to attend a funeral and to console the lady whose brother died. As I went over
there, the lady extended a warm welcome, and with a beautiful smile on her face, spoke how sad she
was and how much she missed her dear brother. What she was saying by her verbal language was
contradicted by her body-language.

(5) PAST AND PRESENT UTTERANCES

Often in group meetings I have observed people contradicting their own previous statements, not
because of new conviction that came about after a discussion, but because of an internal discrepancy in
their lives.

2) CHALLENGING DISTORTIONS

Clients perceive the objective reality in their own subjective way. Take for example projections
which are in reality distortions of objectivity. A rather poor man complained to me about his brother
who is well off, telling that his brother was jealous of him and that is why he would have conjured him.
In fact his brother would not have even thought of harming him, and actually he was even financially
helping him. It was a fact that this poor man was jealous of his brother's prosperity, and not the other
way about. But his perception that his brother was jealous of him was a distortion.

3) CHALLENGING GAMES

When we are unable to cope with certain stressful situations, we take to games as an easy way of
manipulating the situation and saving our face. In Transactional Analysis, Dr. Eric Berne explains a
number of games people play — in three main roles as the persecutor, the victim and the rescuer.
Clients play games outside the counselling session and continue to do the same with counsellors in the
counselling sessions too. Unless they have worked out their game pattern, they will continue to play
games in most of the situations. Their game pattern in the counselling session is a replica of what they
would be outside the counselling session too. Your interpersonal style in any given group is a fair
specimen of what you would be in any other group.

A young girl goes about enticing young men by her verbal and nonverbal behaviour, and when
the men take her seriously and make advances to her, she will turn sour and attack them vehemently,
abusing them orally for their indecent behaviour. She approached a counsellor and played the same
game with him. This was the time the counsellor pointed out to her, her psychological game pattern.

4) CHALLENGING EXCUSES
 Principles and Techniques of Counselling-7 163

Clients want to appear honourable in their own eyes. When the facts do not support their self-
honour they find some excuses to protect their honour. People who do not take responsibility for their
life and the future, people who rationalize their every misdeed, and people who indefinitely postpone
what they are supposed to do at a given time, are all people who lead an unhealthy life under the cover
of excuses. This is one way of remaining in the same pit, and complaining that their life is a misery.
Asking 'What steps have you taken to alter your situation?’ will seriously challenge them.

5) CHALLENGING IRRATIONAL INNER RULE

Clients adopt certain standards of judging and evaluating their own behaviour and those of
others. They may be dysfunctional in the sense they produce unhealthy emotional reactions in them.
Albert Ellis has listed ten irrational beliefs that are self-defeating, and he says that people cling to those
beliefs and suffer from them. They, for example, believe that one should by all means be loved by
everybody; one should be competent in everything; one should be free from troubles, one should have
one's own way at all times, one should be in danger; one should be a victim; one should avoid difficult
situations; one should remain passive; one should want to hurt others who do harm to one; and one is
being conditioned by the past. These beliefs come in their way of rational and healthy living. Take for
example one of the irrational beliefs: I should be loved and appreciated by everybody. Humanly
speaking, one can never dream of such a great success at all times. This is the surest way to be unhappy.
There is a self-defeating internal dialogue going on in the client, and when the counsellor perceives such
a belief expressed externally, he/she could challenge it.

6) KINDS OF CHALLENGING

(1) Simple Didactic (Interpretive) Challenging: It is making the clients realize how they start
and maintain their problems, going along with the clients in their internal frames of reference, and thus
gently drawing their attention to the things that go wrong.
(2) Hot-Seat Challenging: It is directly addressing, not allowing the clients to avoid the
situation or offer excuses.

7) GUIDELINES FOR CHALLENGING

As a principle, it is good to remember two main aspects in challenging others. All the tips that
will be dealt with here refer to one of these two principles. First and foremost, see the strength of your
relationship with the client, and secondly, the client's level of vulnerability. Your relationship strength
and the client's vulnerability are the two main guiding norms.

(1) BASED ON RELATIONSHIP

Make sure that you have a working relationship with the client; otherwise your challenging is
merely threatening.

(2) OUT OF LOVE

One who has no love for the other has no right to challenge the other. You challenge the other
because deep down you love the person and his/her well-being. It is not to take revenge that you
challenge.
 Principles and Techniques of Counselling-7 164

(3) WITH CARE

Care is a delicate way of handling a thing, and in this case a person who is vulnerable. Since
normally clients expect understanding, not challenging, they will be put out if challenges are given in
any way. It is with a sense of great delicacy that it should be delivered.

(4) DEPENDING ON CLIENT'S STATE

Make a judgement about the vulnerability of the client and to what level the person is able to
take the challenge. Challenging is to do good to the client and if you perceive that your challenging is
going to harm the client more than doing good, better refrain from challenging. When the clients are
sick, in crisis, and emotionally disturbed they need more support than challenging. Challenging should
not harm the clients but it is all right if it makes them uncomfortable.

(5) BUILD ON SUCCESS

Do not dump your challenges all of a sudden. Give them in smaller doses and once they are
familiar and have mastered a certain skill in self-managing, then place a higher demand by another
challenge. Therefore, spacing out your challenges according to the success of the experience is
appropriate.

(6) BE TENTATIVE

Challenges are to be presented not as absolute interpretations but rather as hunches and guesses
which can be discussed, affirmed or denied by the client. There should be enough room for the client to
hold a discussion and see the relative worthwhileness of the challenges.

(7) OWN YOUR THOUGHTS AND FEELINGS

Challenges are your frame of reference and not that of the client. Hence your challenges are
external frame of reference to the client. Keeping this in mind make 'I' statement owning your thoughts
and feelings about the client.

(8) PRESENT IT NEUTRALLY

You need not take sides with regard to challenges. If you find two views, for example his/her
view about him/herself and others' view about him/her, you just present both the views telling perhaps:
You are saying that you are always truthful whereas your daughter is pointing out that in fact you had
been telling not the truth at least in three instances. How will you understand this?

(9) REST THE RESPONSIBILITY ON CLIENT

You need not insist that your challenges are to be accepted by the client. Your duty was only to
bring to the awareness of the client and not forcing him/her to accept them. This will make the
challenges non-threatening, and the clients will welcome them.
 Principles and Techniques of Counselling-7 165

(10) DO NOT OVERDO IT

Challenging should be proportionate, neither more nor less. Anything overdone defeats the very
purpose of the activity undertaken with goodwill. Even well-intentioned challenges overdone will be
counterproductive.

(11) BE OPEN TO CHALLENGE YOURSELF

If you yourself are defensive and rationalize every mistake of yours, how are you going to help
the client to be non-defensive by your challenging? I have observed some people holding superior posts
who rationalize whatever they do and defend it whereas the same is considered a fault in their
subordinates. Such persons should be the last ones to challenge others.

(12) BE SPECIFIC

It is not the question of vague realities to be challenged, but what has been found concretely,
expressed in clear terms. Being specific will mean being concrete. Instead of telling a person that
he/she is not dutiful, point out the times he/she was negligent with his/her duties.

(13) CHALLENGE STRENGTH RATHER THAN WEAKNESS

Not that one should not challenge deficits at all but your main thrust should be to enable the
client to lead a better successful life for which challenging their strength will be of greater use. Too
much concentration on deficits depresses the client and eventually he/she might give up. Challenging
the strength will in reality mean that you point out to the client the resources he/she has but somehow
failed to use them. Superiors in position of correcting their subordinates, will do well to find out how
the subordinates can be encouraged to do better rather than pointing out all the deficits they have.

(14) ENCOURAGE SELF-CHALLENGE

Your challenging the clients should be ultimately to help them carry on this challenging attitude
all through their lives for their own betterment. As you yourself are committed to your own self-
challenging, create in the client the spirit of self-challenging. Finally what is more useful is the client's
self-challenging. Let there be a self-direction from within rather than from outside. Self-challenge is a
self-direction from within the client.

(15) PRESENT CHALLENGES AS FEEDBACKS

Finally see that you do present the challenges as a feedback on the observation you have made
on his/her behaviour in the here-and-now. Deliver it in descriptive forms as an attempt to explore
alternatives basing on the value it will have for him/her. Make sure his/her ability to take it and use for
his/her betterment. Present it at the appropriate time in graded doses.

Any accusation is naturally denied at the very outset as a natural reaction unless one deliberately
decides to act the other way about. Even when we are becoming aware of a serious sickness, we deny it
for some time, and that is why treatment is not given on time and the condition worsens. A lady had a
tumour in one of her breasts. She knew about it and said to herself that the tumour was a benign one.
 Principles and Techniques of Counselling-7 166

She kept denying her illness until it was too late to intervene medically. Thus denial is a natural reaction
to anything negative in us. Challenging is a risk you take upon yourself in your interpersonal
relationship. Challenging the clients is one thing, and challenging the people who live with you is
another thing. People are usually anchored to the negative feelings they experience while being
challenged and associate it with you, and thus your very sight might evoke the same negative feeling
they have anchored. We come across people who might have been challenged many years back but
harbour a grudge even now against the one who challenged them. It is also good for the counsellor to
be in the know of the shadow side of challenging but at the same time high-level functioning as a
counsellor demands challenging, and challenging can produce the maximum change if done
appropriately.

7. SELF-DISCLOSURE157

By self-disclosure we mean the intentional, useful and appropriate sharing by the counsellor
of his/her experiences bearing on the problem of the client. We are all wounded healers. We
ourselves have been wounded and we know what it is to be wounded and so we share in the human
struggle with difficulties and we manifest our solidarity with the suffering humanity. Counsellors are
not superhuman persons and they are very vulnerable. At times they are more vulnerable than the
ordinary people just because first of all they are by nature people of empathy towards themselves and
others and secondly they deal with the shadow sides of persons most of the time. They are also most of
the time burn-out. They are just like any of the counsellees but they have committed themselves to self-
growth and thus have known the pain of growth internally and interpersonally and thus they could
encourage others to come to grips with their problems. When the counsellor shares his own experience
connected with the problem of the client that is presented, the counsellee feels relieved of the funny
feeling of being a freak.

About the usefulness of self-disclosure counsellors are divided. Some favour it while others do
not. In any case, it can really be useful when done appropriately. There are times when self-disclosure
would have saved many lives. At its worst, it may not kill the clients, but only become a nuisance.
Therefore, it is worth using it as I said, appropriately.

1) KINDS OF SELF-DISCLOSURE

There are two types of self-disclosure: one is nonverbal which is implicit and indirect, for, the
whole person of the counsellor speaks loudly to the counsellee ever since the first moment of their
meeting; and the second is the explicit, and direct verbal self-disclosure. The second one is intentional
whereas the first is not intentional. For the body disclosure, you do not have to intend to reveal yourself
whereas for the verbal disclosure you need to make up your mind to do so. What you share should be
connected to what the client is speaking about, and appropriate to the context and the person — the
counsellee.

Counsellee: (Joining the Alcoholics Anonymous) However hard I may try I am not able to
keep a check on my drinking habit. At night I resolve not to touch liquor in
the morning, but early in the morning as though I am compelled by some external
force, I find myself drinking.
Counsellor: (Belonging to the Alcoholics Anonymous) I remember my own good old
days when I struggled like you, making resolutions practically everyday and
breaking them in an hour's time. And finally after a long struggle I could get
myself out of its clutches.
 Principles and Techniques of Counselling-7 167

2) SELF-DISCLOSURE IS A CHALLENGE

It is a challenge for two reasons. First of all self-disclosure is a form of intimacy. We share
about ourselves only with the people whom we know very well, with whom we are rather intimate. It is
a kind of verbal intimacy for which the clients may not be prepared or some people are naturally averse
to any closeness be it bodily or verbal. The people who are not comfortable with intimacy will find it
difficult to accept self-disclosure. Secondly it is a challenge for the simple reason that the counsellee is
invited to follow the example of the counsellor in an indirect way. Sharing is for the sake of the client
so that he/she could change like the counsellor and the invitation to change is a challenge.

3) ADVANTAGES OF SELF-DISCLOSURE

(1) FREEDOM FROM FEAR

Many times the counsellors whom the clients meet are strangers. Counselling is an intimate
interaction in which the client discloses his/her intimate concerns and therefore he/she will have fear of
opening up to a stranger. When the counsellor starts speaking about him/herself and his/her problem the
counsellor becomes personal to the client and the fear of being open to a stranger subsides.

During the Sadhana sessions (group therapy) at Lonavala, Pune we were twenty-two
participants. It was the first week in which community building sessions were going on. In one of the
sessions the facilitator was talking on adult development. He said that we need to take back our
projections to be integrated and then he asked us to jot down in our notebooks the projections each one
of us had. We did write them in our notebooks but were hesitant to share them with others since we
were relatively strangers to one another in the first week of Sadhana. Then the facilitator himself started
to share his own projections after which each one of us without any hesitation started to share ours, so
much so that session had to be extended so that each one of us could share. But for the self-disclosure
of the facilitator, perhaps that sharing we did as a group would not have been that lengthy.

(2) APPEARING HUMAN

After all, the counsellor is not a saint who is holier than the counsellee. It is very consoling for
the client to realize that the counsellor is human like him/her, having even similar problems like his/her.
This frees the client from the fear of being freak in his/her problem. After all, the client is not alone in
this particular problem.

(3) MODELLING

The counsellor is not only a person who had a problem similar to that of the client but also
he/she is a person who has struggled to go through the problem and reach the solution and in that way
the experience of the counsellor becomes a model for the client to imitate and also it is an invitation to
become like the counsellor in dealing with the problem.

(4) DIRECTION

Counsellor's self-disclosure provides a direction to the client, for, till the counsellor shared
his/her problem the client was wallowing in his/her own misery and after hearing a self-disclosure of the
counsellor he/she knows where to go and how to reach there because there is someone in front of
 Principles and Techniques of Counselling-7 168

him/her concretely who has achieved what he/she is struggling to achieve. In that way counsellor's
sharing points the direction to the client.

4) DANGERS OF SELF-DISCLOSURE

The result of self-disclosure is ambivalent. In any case, too much of self-disclosure will be
exhibitionistic and too less of the same will indicate psychological ill-health on the part of the
counsellor. When the self-disclosure is inappropriate it might be harmful. Here below let us consider
certain criteria to judge a self-disclosure whether it is appropriate or inappropriate. If they are done in
the following ways they are definitely inappropriate.

(1) BURDENSOME

Clients are already burdened with their problem which is subjectively too much for them to
carry. And now if your sharing also were to add a load to their already existing problem it is
burdensome to the client. Of course there are persons who invite and appreciate your sharing but not
everybody and if you by chance judge that your sharing is definitely going to do harm to the client
making him/her more troubled, it is better that you refrain from sharing.

(2) APPEARING WEAK

Clients with problem feel that they are weak. Weak persons usually approach a strong person
for help. In the eyes of the client the counsellor is a strong person. Even if the counsellor is not actually
strong at least the client needs to think so. They need to idealize a strong person and now in this context
the counsellor happens to be in that position. Just like the clients when they were young idealized their
parents and saw them strong, now they see the counsellor as a strong person. In such circumstances the
counsellor's sharing is going to bring down his/her image in the eyes of the client and it might interfere
with the client’s confidence in the competence of the counsellor thereby becoming counterproductive.

According to Heinz Hohut, the father of Self Psychology, we have three basic needs. The first is
the need to be mirrored. Children have a strong need to be shown by parents that they are very special,
great, and welcome. When the parents do this affirmation, they are mirroring. The second need is the
need to idealize. The little child needs to idealize the parent, especially as he/she senses that his/her
grandiose self cannot reliably master the world. It is quite important to the child that the parents are
powerful and knowledgeable. They merge with the perceived greatness and calm of an idealized self-
object who is often the father or mother or any parental figure. The third need is for twining. Children
need to know that they share important characteristics with one or both of their parents and that they are
not too different from the world into which they have been born. Now the point is that clients idealize
the counsellors. Therefore if they come to know the weakness of the counsellors through their self-
disclosure that might endanger their psychological equilibrium or homeostasis. Therefore this is one of
the dangers of self-disclosure.158

(3) DOMINATING

Sometimes sharing one's problem with the client might indicate an attitude of ‘I know better
than you and so I will take care of you and your problem.’ Instead of helping the client to play the
primary role in dealing with his/her problem he/she may be pushed to the secondary role by your
generous attitude of doing things for him/her. This happens by way of sharing your problem and the
way you handled such situations and now concretely being willing to do the same for the client.
 Principles and Techniques of Counselling-7 169

(4) COUNTER TRANSFERENCE

Usually the clients project their earlier unresolved relationships of both positive and negative
nature on the counsellor which is called transference. In the same way if the counsellor were to project
his/her unresolved earlier relationships on the client and get attached, it is called ‘counter transference.’
It is also possible in a subtle way both consciously and unconsciously to manipulate one's self-
disclosure to get one's needs met like the need for approval, intimacy, and sex.

5) FACILITATIVE SELF-DISCLOSURE

Having seen what self-disclosure is and what its advantages are and its dangers, we now
consider how the self-disclosure ought to be.

(1) RELEVANT AND SELECTIVE

What you share should have a bearing on the problem presented. You may have many
experiences but not all of them are relevant. Your sharing should not distract the client from the main
issue. It should only help the client to understand his/her problem better. Therefore, it has to be
relevant, selective, and focused.

(2) APPROPRIATE

Your sharing need not be for every sentence of the client. It should not be so frequent as to
occupy so much of the time of counselling without giving the client a fair chance to express him/herself
fully and explore his/her problems and find solutions for the same. It should not be done right at the
beginning. Your sharing should be well-timed, trim and not too frequent.

(3) FLEXIBLE

Self-disclosure might help a client; but it is not a must. There may be counselling situations
where self-disclosure may not be needed. In those circumstances be content with the sharing of the
client and you need not force your sharing on the client. Only if you judge that your sharing in some
way will help the client you need to self-disclose, otherwise be wise enough not to impose your sharing
on the client.

8. IMMEDIACY (DIRECT, MUTUAL TALK)159

Immediacy is the ability to explore with another what is happening in their relationship. In
counselling there is an interplay of emotional reactions between the counsellor and the counsellee.
Emotions usually colour our interactions. Either they do good to the counselling or act against the
success of the counselling. The counsellor needs to know the subtle interplay of his/her emotions and
those of the client and deal with them before they take a gigantic proportion and destroy the counselling
process and outcome. Feelings and emotions are actually important motivating forces. To say that one
does not have feelings is talking out of non-awareness of the feeling, not out of its non-existence.
Immediacy refers to the counsellor's reactions to the counsellee during the counselling sessions. It is the
ability of the counsellor to explore with the client what is happening in their relationship. It is a direct
and mutual talk between the two, of what happens between them. It is a kind of ‘ you-me-talk.' The
 Principles and Techniques of Counselling-7 170

client's interpersonal style can be to some extent seen in his/her relationship with the counsellor and if
there is a group, his/her relationship to the group will resemble his/her reaction with other groups also.

1. KINDS OF IMMEDIACY

In all there are mainly two kinds of immediacy. One is overall relationship immediacy and the
other is here-and-now immediacy.

(1) OVERALL RELATIONSHIP IMMEDIACY

Here the counsellor discusses how the counsellor and the counsellee relate to each other. They
do not take up issues like any particular items that are spoken of but only the relationship they have with
each other. An exploration into such a relationship is called overall relationship immediacy. The
counsellee relating to the counsellor as his/her father is an example. If the expectation of the client
interferes with the counselling process, a discussion on the very expectation of the client to be treated by
the counsellor as his/her father would do, is helpful. This is called overall relationship immediacy since
it deals with a particular relationship of the client with the counsellor.

(2) HERE-AND-NOW IMMEDIACY

Here the consideration between the counsellor and the counsellee is what is going on between
both of them right now. Here they do not worry about their general relationship at all but only what is
just happening between them. If a counsellor were to deal with a certain irritation he/she has when the
client is not distinct and clear in his/her expression it is a here and now immediacy. For example, the
counsellor asks direct questions for which the client gives indirect answers. This fact does not touch
their relationship but what happens concretely during the session here and now. Therefore a discussion
on what takes place here and now in the session is called here-and-now immediacy.

2) COMPONENTS OF IMMEDIACY

(1) AWARENESS:

Unless you are aware of what is happening between you and the client you cannot be immediate.
Through much nonverbal language the client and you are communicating and you should be able to pick
it up for consideration and that requires a certain amount of awareness.

(2) COMMUNICATION

Awareness alone is useless unless you communicate the awareness to the client. For immediacy,
there should be a dialogue between you and the client. If you are only aware of what is happening, then
no dialogue will take place. You need to communicate. Here make use of all the skills required to be
empathic in communicating to the client.

(3) ASSERTIVENESS
 Principles and Techniques of Counselling-7 171

Since immediacy calls for courage because of the delicate situation and the fear of offending the
client, this particular skill requires assertiveness to dialogue with the client at times on unpleasant
matters.

3) PURPOSE OF IMMEDIACY

(1) TO BE IMMEDIATE WITH COUNSELLOR

Immediacy helps both the counsellor and the counsellee towards effective working together at
the counselling sessions. Since their relationship is being taken care of by the use of immediacy, the
counselling can be effective without major hurdles. The client learns to rectify the deficit in his/her
relationship with the counsellor and the way he/she relates to him/her.

(2) TO BE IMMEDIATE WITH OTHERS:

Dealing with their relationship helps the client to review his/her relationship with others outside
the counselling sessions. If the counsellee works out his/her relationship problem with the counsellor,
his/her relationship with others gets automatically rectified. Thus immediacy helps the client to set right
his/her relationship with the counsellor for efficient working together and secondly it helps him/her to
be effectively immediate with others in his/her relationship.

4) CONTEXT OF IMMEDIACY

A girl of 23 was sent to me for counselling. She was uncomfortable with her father whenever he
visited her in the hostel. She said that she was afraid of him.

Counsellor : What are you afraid of?

Counsellor : I am afraid that my father will rape me.
Counsellor : Do you have such fear only with regard to your father?
Counsellor : No, I feel the same with every man when I happen to be alone in the
company of any man.
Counsellor : OK, and now that you are alone with me a male person what are you
experiencing right now?
Counsellee : I feel the same with you too.
Counsellor : What are the possibilities that I will rape you?

The above illustration is a case in point. The girl was afraid of her father that he might rape her
and that could be dealt with since the same fear was there about the counsellor. Here by dealing with
the client's fear of the counsellor, the counsellor could help her to deal with the fear of her father. This
is precisely the work of immediacy. Let us now consider the situations that call for immediacy.

(1) TRUST ISSUE:

Counsellee : Usually I don't like to be guided by women. If I were to relate to a

woman I should feel better than she is. This does not happen to me in
relating to men.

Counsellor : Since I am a woman counsellor do you feel comfortable to share with

 Principles and Techniques of Counselling-7 172

me since you might consider my role as superior?

Counsellee : I am not comfortable with you.

(2) DEPENDENCY

Some clients want to play a subordinate role and they may be seeking occasions and persons to
play that role. They would appreciate that someone takes charge of them and they become dependent.

Counsellor : I have been noticing from the beginning that you seem to be
relating to me as though you would do to your mother.

(3) DIFFERENT STAGES

Here there is a discussion about the approach the counsellor takes and the approach the
counsellee takes.

Counsellor : All that I am saying seems to be a joke for you and I wonder when
you will take the issue seriously.

(4) DIRECTIONLESS SESSION

Counsellor : It looks to me that both of us are missing each other during

this session, and I am wondering what could it be.

(5) ATTRACTIONS

Counsellor : From the first moment we met each other we seemed to have
liked each other and that may be the reason, I suppose, that the counselling does
not proceed.

(6) SOCIAL DISTANCE

Counsellor : I am wondering whether my belonging to a different ethnic group

from yours plays a role in your hesitation to deal with me.

(7) ANGER

In counselling you may get angry in the following situations:

1. When you find negative transference and negative reactions of the client.
2. When you are frustrated with the way he/she is working.
3. When he/she clings to his/her irrational beliefs and refuses to budge.
4. When he/she blames you for the failure of the procedure.
5. When in a subtle way he/she is trying to blackmail you.
 Principles and Techniques of Counselling-7 173

Immediacy and self-disclosure seem to be the same but they are not. In self-disclosure the
counsellor shares his/her experience resembling the problem the counsellee had presented, whereas in
immediacy the counsellor speaks about the overall relationship with the counsellee or some issues that
crop up between them in the counselling situations.

11
PERSONALIZE THE CLIENT’S DEFICIENCY

PERSONALIZING

Personalize the client’s deficiency (what the client is doing or not doing that contributes to his/her
problem) by susing the formula ‘You feel…..because you cannot…..’

Now we have reached the middle of counselling. It took a pretty long time to arrive at this
point. There had been a lot of preparation at various levels. Finally the moment has come to look into
the problem and own the deficiency. There are three cardinal steps in counselling. They are pacing,
personalizing, and reframing. Now we are at personalizing level. From now onwards the process of
counselling takes a different turn. Once this is done then comes the goal. But to arrive at the goal,
personalizing is very essential; what has been personalized becomes the goal.

Somehow we have learned to blame others for our own mistakes and faults. We do not take the
responsibility for our own actions. We look for some scapegoats to put our blame on them, and thus
exonerate ourselves from the burden of the responsibility of owning our mistakes. Even as children we
have learned these tactics and the elders themselves taught us tricks. A child falls down because of its
clumsy gait and unsteady steps stumbling over a stone. The child was not careful to walk and so it
stumbled and fell down, but immediately the elders make the child beat the stone, or the ground, or the
elders themselves give the punishment to the ground for having made the child stumble down. The
child learns very early in life that it can always find someone to blame for its mistakes. This goes on
 Principles and Techniques of Counselling-7 174

even unto adulthood. The people who go about blaming everybody else for one thing or other have
learned such habits from their childhood, but later it becomes a manipulative technique for them to deal
childishly with people around them. This is one of the unhealthy ways of living a phoney life without
substance.

In every quarrel both the parties are to blame to some extent. It is a question of degree. By this
I do not mean that there could be injustice done to an individual without that individual being at fault.
Mostly in interpersonal relationships we find that the individual who complains has some part to play
towards the problem.

Personalizing is an attempt on the part of the counsellor to make the client realize his/her
contribution towards the problem. The counsellor cannot deal with the third party in the case of the
client having some problem with another individual. All that the counsellor can do is to deal with the
client right in front of him/her. He/she makes the client understand where he/she stands with regard to
where he/she has to go. To bring to the awareness of the client his/her personal deficits is called
personalizing.

In the first few interviews with the clients, you will hear them talking about others and what is
wrong with others and not with themselves. Later they speak about what happened to them, that is their
experience and still later they speak about their feelings and lastly and with reluctance they might speak
about what they did, that is, their behaviour. While speaking about their experience and feeling they
conveniently leave out their behaviour because perhaps in their own eyes they want to appear blameless,
or the awareness of their contribution to their problem is so shocking a thing that as a defence
mechanism they avoid even the thought of it, just like drunkards will not like the very mention of the
word ‘alcohol’ because they feel guilty about it.

The counsellor should be careful about the timing of personalizing because the clients take a
long time to own their responsibility. Because of a defence mechanism they delude themselves telling
that only the other party is at fault. In that way they become blind to their role. I have seen clients
taking even months to own their part in the problem situation. This only shows how strong the defence
is. When the client is not ready for personalizing, you fall back on the pervious stage reflecting the
feeling until such time the client is ready to review his/her convictions.

Personalizing is internalising the personal deficit. Personal deficits of the clients can be in the
form of what one does that is a problem or what one does not do that is a problem. One may contribute
to the problem by commission or omission. What the client did that should not have been done or what
the client did not do that has become a problem. Let us illustrate these situations by examples.

1. WHAT ONE DOES

Sounder: I am a failure in my office. Nobody obeys me even though I am the chief in the office.

Counsellor: What is happening in your office; tell me more about it.

Sounder: Whenever I give some orders, the subordinates do not carry them out; they drag any work
and nothing is competed on time.

Counsellor: What do the subordinates do?

Soundar: They react and murmur.

Counsellor: What do they murmur?

 Principles and Techniques of Counselling-7 175

Soundar: That I am too rough in commanding them.

Here the deficit of the client was that he was commanding his subordinates in a rough manner.
Here it is the question of commission which has become a problem for the client.

2. WHAT ONE DOES NOT DO

Cithara has already joined the staff-nurse course. Her family is not well off and yet it managed
to see to her admission and will like to see her through the course.

Cithara: I thought it would be glamorous to be in the nursing profession, but after joining it, I
realize that I will not fit into this programme and much less take it as my profession all
through my life. Honestly speaking, I want to give it up. But how my parents will take
it, I am afraid. They have already spent so much of money on my course.

Counsellor: You realize that you do not have the liking for the nursing profession and
would like to give it up, but are afraid of offending your parents.

Cithara: That is true. I don't have the guts to take a stand for myself even if it were to
offend my parents.

Here personalizing the problem means her lack of courage to take a decision and execute it. The
deficit of the client is not having the courage to tell her decision. Here the problem is by way of
omission.

There is no fun in discussing about the deficit of the third party. The client can do that for days
together but the counselling will not proceed. Therefore one day the client should settle down to look
into him/herself and see what he/she is doing or not doing that is his/her problem.

Some might ask what about innocent persons involved. For example, one is wrongly accused of
stealing. Here what is the commission or omission? For, the client never did anything. It is true that
the client did not commit the offence, but he/she allowed him/herself troubled by the accusation. The
fact that he/she permitted to be worried on account of the accusation. Of course, this does not mean that
the client should not defend his/her innocence. He/she should do all that. Here we are only speaking
about personalizing the problem. In this context the client failed to refuse to be troubled by the
accusation. This only shows that in every problem, the client has a share. In counselling, the counsellor
facilitates the client to identify that share which is a deficit by way of commission or omission. Once
this has been done, you are on the right track, otherwise you are half the way through.

In personalizing you could use the formula like: "You feel..................because you can't ............"

The client in his/her narration was avoiding looking into his/her role and at an appropriate time
the counsellor personalized the problem. Counselling will not be complete if the client does not
understand his/her role. An empathic way of responding is essential at the beginning and sooner or later
you should facilitate the client to perceive his/her deficiency and own it.

If the client is not ready to reach this level, there is no fun in proceeding further with the
counselling. Perhaps to prepare the client one may go back to the previous stage, but somehow the
client should be prepared to face the situation. Among the most important tasks in counselling, owning
responsibility comes as one of them. One who thinks that he/she made a mistake will in all probability
mend his/her life, whereas he/she who thinks he/she is immaculate will never improve his/her life. This
 Principles and Techniques of Counselling-7 176

is the most threatening part of counselling. There was a young man who was coming to me for
counselling for months, but he could never arrive at the personalizing stage, for, somehow he would
avoid any attempt on my part to personalize. For want of personalizing, he never solved his problems.
In his office he would act like a boss even though he is only one of the subordinates and get the odium
of others, but it never occurred to him that his bossing over others was his problem rather than the
hatred of his colleagues.

Realizing the importance of personalizing the deficiency of the counsellee for the benefit of
counselling, the counsellor should make every effort to do that at an appropriate time.

The concept of personalizing the problem is simple and very essential for the success of the
counselling. It may not be prudent to personalize the problem of the client very early unless the client
has been sufficiently prepared. If done early, you might lose the client. Because personalizing is
threatening practically for all.160

12
FIND OUTALTERNATIVE FRAME OF REFERENCE

Find out alternative frame of reference using the formula ‘you feel… because you cannot… and
you want to…’

Having seen what reframing means, now we enter into this step to articulate different ways of
reframing. Reframing in short is nothing other than ‘alternative frame of reference.’ In alternative frame
of reference you just reframe. You see the reality from another angle. Therefore, reframing and
alternative frame of reference are the same. Now let us spell out the different ways of reframing or
finding out alternative frames of reference.

Here the concern of the counsellor is to stimulate alternative frame of reference for a client who
is stuck with one frame of reference. We have problems because we have one way of dealing with
reality that is problematic, and if you develop some other ways of dealing with the same reality then the
problem disappears. The counsellor stimulates the client to have such a different frame of reference
which is alternative to the one he/she already has. The more alternative frames of reference you find the
better it is. Here below let us consider different ways to stimulate the clients to various alternative
frames of reference or reframing.161

1. SOLVABLE PROBLEM
 Principles and Techniques of Counselling-7 177

Clients have the tendency to catastrophize their problem situation to such an extent that they
believe that there is nothing that can be done about the situation. This can be made out from the use of
their vocabulary. Clients state their problem as unsolvable and that is why they are helpless. To express
such a helpless situation they use the ‘I can't’ language. By such use of language they already decide
beforehand that nothing can be done to change the situation and make them feel better. One cannot
change one's height, one's complexion and the like. In the same way clients think of their problems too.
It is perhaps they ‘don't’ do rather than ‘can't’ do. There is a vast difference between 'can't do' and 'don't
do'. If the clients were to state their problems as 'don't do' then it is solvable and we can facilitate
growth in the individual.

Counsellee: My sister and I are not on talking terms since the time we quarrelled over
property division and I can't face her anymore particularly when I remember
how selfish she had been.
Counsellor: Is it that you can't face her or you don't face her?
Counsellee: It is not that I can't face her but I do not take the trouble to talk to her.

The counsellee came with an unsolvable problem of impossibility and the counsellor helped him
to state it as solvable. After this the process of counselling will be made easier.

2. CONCENTRATION ON RESOURCES

Clients are in their depressive deficits when they are talking to you. The counsellors should be
aware of the deficits of the clients to be sure and also make sure that the clients too are aware of them in
the personalizing stage, for without that awareness nothing worthwhile can be done. But it is not
recommended to dwell on the deficits only. Having taken stock of the deficits, concentrate on the
resource of the client which will brighten up his/her future. The client concentrates on the deficits,
whereas you help him/her to concentrate on the resources, and this is stimulating the client to an
alternative frame of reference.

Counsellee: I just can't manage with my mother-in-law most of the time. See, this very
morning we had a big fight and I do not know what he/she will tell my husband
when he comes home this evening.
Counsellor: You feel unable to handle your mother-in-law and while speaking about it
you said that most of the time you are not able. Are there sometime when you are
able to manage her?

Counsellee: Yes, of course, there are times when I am able to manage her.

Counsellor: Could you tell me the way you manage her sometime?

The fact that most of the time she was not able to handle well her mother-in-law is a deficit
indeed, but it contains a ray of hope that at times she is able to handle her well. Probing more into her
ability to deal well with her mother-in-law might be useful for the client. Identifying the resources and
concentrated on them rather than on deficits is another way of stimulating the client to an alternative
frame of reference.

3. POSITIVE FUTURE
 Principles and Techniques of Counselling-7 178

Clients want to have a bright future without the problem they are currently facing. But they
have not contemplated how the future will look like. If only they were to contemplate their bright
future, they would find ways and means to change the present problem, for, the contemplation of the
future pulls them as an incentive to invest their energies in changing the present situation. Of course,
the way the counsellor stimulates a client to the positive future could be in many ways. The present
problem being faced and experienced as such is one frame of reference, and the future imagined without
this problem is an alternative frame of reference that might ultimately help the client.

Counsellee: When I come home after my office work in the evening I find myself
quarrelling with my wife and beating up the children so much so nobody is
happy at home especially when I am present.
Counsellee: What will you be doing if you are not quarrelling and beating up the children?
Counsellee: I will be patient and appreciative of my wife and children.

The client is immersed in his present behaviour, and imagining the type of future with no
quarrelling and with patience and appreciation of the family members is an alternative frame of
reference.

4. DREADFUL FUTURE

People who continuously, by acts of self-defeating behaviour patterns, engage in activities

detrimental to their safety and reputation are oblivious of their dreadful future that will be the outcome
of their present behaviour. Making them peep into that future that will eventually dawn upon them will
perhaps help them change their ways.

Counsellee: Lying and stealing have become a way of life for me. Ever since my parents
died when I was too small, I took to stealing and I tell a number of lies to
escape apprehension and eventual punishment.
Counsellor: If you continue to behave the way you do, after some five years from now how will
your life look like?
Counsellee: Maybe, I will land up in the jail.

The client may be implicitly aware of how his future would look bleak with his present stealing
habit, but perhaps he did not think it out in clear terms how exactly his future will look like. The
counsellor by his knack and skill made the counsellee see the evil consequences that will come as a
result of his present self-defeating behaviour.

5. OPEN FUTURE

In positive future we concentrate on making the client see the positive aspects of his/her life
without the present problem, and in dreadful future we draw his/her attention to the evil consequences
of his/her present activities in the future. In open future we only raise question as to the future leaving
the rest to the client to decide for him/herself. This drawing of his/her attention to the future itself is an
invitation to make his/her future better.

Counsellee: I work as a clerk in a high school. My salary is sufficient enough to maintain

my family. Often I host parties to my friends and colleagues and somehow
nothing is saved for my future. My first two daughters are of marriageable
age and to see them settled is a big financial burden. Already twenty years
have elapsed without my saving anything. Only fifteen more years are left.
 Principles and Techniques of Counselling-7 179

Counsellee: You have been spending all your earning on friends and parties the last
twenty years and now how are you going to spend the rest of you earning
years?

The client is aware that he has been spending and nothing has been saved. But it never occurred
to him that he should save for the future. The counsellor presents an open future that the client can fill
up with saving. But in all likelihood the probe of the counsellor is an invitation to the client to use his
money sparingly. And this is an alternative frame of reference.

A cancer patient was informed by the doctor that he would live for a year or so. The patient has
already spent six months in depression. He goes to a counsellor for counselling.

Counsellee: There is nothing I can do. My life is over. I was told by the doctor that I might live for
one year. Already, you know, six months have gone. I am still in depression.
Counsellor: You feel desperate about your debilitating illness. You have already spent six months
in depression. How are you going to spend the rest of your life?

Here the counsellor is attempting to stimulate the client to another way of living not necessarily
in depression as the client does. This is another way of stimulating the client to alternative frame of
reference.

6. ANOTHER ANGLE

The client's way of looking at the situation is not the only way. The counsellor can look at the
same reality differently and likewise people also will view the same situation differently. The
counsellor could challenge the client by presenting his/her angle of the reality which is another angle to
the existing angle of the client.

Counsellee: In fact I am very much concerned about everybody, trying to help them on
time. But somehow people call me a 'Paranoid' for my acts of deep concern
for them. I do not know why they call me so.
Counsellor: How do you manifest your concern for others?
Counsellee: With great care I probe into their life to know if they need my help.
Counsellor: How your probing will be understood by others?
Counsellee: They could think that I am suspecting them.

Whether the counsellee was really suspicious of others' behaviour is not sure. Even if he/she
was not suspicious, at least others have understood him/her to be so and that is another way of looking
at the concerned behaviour of the client. The client thought that he/she was very much concerned about
others, whereas others thought that he/she was suspicious. Thinking all by him/herself the client would
not have come to the realization that he/she was appearing to be suspicious, and this angle was provided
by the counsellor which is an alternative frame of reference.

7. SOFT PEDALLING

When your feedback to a person is too direct and he/she is not able to accept the direct
accusation as it is, you can convey the same message by different ways that are less threatening and less
personal. If the accusation is aimed at the client, he/she will feel threatened but if you word it in such a
way that it was the problem of the other that has brought about a problematic situation for the client, the
client may not feel threatened.
 Principles and Techniques of Counselling-7 180

Counsellee: My husband always blames me for the misconduct of the children as if I am

the only person responsible for their waywardness.
Counsellor: What does he think that you are not doing to bring up the children well?

The counsellor wanted to ask the question ‘what are you doing or failing to do that did not help
the children grow disciplined?’ But this question is too direct and pointedly speaks about the
deficiencies of the client, which perhaps she may not own. But by asking the way he/she did, the
counsellor puts the same message and intends to make the client own her deficiencies as though it was
the husband who thought that she did not do well rather than in reality she did not do well. This is
softening the direct message. Maybe after sometime she will be prepared to accept a direct message and
until that time it is wise on the part of the counsellor not to personalize too soon. As a preparation to
personalize the deficiencies of the client, the counsellor can make use of indirect and soft measures to
drive home the idea.

8. TWO PERSPECTIVES

There are at least two distinct ways of looking at something. One is positive and another is
negative. One is an optimistic attitude, and the other is a pessimistic attitude. If one has a pessimistic
view he/she can be stimulated to have an optimistic view

There is a classical example for these two perspectives.

Prisoner A: (Looking out and seeing the mire in front of the ward moaned with disgust)
How dirty is this hell!
Prisoner B: (Looking out through the bars at the open blue sky studded with stars
exclaimed) How beautiful is the atmosphere!

Both the prisoners are behind the bars in the prison, but their way of looking at the things that
surround them are quite different.

9. CHANGING ROLES

The counsellee acts as the counsellor and you act as the counsellee. When you are at a loss to
make the client see your point of view, and when the client is stuck with his/her own view, then
changing the role as an exercise for a while will be beneficial for the client to see the things you have
been labouring for hours to make him/her see. To a client who had been negative from the beginning of
the session, the counsellor might say thus:

Counsellor: Imagine whatever you said and did in this session is said and done by me.
How will you respond to me?
Counsellee: um…it is difficult to do that. Anyway…I attempt. You seem to be negative towards
me for no apparent fault of mine. It may be good that you are a little positive
toward me if you want to deal smoothly with your problem.

The counsellor gets the behaviour and attitude he wanted from the client by making him/her take
the role of a counsellor. This also is a way of stimulating the client to an alternative frame of reference.

10. CHALLENGING VALUES

 Principles and Techniques of Counselling-7 181

We behave according to our value system. At times, the values we cherish may be limiting us to
such an extent that one does not lead a healthy life. It is worth challenging one's values and making
them reasonable and in tune with the best way of human development. A young unmarried girl had an
affair with a married man, and on account of that she refuses to marry the boy she loves since she thinks
that she is not chaste.

Counsellee: I feel ashamed of myself. On the one hand I want to marry the boy I love, but on the
other I am feeling very low and depressed that I am not able to offer my chastity to him.
Counsellor: You seem to genuinely love the boy. Which is a higher value for you, to
offer your chastity or your love?
Counsellee: Of course, love.

Here the counsellor is not attempting to undermine the value of chastity, but only helps the client
that on account of the value she has placed on chastity she need not remain unmarried for her whole life.

11. CHALLENGING BELIEFS

A young officer involved in a criminal case wanted to end his life. He has already escaped the
clutches of the law, and yet out of shame he wanted to commit suicide.

Counsellee: I lost my face, my reputation and everything else. What is the use of living?
Counsellor: Life seems meaningless after losing you reputation.
Counsellee: What is left for me is death and nothing more.
Counsellor: You seem to be saying that everything is lost, but what about your life?
Counsellee: Yes, only life is there and what for?
Counsellor: Is your reputation more precious than your life?

Here the counsellor is trying to revive the client's will to live by using a certain strategy. He/she
challenges the very belief of the client. Of course, all of us should live with reputation and at times it
may be also lost, but life is not meant for reputation, but reputation for life. If reputation is lost, still life
is left and that is worth living.

12. USING 'I' STATEMENT

Certain expression of yours may sound like accusations. If the clients feel they are accused,
they may close up for fear of confrontation. In such moments you could reframe in such a way that the
client does not feel threatened, but at the same time you convey the message. For example, you could
not follow the expression of the client in spite of your attention and concentration because the client did
not clearly articulate. You could speak to the client in the following ways:

Counsellor: What you say is not clear to me. It will be better if you express yourself with
some clarity.

Definitely the client will feel that this statement is an accusation and may become nervous about
his/her expression, excessively being worried about the way he/she reports, and thus inhibiting his/her
spontaneity and the free flow of language.

Counsellor: I have not followed what you have said; would you care to say it once again?

In this second way of responding, the counsellor puts the blame not on the client but in a way on
him/herself, indicating perhaps that he/she for some reason or other could not follow the client. Here
 Principles and Techniques of Counselling-7 182

the implication is that the client need not be at fault for the non-clarity, for, it could have been the
mistake of the counsellor him/herself. Here the client may feel comfortable to repeat what he/she has
already said without being embarrassed.

We can go on giving examples of alternative frame of reference. Depending upon your

ingenuity, you might invent a number of ways to reframe the clients. You may make use of any method
to reframe the client and make him/her life happy.

13
EMPLOY PROBLEM-SOLVING TECHNIQUES,
BEHAVIOURAL STRATEGIES,
AND ACTION PROGRAMMES

INITIATING
When the client spoke to you, you listened carefully, responded well, pinpointed the problem,
went along with him/her, personalized the client's deficits and finally reframed. So far what you have
done is a grand success. Practically we can say that the counselling is complete but if left like this
nothing may be practised. Hence it is your duty to initiate the action of the client. You are facilitating
him/her to take the necessary steps to act according to the new orientation he/she has got after
interacting with you. In a way, you become a social influencer and somehow the client feels you have
influenced him/her to a great extent and your influencing goes on right till the end of the counselling.

More specifically you will initiate problem-solving techniques, behavioural strategies and action
programmes by setting goals and making contracts with the client. There is no hard and fast rule as to
what you should do and which school of thought you need to follow. Schools of thoughts are
orientations different psychologists take towards human personality, problems, and possible solutions to
 Principles and Techniques of Counselling-7 183

the problems. What is the fun of sticking to a particular school of thought and yet not being able to help
the client? Your adherence to any school of thought is in view of helping a client. Therefore, instead of
asking which school of thought you should use, it is good to know that you can do all that is ethical to
help the client out. You could follow any school, or any method provided the client is helped. From
your vast repertoire of psychological knowledge and experience draw out anything that fits the client
sitting in front of you. I, on my part make use of anything I can catch hold of at that particular moment,
the method that I judge at that time to be helpful. At times the method I adopt does not work, then I
change to another method and if that too fails I am not put out, I try again with another until the client is
helped. Your concern should be one of helping rather than using a method. There are times when I
combine many techniques together.

In this step you are going to initiate the client into action. The client explored, understood and
now he/she is going to act. What he/she is going to achieve is the goal and how he/she will arrive at the
goal is strategy. The way he/she will stick on to the process of the strategies until he/she reaches the
goal is sustained by the contracts he/she makes with you. Before you enter into the goals proper, certain
guidelines with regard to this step of initiating will be in place.

1. FIND A LEVERAGE162

Clients may visualize many goals. Not all of them can be carried out all at once. The clients
need to establish priorities of goals and accordingly they can achieve their goals. The counsellor and the
client invest a lot of resources in the process of counselling. They should get a reasonable return on the
investment of the resources. The principle of leverage would be: a reasonable return on the
investment of the resources of the client and the counsellor. Elaborated it will mean the following
points:

1) ATTEND TO CRISIS FIRST

When there are many issues surrounding a client and if one of them is very critical, you need to
address the crisis first since for a client what would be uppermost in his/her mind is his/her crisis. For
example, a client has just received his/her medical report which says that he/she has a cancer and comes
to your office bursting out into tears. You need to be with the client comforting him/her more with your
presence than by probes like: Do your friends know about it? How much would it cost to take a
treatment? and the like. Accepting the client with his/her feelings and making, if necessary, some
understanding responses would be appropriate.

2) ATTEND TO PAIN

Even if the clients are not in crisis they may be in great psychological pain. A lady was forced
to have sex in a joint family situation by a male member of the family. It so much hurts her since she
feels she was unfaithful to her husband and if somebody were to know such an affair it would be
disastrous for her and her family. The pain she feels is real even though it is psychological. And such
pains merit immediate attention.

3) ATTEND TO WHAT CLIENT CONSIDERS IMPORTANT

What is important for the client may not appear important to the counsellor. Even if it is true
that what the counsellee holds as important is not really important because the client wants to escape
from real issues it is recommended that the counsellor starts with the internal frame of reference of the
 Principles and Techniques of Counselling-7 184

client. Maybe at a later stage the client can be led to consider serious issues. Therefore, it is always
recommended to consider the issues that the client considers important. For example a client brings up
two issues. One is about his health and the other is about his family. He wants to deal with the family
problem whereas you see the health issue as urgent. Since the client considers the family problem as
important, you could attend to it first.

4) ATTEND TO A MANAGEABLE SUB-PROBLEM

The whole problem may be too complex and complicated and it will not be possible for the
client to start all of a sudden working on the problem all together. Instead, the counsellor could make
the client focus on a small bit of the problem and after dealing with it he/she can lead him/her to the
other areas of the problem. In a college, the principal was not doing well; he had quarrels with the staff,
the students, and the non-teaching staff. His whole interpersonal style was at stake. Instead of dealing
with the whole range of problems in the college, the counsellor could deal, for example, with one of
these three issues that is manageable. If the problem with the non-teaching staff seems manageable let
him/her start with that and go to other issues on the agenda.

5) ATTEND TO THE PROBLEM THAT WILL YIELD GENERAL IMPROVEMENT

Many issues may be interrelated in one big problem. And not all the issues are of equal
importance in terms of general improvement. Therefore, instead of wasting time on issues that will not
enhance life very much, the counsellor could concentrate on an issue which when handled well will take
care of other issues automatically. A young man was having problem in the office. His colleagues do
not get on well with him and his subordinates find it extremely difficult to work under him, and even the
visitors to the company feel at times humiliated by him. He admits that he is a perfectionist. He
demands perfection from everyone including himself. Instead of dealing with the relationship with the
above mentioned categories of people, if he could deal with his drive ‘be perfect,’ I think his other
problems will subside; the other problems are only symptoms of his dominant drive ‘be perfect.’

6) ATTEND TO PROBLEMS FOR WHICH BENEFITS WILL OUTWEIGH THE COSTS

Here follow the law of economy. At times with great effort and spending a lot of time you might
do a worthwhile job with the client and for the client it would have cost a lot. But the question to be
asked is whether the result is proportionate to the time spent, the efforts taken and the cost. In a small
town there was only one psychiatrist worth the name and efficient. He had a client who needed special
attention by way of therapies for which he had no time. He first thought of sending the client to a far off
place to meet another psychiatrist which will cost much for the client. On a second thought he made use
of the services of a clinical psychologist available in the town with his guidance to help the client.

7) INSTIL CONFIDENCE IN THE CLIENT

Confidence does more magic than the skills. I know a doctor who whatever be the type of
ailments the patients go with, immediately says ‘Don't worry, I can make you all right 100%.’ This is the
first sentence he uses on meeting any patient especially if the patient is discouraged, maybe after
visiting many doctors. Actually the confidence the doctor has in himself and his ability to cure the
patient is somehow unconsciously transferred to the patient and the patient too gets confidence in
his/her getting well. In fact, most of the patients, even cases that were abandoned by other doctors
responded favourably to his treatment and got well. Somehow confidence triggers on latent energy and
that achieves the goal. If you believe that you will become all right, you will see that you get all right
 Principles and Techniques of Counselling-7 185

just like if you believe that you will be rejected, you behave in such a way that you will be rejected by
others. The client's confidence is connected with his/her beliefs and beliefs can do wonders. Actually
lack of self-confidence seems to be the root cause of the people who get addicted to alcohol or drugs.
Therefore much could be achieved if only you could instil confidence in the client.

The above-mentioned considerations are only leverages and they are not to be carried to the
extreme in the sense till the end of the session. To start with the work, you will use these leverages and
later get down to business with all seriousness; otherwise it is a mere waste of time and energy. You
should be able to move the clients beyond the leverage. The leverages are only meant to lift initially
and not meant to support till the end. Whenever you want a lift you will use the leverage and leave it.

2. HELPING CLIENTS COMMIT THEMSELVES

Goals are not achieved in spite of the clients but because of the clients. Unless they bind
themselves to the plan of action they have decided, nothing is going to take place. One thing is the
initial commitment and the other is the ongoing commitment. Both are essential for the success of the
counselling. If the initial commitment itself were to be lacking, nothing will get started. To start the
action plans the client has to commit him/herself. Commitment means responsibility. Some fear
responsibility, and wish others take the responsibility and leave them free so that they are not
answerable. A responsible person is answerable. If you committed well and later after a setback you
stopped, and if you pick up courage and continue the effort, you have ongoing commitment. Only
commitment will generate success. The client who is reluctant to commit initially will not march a step
forward and he/she will sabotage his/her own success. 163

3. ECONOMY IN ACTION

Energy, time, and resources are so precious that one cannot afford to squander them anyway one
likes and the loss may be too much and the cost would have been too high. Take for example a man
who wanted to buy a television set. As soon as he thought of buying a television set he remembered a
company that sells televisions. He rushed immediately to that company and bought one. Later he
realized that the one he bought did not meet all his requirements he wanted; there are other companies
that offer the ones he could have liked and for less price. In the same way one may act in counselling.
For a problem the client gets an idea and immediately he/she decides to execute the idea that first
entered his/her head; had he/she waited for some more ideas and sober thinking he/she would have got
better solutions costing less. One may be foolish in delaying action too. There are situations for which
it is worth waiting for a while before investing your resources and there are situations for which waiting
will prove to be harmful; you may have to act immediately. The counsellor will facilitate the client
either to delay action or goad on to action depending upon the nature of the issue, so that the client
invests his/her resources economically. Thus when resources are saved, the client could use them for
something productive, more enhancing and worthwhile. 164

4. REACHING THE GOAL THROUGH STRATEGIES165

Goals cannot be achieved just by wishing. One has to work at them. The means employed for
achieving the goals are strategies. Once the goal is fixed and shaped to the needs of the client then the
client has to find out by what means he/she can arrive at the goal. There is not just one means to
achieve an end or a goal. There could be a number of ways to achieve the goal. Unless one knows
about the many means available one cannot make a choice among the means. For this, it is
recommended to use divergent thinking which is a wild thinking. It could be bizarre and unpractical.
To do the divergent thinking which is a type of wild thinking, one can make use of brainstorming by
 Principles and Techniques of Counselling-7 186

using a series of open-ended questions and probes. One allows one's mind to wander freely and find out
all the possible means to achieve the end. Once the client has exhausted all the possibilities, then you
can help him/her choose one that is appropriate to the context. Certain guidelines for divergent thinking
would be useful.

1) SUSPEND JUDGEMENT

In the process of divergent thinking the client comes up with a number of possible means. As
each possible means is thought of, one need not criticize it and assess the relevance; this can be done
later. If one starts to evaluate every possible means that comes to the mind, the client may be inhibited
in producing more possible means. For example, one wants to get enough money for starting a business
and one of the possible means he/she first thought was skyjacking a bus and taking all the valuables
from the passengers! It is only a wild thinking and either you or the client need not pass a judgement on
that instantaneously for later it can be judged as unethical.

2) ENCOURAGE MORE STRATEGIES

In brainstorming, the client may stop after enumerating a few ideas and look up. Do not leave
the client unless you are sure that he/she has really exhausted all his/her thinking in that regard. If you
have not completely exhausted in thinking out you have only limited choices.

3) ENCOURAGE CRAZY THINKING

Let not the client be ashamed of what he/she is thinking aloud, for, many of them may appear
crazy to the counsellor and even to the client him/herself. The world is a better world now because our
forefathers did some crazy thinking. For example, to think of flying in the air might have been a crazy
thinking before the invention of aeroplanes.

4) LET THE CLIENT CHOOSE A STRATEGY

Now you are with a lot of alternatives or choices and not all of them are useful. The client has
to choose the best out of them. How to get the best out of the many alternatives is a problem for which
one can use balance-sheet methodology which considers a choice in terms of gain and loss, acceptable
and unacceptable or decision-making through pros and cons or through CRAVE analysis followed by
force-field analysis, or through any other method that you know of. By now the client would have
arrived at one particular strategy which he/she is going to implement.

5) MAKE USE OF OLD STRATEGY

Instead of going for new strategies one would search for strategy that would have worked well
for the client in the past. Just put a question to the client asking him/her, how in the past in similar
situation he/she managed to deal with such problems. The clients usually remember some of the
techniques that they used which were helpful to them.

Once when I was at a loss for new strategies, I asked the client who was unjustly accused of
something serious by some responsible persons what she used to do in such circumstances. She said
that she used to picture to herself the image of her God in front of her. She would talk to him telling that
he knew her difficulties and that she was unjustly accused. By this she got a certain inspiration as
though coming from her personal God after which she would feel relieved and with renewed strength
 Principles and Techniques of Counselling-7 187

she would set about carrying out the decisions. Another client, a girl studying in the college said that
when in crisis she used to imagine her mother who was dead and have a dialogue with her.

Once I happened to counsel an efficient counsellor. He had depressive thoughts because of the
many calumnious accusations. I asked him what would normally help him in such situations. He said
that he would remember the counselling he gave to people who were depressed, telling that life is far
more precious and important than the problem one faces. With such an idea he used to console himself.
I heard one client telling me that when he encounters serious problems, he imagines how people with
more serious problems used to survive and live happily. Thus each one of us has certain strategies to
deal with problems. The counsellor could help the clients to remember their old techniques and make
use of them. Whatever is useful either old or new will do to achieve the end.

6) SUSTAIN THE STRATEGY

It is not enough to have found out a goal, defined it, then found out some strategies and later
chosen one of them and initiated activity but it is equally important to sustain the strategies otherwise
everything falls flat in the middle. Entropy is the word to denote the tendency to give up an action that
has been enthusiastically initiated. Initially clients do not realize the hardship involved in the
implementation of the strategies or the changed lifestyle as a result of new goals being achieved; but
soon the temptation to give up comes spontaneously for the client and in fact they just give up.
Foreknowledge is forewarned, it is said. Therefore it is required to be aware of the tendency to entropy
and take the appropriate measures for the same.

5. COUNSELLEE'S TASK

The client explored deeply into him/herself to find out what would have gone wrong and came
up with the awareness of certain deficiencies in him/herself. With the awareness of his/her deficiencies
and with the facilitation of the counsellor he/she started to have alternative and constructive ways of
thinking, feeling and behaving. Now what is at the intellectual level of reframing should flow into
action. That is what the counsellee is going to do in this step.

1) WILLINGNESS TO APPROPRIATE

The client has worked with the counsellor and finally came to a particular course of action. It
should not rest as the work of the counsellor but it should be primarily the work of the client
him/herself. Now he/she should be willing to appropriate whatever has been arrived at, both by
him/herself and the counsellor. It has to be the action of the counsellee and not of the counsellor. It is
going to be his/her work and he/she should make the strategies his/her own. Unless he/she makes the
strategies his/her own, he/she cannot work at it. Hence willingness on his/her part is of paramount
importance. In other words he/she has to be highly motivated to enter into action, taking a risk and
plunging into the future hoping for the best.

2) COURAGE TO CARRY OUT

What the client has decided is something new to him/her and so far he/she is not used to it. To
venture into something new and strange requires a lot of courage on the part of the client. Without
courage, the appropriated strategies will die out. That which gives life to strategies is the courage of the
client. 'Come what may' should be his/her attitude and he/she should be daring enough to carry out what
he/she has decided.
 Principles and Techniques of Counselling-7 188

3) SUSTAINED ATTEMPT

Willingness and courage might fail in the midstream. Relapses and failure are part of the total
picture of the client. One should not imagine gloriously that everything would be all right by itself.
Things might fail even with the best of motivation and courage. Let the client keep the attempt
sustained lest he/she should fall flat and bemoan saying that nothing worked for him/her .

4) RESUMING AFTER A RELAPSE

In spite of the high motivation, tremendous courage, and carefully sustained attempt, strategies
might fail. Let not the client be dismayed as though the whole world has collapsed. Nothing has been
lost. He/she only got the feedback information that something did not work for him/her, maybe due to
certain factors that were not under his/her control or were not foreseen.

Taking the failure as a feedback information he/she should resume his/her sustained attempt
with the same vigour, motivation and courage. If needed, he/she should redouble his/her efforts to reach
the goal. It could also be an occasion for him/her to find out what would have caused the failure and
rectify it. Failures are a part of the complicated process of success. The attainment of every goal may
be beset with a lot of setbacks and failures.

As though the client had been looking for setbacks as a part of the process of attaining the goal,
he/she should after a relapse get up and walk briskly towards his/her goal.

5) INVESTING THE MAXIMUM

What at times sabotages one's success is lack of generosity. If the client is not willing to invest
as much as he/she could, the results will also be scanty and stingy. It is not a question of squandering
one's resources but to invest whatever is absolutely necessary to attain the goal. In that way let the
client mobilize all his/her energies and resources that are needed for the attainment of the goal. It is
being generous towards him/herself. In the long run, his/her own generosity towards him/herself will be
an asset to him/her for better and healthy future.
 Principles and Techniques of Counselling-7 189

14
INSIGHTS
HELPFUL PRACTICAL TIPS

Over the years in counselling practice I found certain commonsense insights which we make use
of in different circumstances very useful in my helping profession. I consider them as practical tips for
counselling sessions. Here below I would like to share them with you. 166

1. CHANGE WHAT CAN BE CHANGED

Change is the aim or objective of counselling. It may be a behaviour, or a feeling, or a thought,

or a situation. There are things that one cannot change. First let us consider things that can be changed
and how you will go about helping the client. You are only dealing with the client and not with any
third party. You can help the client to change his/her behaviour. But with regard to the third party it
may not be within the control of the client. See if by any means you can effect a change in the client.
Just fancifully thinking and concluding that there is nothing that can be done is a naïve way of
approaching in this helping profession. The client along with you should be genuinely searching for
something that can be changed which in turn enhances the life of the client.
 Principles and Techniques of Counselling-7 190

Here remembering the former steps will be of use. Personalizing the problem and the goal go
together. The problem has been changed into a goal. The deficit you found as a problem is converted
into an aim or goal. Therefore mere wishing about change is not enough. It has to be systematically
worked out for which first and foremost you shall set the goal and go about using certain strategies to
reach the goal.

2. LET THE CLIENT ACCEPT GRACEFULLY WHAT CANNOT BE CHANGED

Human situations are not always rosy nor can all the problems be solved. Change is our aim in
counselling. You should by all means strive for it by making use of every method you know of and
straining every nerve of yours. There are situations that cannot be changed; there are other persons
involved in the problem of the client and they cannot be changed. One should not naively give up the
hope of change but if after a thorough investigation it becomes clear both to the counsellor and to the
counsellee that no change is possible, the next best possible course of action is to accept the situation.

Our society is madly success-oriented. Success seems to be the criterion of a good life. We
need to know that failure is as effective as success. Have we not learned a number of lessons for life
personally because of failures? The people who cannot accept failures are moving towards catastrophe.
You can never find a single life without any failure. The more the failure the better it seems in some
cases. Some of the outstanding people in history have met with innumerable failures. Abraham Lincoln
in the United States seemed to have suffered twelve major failures in his life before he could be elected
the president of his country. If he had given up with the first few failures he would not have become the
president of America. To take failure as part of one's life is wisdom.

People do accept failures but how many do it gracefully is questionable. What you resist usually
hurts you most. If you do not resist, you suffer less. A lady had a few spontaneous abortions after
which it was diagnosed that she would not have children. That was a tremendous blow to the lady.
Here nothing could be done to change the situation of her barrenness since it is medically impossible.
What is left is to accept the fact of her barrenness and do it gracefully. If she were to keep sulking, her
sulking hurts her more than the barrenness. Not that she will not sulk at all, what we mean is that a life
full of sulking is not going to help her anyway.

In my counselling practice an insight I found so useful is this, I would say. For I have been
meeting situations where hardly anything is possible. In those circumstances, I endeavour to help the
client with the attitude of accepting an impossible situation with grace.

3. PREPARE THE CLIENT FOR THE WORST

It is good to change the things that can be changed and it is even better to make the clients
accept the inevitable gracefully and it would be the best if you could prepare the client for the worst.
People in fantasy imagine all sorts of failures and in anticipation get troubled about them. They are in
general afraid of the future failure or so. When you name your fear that fear disappears. What is
unapprised looms large and frightens the individual but the moment you name the fear it loses its grip
on the individual.

It is praiseworthy if you could lead the clients in fantasy to see all the worst consequences and
results which are not pleasing. Make the client digest those negative results in fantasy for it is only
fantasy that troubles the client more than actuality. If by chance the client is prepared to accept the
worst type of results, in reality when the actuality comes, it will not be that serious as the client
imagined and the situation could be met serenely.
 Principles and Techniques of Counselling-7 191

Margaret, from a respectable family, eloped with a boy she loved. After a few days she wanted
to return to her family and was afraid of what her father would do with her. When she had expressed all
her fears I asked her in graded dose what is the worst that can happen to her in her family on her return.
At the most they may not accept her and drive her away. But definitely they will not use physical
violence, she said. Then slowly I prepared her to accept being driven away from home and beaten up
and even volunteering to go and start her life anew elsewhere. After that I called the father and made
him meet his daughter. It was a happy reunion. Even if the situation were to turn out to be sour as she
imagined she would have faced it bravely for she was already prepared for the worst.

Even when you yourself are threatened by future fears, make use of your parent ego state and
say some soothing words and thus calm down your fear. You could also encourage yourself getting
ready to meet a situation even if it were to be adverse. Preparing the client to meet the worst is a way of
safeguarding the mental health of the client.

Preparing the client for the worst is a kind of desensitizing behaviour therapy. When you have
become callous to very adverse situations in fantasy, then minor setbacks may not upset you much. You
will find it easy to meet challenges that are sufficiently serious since you have already been prepared to
face the worst situations.

4. PREPARE THE CLIENT TO BE HAPPY

Accepting the inevitable and even getting ready for the worst possible disaster are all useless
unless at the same time you prepare the client to be happy. Happiness is the ultimate aim. There may be
change or no change in counselling but what ultimately matters is whether the client is happy. Even in
the worst situation if he/she has learned to be happy that is a grand success as far as counselling is
concerned.

There is an irrational belief among us that feelings are caused by others and situations. Feelings
are our own products and we only have control over them without realizing it. Nobody and no situation
can cause feelings in us. If feelings are caused by forces outside oneself, to be happy is not within the
control of the client whereas since feelings are caused by the client it is possible to create whatever
feeling one wants. First and foremost one should be aware of the fact that feeling can be caused by
oneself only and secondly with some training and effort one may get the feeling one wants. If some
clients erroneously believe that by looking sad one can receive sympathy and love, the clients will like
to perpetuate the feeling of sadness unconsciously. This is a psychological game pattern and it is not
healthy either. Happiness that is an internal sign of mental health should be the reason why people take
to counselling. Hence preparing the clients to be happy is worth the trouble, and worthy of the task as
counsellors.
 Principles and Techniques of Counselling-7 192

15
DEFINE AND OPERATIONALIZE THE GOAL

A. DEFINING THE GOAL

This chapter deals very particularly with the goal. The clarity and attractiveness of the goal will
enhance its achievement. Let me spell it out in detail. Just as you defined the problem or the client did
it, and made it easy to deal with it, you need to define the goal in order to achieve it easily. It is ideally
done by the counsellee and the counsellor can be of great help. Or both of them do it in such a way that
the goal is of the client.

1. DAY-DREAM THE GOAL

 Principles and Techniques of Counselling-7 193

Day-dreaming is psychologically a healthy sign. People who have achieved something

worthwhile in history and in personal life are the ones who dreamt a lot while they were awake. In fact
what you dream when you are awake, is sure to come up in your sleep also. Unless it interferes with the
normal day-to-day functioning, daydreaming is very useful and healthy. I would even propose that we
set apart sometime during the day, to daydreaming. Daydreaming in a stupendous way motivates the
individuals. Daydreamers usually have something to achieve in future and that is their goal.

Take for example all your achievements. Which of the achievements came to you by itself?
Practically nothing; you had visualized something and dreamt of it and later achieved it by hard work.
There are very few things that come just by themselves — by chance. In day dreaming the goal is rather
vague without details. The goals are like clouds constantly changing and taking different shapes. It
could be also very hazy and vague. The merit of daydreaming is that it pulls you up like an incentive
and motivates you to undertake any hardship to attain what you dream since it is very attractive.

2. POWER OF POSSIBILITIES

There are a lot of potentials in possibilities. As the name suggests, possibilities are not
actualities. Actualities are real whereas possibilities are potencies. The more you daydream of the
possibilities the better it is. The one who does not have many possibilities is a limited person and that
itself is a problem. The people who have a number of possibilities have fewer problems than the people
who have hardly any. Possibilities are different avenues open to the client and not all of them are useful
and practical. And having many possibilities is richness. At times even very intelligent and efficient
individuals seem to have only one possibility of activity. In their lifetime they have failed to develop
other possibilities even though they have every talent and strength to pursue another activity equally
good as the one they currently hold. Just because they have no other option or possibility in mind they
tenaciously cling to the one they operate.

Actually clients are clients just because they are in a rut without any other avenues. If only they
could invent some other avenues they become healthier. So let daydreaming extend to numerous
possibilities.167

3. DEFINE THE GOAL168

Goals that are daydreamt and extended into many possibilities may not have any shape. The
goals are to be shaped, in order to make them work for you.

1) OUTCOME-ORIENTED GOALS

Goals are not for activities. One may do a lot of activities which are useless in themselves. If
activities are undertaken it is with a view to get an outcome. Ask the question what one intends to
achieve by such and such activities. One student says that he will study biology well so that he can get
an admission into a medical college. Studying biology well is an activity and it is to obtain an
admission in the medical college, which is an outcome.

2) SPECIFIC GOALS

Sometimes goals may be merely a declaration of intent. A clerk in the office says that he wants
to improve his lot which for him is a goal. It may be a goal but not specific. It is only a declaration of
his intention. He should spell out concretely what this improving his lot is. If he were to say that he
would work overtime and earn more money and thus improve his lot, it is a specific goal.
 Principles and Techniques of Counselling-7 194

3) MEASURABLE GOALS

The goal should be spelt out in terms of quantity. If the clerk in the previous example were to
say that within a month he would work 15 hours overtime it is a measurable goal. At the end of the
month one can check if he has worked 15 hours overtime.

4) GOALS WITH IMPACT

The goals that are chosen should make a substantial change or impact in the life of the client.
According to the research what emerges is that if the goals are sufficiently hard it is more motivating
than the easier ones. The goals should be such that when they are attained they create an impression for
the better. If an alcoholic dependent decides to stop drinking it is going to have a tremendous impact on
his life and family with its many ramifications.

5) GOALS WITH NO OBSTACLES

With all goodwill and other things being equal, a goal may not be achieved for reasons of
environmental obstacles. For example, a man with financial difficulties wanted to start an English
medium school as a way of earning his living in a place where there had already been a number of
English medium schools and where he would never be able to compete with other well reputed schools
that were already existing.

6) GOALS UNDER CONTROL

The goals that are defined should be within the control of the client for achievement. In
interpersonal relationship, for example, the client may not have control over the other person but he/she
has control over him/herself and his/her reactions. Therefore, while setting the goals, the counsellor
sees that the client sets a goal that is under his/her control. A clerk working as an accountant in a
company sees a lot of corrupt practices like cooking up the accounts. He cannot take a decision to
change the lives of those working with him. All that he can do is to make a goal of changing himself or
his reacting to the unethical things that go on since that is within his control.

7) ECONOMIC GOALS

The principle here one needs to keep in mind is what can be achieved with less energy, time, and
cost need not be achieved with an expenditure of a lot of energy, time and cost. Clients need not
squander their energies on outcomes. Make the client budget their resources. A person of high
intellectual calibre with a school final qualification wanted to do M.A. history through open university
system. He could either spend five years going through three years of bachelor's degree and two years
of master’s degree or he could straight away go for two years of master’s degree since he has the
intellectual calibre needed. Therefore assist the client to achieve the goal with less energy and time. In
the same way, therapies should not be too cumbersome for the client. Effecting greater change with less
time is ideal unless you judge it opportune to create a big ceremony in order to impress the client and
thus bring about a worthwhile change.

8) GOALS CONSONANT WITH THEIR VALUES

 Principles and Techniques of Counselling-7 195

Values play a vital role in the life of people. If the goals are set against the cherished values of
the clients they might land up feeling guilty. A lady already with many children, with her husband
unemployed, is again pregnant and she comes to you for counselling to know if she could go for
abortion. If you were to urge her to go for an abortion which is against her religious values you may not
be doing the right thing. You can help clients clarify their values and not interfere with their values. By
the by, it is also true that knowing your ethical background, clients come to you for counselling. For
example, if you are a pro-life person you will not support pro-choice activities. Here you are being
faithful to your own value systems. As much as you are faithful to your own value system, the client
has the right to stick to his/her value system. In any case, you have the duty to clarify the value systems
of the client.

9) GOALS WITH A TIME-FRAME

Goals should not be kept hanging in the air as though they can be achieved when it is possible.
If you do not fix up a time-frame for the accomplishment of the goals it is likely that the client will
postpone the execution of the strategies to achieve the goals. A sick person who had been unwilling to
go to the doctor decides to consult a doctor. You could ask him/her when or before what time he/she
will have met the doctor. This process sets a time-frame.

B. KEEPING THE GOAL SMART

Here the word SMART is an acronym which is made up of the first letters of the following
words: S – for Specific, M – for Measurable, A – for Achievable, R – for Realistic, and T – for Tangible.
The goal should have the characteristics denoted by the acronym. Let us consider them in detail. 169 I
am putting in a nutshell what we have hitherto seen in this chapter. For this I make use of an acronym
which was taucht to me when I learned counselling.

1. SPECIFIC GOAL

First and foremost the goal the client envisages should be specific. Take for example a father
who does not spend much of his time with his children. Of course, he is a very loving father, but
because of his manifold social works he is not present with his children even on holidays. When he
comes home late at night, the children are already in bed, and in the early morning he starts off for his
work. In this situation the father spells out the goal as “I will spend some time with my children.”
Certainly it shows the good will of the father and there is no doubt about it. In all probability, he will
continue to behave in the way he has been doing. The goal had not been specific and the goal setting
would be a failure for lack of being specific. If he were to say for example: “I will spend evening time
with my children, helping them to do their home work and recreating with them,” then the goal is very
specific. What we are aiming at here is concreteness in its different aspects.

2. MEASURABLE GOAL

In the foregoing example of the father being with the children in the evening time, though it is
specific, it has a loophole. The father may remain for ten to fifteen minutes to fulfil his obligation
towards the goal and console himself saying that he has done his best. The goal should be measurable,
as for example, if the father were to say that he would spend four hours in the evening with the children
and that too from 17.00 hrs to 21. 00 hrs, then the goal is very specific and measurable. He knows for
certain, the exact time and from when to when he will be available to his children.
 Principles and Techniques of Counselling-7 196

3. ACHIEVABLE GOAL

A goal could be specific and measurable and yet it may not be possible to achieve it. The next
characteristic of a goal is to keep it achievable. Given the context and the situation we are only probing
to see if the goal set so specific and measurable will be achievable. Humanly speaking and speaking in
terms of the resources and good will of the client concretely it is to be seen whether the goal he/she sets
is achievable by him/her. The goal of the father of our example, in spite of its being specific, and
measurable may not be achievable. A person who had been so busy with all sorts of social works is not
likely to sit for four hours continuously with his children. Therefore, we could raise the question to the
client asking him if it would be possible for him to spend four hours in the evening every day. Perhaps
to start with, the number of hours could be reduced, for if a client sets about fulfilling his goal and finds
in the midway that it is not possible for him, then he is likely to get frustrated and give up the whole
process. To avoid such pitfalls we forewarn the client by raising questions with regard to the
achievableness of the goal in concrete.

4. REALISTIC GOAL

Goal needs to be specific, measurable and achievable but also realistic. In Neurolinguistic
programming it is called Future Pacing. Both the counsellor and the counsellee consider whether the
decision taken fits into the context of the counsellee, especially in the future and in what way it is
appropriate.

Here I remember an incident about assertiveness training as an example. A person who is not
able to voice his/her opinion and demand his/her rights is given certain exercises, and perhaps told
how to be assertive in future with others. I happen to know one such person who after the
assertiveness training from a well known counsellor was going about asserting everywhere and with
everybody. Since the person was in the helping profession, a number of people used to come to him
and he started being assertive with every one of them and to his superiors of every rank and the like,
and the net result was that he was hated by one and all. Perhaps the counsellor did not reframe the
client, specifying where he has to be assertive or with whom he has to be assertive. One has to be
very careful being assertive with a superior whose disfavour might adversely affect one’s future, and
being assertive to a sick and weak person is not becoming, and being assertive with the friends and
companions will make one lonely and friendless. Therefore the second state would be worse than the
first state and that is not very much desirable for a client.

Realistic also will mean that the goals should not be either too high or too low. If the gtoals are
too high they will bread failure and if they are too low they will not sufficiently motivate the clients.
This is what we mean by the word 'realistic.’ For example, a student of middle school cannot take the
goal as studying till 12 midnight as his goal nor should a college student be content taking as his goal to
study only an hour in the evening. For the middle school student the goal is too high and for the college
student it is too low.

While specifying the goal the counsellor could raise such questions as those that would look into
the future context in which the new behaviour will be tried out. And if adverse reactions are
forthcoming then one could forewarn the client of the consequences and if in spite of your warning
he/she persists in doing it, then you better respect his/her decision. But not to have facilitated the
client to future pacing will be failing in one’s responsibility as a counsellor. At times it may happen
that the client has to change his/her goal altogether since it may not be realistic. For example, if a
girl from an Indian family wearing the traditional Indian dress decides to wear jeans, then the whole
 Principles and Techniques of Counselling-7 197

family might reject her. Therefore, the goals set should be realistic in the sense that it should fit into
the context of the client.

5. TANGIBLE GOAL

Here being tangible refers to the satisfaction the client derives from the achievement of the goal.
The client should have the maximum satisfaction in attaining the goal. In NLP it is clearly brought out.
The desired state even in fantasy should be so attractive that the client is compelled to achieve it.
He/she cannot but achieve it. The counsellor should see a glow on his/her face, and his/her non-verbal
behaviour should say an unequivocal ‘yes’ to the decision he/she is going to make. If the goal is not
attractive and does not give enough satisfaction, the client will not have the necessary motivation to
pursue the goal. And without motivation, no one achieves anything, for interest and motivation play a
vital role in our human behaviour, that we cannot think of a goal being achieved without being so
tangible.

When the goal is achieved the client should have the maximum satisfaction out of the
achievement of the goal. A person who desires a decent job to earn more money getting a first class in
Arts may not be delighted because in view of the job opportunities his/her securing a first class in Arts is
of no use for him/her whereas if he/she were to invest his/her resources in computer science that would
get a job immediately which would be very satisfying to him/her.

C. OPERATIONALIZING THE GOAL

BREAK THE GOAL INTO SMALLER UNITS AND LET THE CLIENT PROCEED STEP BY
STEP

While working towards the goal by means of strategies the client may not achieve the goal
altogether because the goal may be too complicated and may require time on account of its sub-goals. A
professor of mine while teaching Neuro-Linguistic Programming said that one could really eat a bicycle.
We were wondering how it is possible. He continued to tell us who were bewildered: First break the
bicycle into pieces, then powder them into fine dust; everyday take a pinch of dust and eventually you
would have swallowed a bicycle! This was to drive home the idea that any 'impossible' thing can be
achieved when we break it into small units and start working on a small unit at a time. What is
overwhelming for the client is the size of the problem and the greatness of the solution. You do not have
to look at the solution at a time for solving, you need to take a bit of it and work at it and thus by and by
you will have worked out the whole problem and reached a solution.

A man had a number of abusive ways of wasting his life. He was counselled and as a result he
wanted to amend his life but the goal was too big for him. He was using drugs, smoking heavily,
drinking, womanising, stealing, and lying. He was so exasperated and did not know where to start, for
the goal looked gigantic and enormous. The counsellor facilitated him first to be truthful to start with.
He attempted with a few failures and later he was speaking the truth. Then he gave up smoking, the
drug and thus one by one and finally he could overcome all his bad habits. This is operationalizing the
goal. There is nothing like success breeding success. Since the client was happy about his success in
speaking the truth he could go forward to work on his other bad habits.

The advantages of operationalizing the goal:

 Principles and Techniques of Counselling-7 198

(1) The demand that is placed on the client in achieving the goal is spaced out and he/she does not
realize the burden of it.
(2) Seeing the success of the achievement of a small sub-goal, the client is encouraged to go
forward.
(3) He/she might also get the applause of the counsellor for his/her success which in turn will work
as a reinforcer. Thus operationalizing the goal benefits the client. 170

16

MAKE CONTRACTS AND EVALUATE

A. MAKING CONTACTS

Contracts bind actions with responsibility. Contracts are agreements on a given issue with the
terms specified between two persons or parties. I have mostly found a lot of difference between persons
who made contracts with the counsellor and those who did not make them. If the client makes a
contract he/she is compelled to honour his/her own word. Honouring the contract is a sign of one's
personal integrity and strength of character. You may come across persons who make a lot of promises
but never keep up which means that they are suffering from character defect. A client who keeps up
his/her contracts becomes worthy in his/her own eyes. The contracts made become self-motivating
factors working internally in the client. Thus the client puts in-built motivating factor in his/her system
 Principles and Techniques of Counselling-7 199

which automatically regulates his/her activities, sustains them when necessary and leads the client to the
complete successful achievement of the goal. Therefore, the counsellors are encouraged to stimulate the
clients to make contracts.

A client had poor pronunciation in public reading. In counselling he decided to have half an
hour of reading practice from Monday to Friday at 17.00 hrs under the supervision of an expert for one
month. From the counselling part, the decision made is excellent according to the well-defined process
of setting a goal. In this context the counsellor stimulated him to make a contract.

Counsellor: How am I to know that you are having a reading practice everyday?
Counsellee: I shall phone you every weekend to let you know how I have done.

The reporting need not necessarily be to the counsellor; it could be also to someone else. All
that is needed is to check if the decision is carried out according to the way it was envisaged. Here it is
good that someone other than the client is involved to make the checking. In case the nature of the
decision is such and the possibility of reporting to the counsellor or to another individual is not possible,
then we can entrust the whole checking to the counsellee him/herself.

This is a model of contract. A contract is usually a concretization of the execution of the

decision (goal) the client makes.

With this the counselling interaction of the client with the counsellor formally gets over. With
the hope of executing the strategies the client moves out into the real field to experiment what he/she
has gained by way of insight and the strategies he/she has decided upon. The client will go and
experiment for him/herself and come back once in a way to evaluate the implementation of the action
plans. The counsellor and the counsellee will enter into the next stage only after sometime that is after
implementing the strategies to see how far things are working for the client and what needs to be done
still further and if there is any modification that is needed to make the strategies workable. For the time
being the client says good-bye and goes to his/her life situation and the counsellor hopes that everything
will be working well with the client. 171

B. EVALUATING

Evaluating is an assessment made on the performance of the counsellee. The client would have
left you enthusiastically with the newly-formed attitude and with certain strategies to work towards
his/her goal and in fact he/she would have tried them out in his/her life situation. After a lapse of time
during which the client would have gone ahead at least for sometime with his/her action plan, he/she
comes back to the counsellor to review the performance so far done.

In some countries, normally clients do not come to the counsellor for an evaluation. They are
one-time clients who come for a specific problem, work it out and get away. That is the end of their
story. I have also witnessed in some countries where clients pursue counselling on the average for 10
years with the same counsellor. In this case, there is the possibility of having many evaluations.
Therefore, the practice of counselling evaluation varies from culture to culture depending upon the need
of the clients. In some cultures, the whole society is helpful in assisting someone in crisis to have a
catharsis or at least to lend a listening ear. Clients can even speak their problems to any relative
strangers. In some other cultures one needs to find out a person who will listen to you by paying. Thus
 Principles and Techniques of Counselling-7 200

I also see a cultural difference which necessitates/favours periodical evaluation in some cultures and not
in other cultures.

1. ONGOING EVALUATION

Actually evaluation only at the end is too late. So much learning would have been lost if
periodical ongoing evaluation had not been there during the counselling process itself. To think of it
only at the end is profiting only less from the counselling interview. While taking classes I keep asking
the participants to take stock of what they had learned up to that time. If you leave them to themselves
even though they would have learned much during a short period it would not appear to them that they
have learned something worthwhile. At least to make them realize that they had been learning quite a
bit it is necessary to make periodical ongoing evaluations. During the evaluation the client not only
evaluates his/her own performance but also the helping process of the counsellor him/herself so that if
anything should be changed either by the counsellor or by the counsellee it could be undertaken at the
earliest instead of carrying on the mistake till the end and lament over the waste of time and
opportunities.172

2. CLIENT-CENTRED EVALUATION

Evaluation is primarily meant to help the client. It does not mean that the counsellor him/herself
will not profit from such a beneficial work but the main interest is the client. Evaluation either ongoing
or at the end is meant to see if the client really profits from the counselling process. It is for helping the
client and during the evaluation the counsellor checks if the process really helps the client, if his/her life
is substantially changed, and if it is a learning process for him/her. Side by side the counsellor too
learns about the efficiency of his/her helping process. 173

3. SELF-EVALUATION:

There are many advantages in having an evaluation with the client. Some clients naturally turn
to the counsellor and report and get the things checked. Some others will be reluctant. If evaluation is
not forthcoming, the counsellor could gently draw the attention of the counsellee for having an
evaluation with him/her. Before having evaluations with you the clients should be encouraged to self-
evaluate their own performance. Training the clients to evaluate themselves should be normally done.
A life that has not been evaluated usually deteriorates. Helping the clients to self-evaluate is an
invaluable service to them.

4. ADVANTAGES OF EVALUATION174

Whatever type of evaluation one may have, one can draw a number of benefits from such a
process.

1) SUPPORT

In a troubled world of the client, the one who understands the internal frame of reference of the
client hopefully is the counsellor. Since it was the counsellor who established a rapport, took interest in
the welfare of the client, came to know very closely his/her thoughts, feelings and behaviour and had
been with him/her all through the helping process, he/she should be the one to whom the client will turn
for support, mostly for emotional support.
 Principles and Techniques of Counselling-7 201

2) BEING WITH

The counsellor gives the impression to the client that he/she has not left the client or abandoned
him/her. His/her interest in the welfare of the client continues irrespective of the time lapse. The client
will feel that he/she is constantly being helped by a caring hand.

3) OVERCOMING INITIAL DIFFICULTIES

The client goes and experiments things that are quite foreign to him/her, and the world in spite
of his/her having had the benefit of counselling, has not been changed. Entering into the same world
and being encountered with the same stimuli that stimulated him/her early he/she may be at a loss,
overwhelmed by the initial difficulties which if overcome will become a great advantage. A timely
intervention of the counsellor will enable the client to overcome his/her initial fear and difficulties and
thus enhance his/her onward march.

4) HONOURING THE CONTRACTS

Evaluation makes the client to be faithful to the contracts he/she has made. He/she feels that
since he/she has to go and report to the counsellor, he/she is obliged to keep up his/her contracts. There
may be an unconscious desire to be appreciated by the counsellor or at least the desire that the
counsellor should not find fault with him/her for not having kept up the contracts. In view of the
evaluation, the client wants to honour his/her contracts made with the counsellor.

5) MODIFYING GOALS

It may be true that the goal set by the client looked bright and viable. But later as the client
started to work on it, he/she might meet with major difficulties because of the very nature of the goal.
At that time he/she needs to evaluate the goal and scrutinize it thoroughly in the presence of someone
else. For that, the person most fitting would be the counsellor since it was the counsellor who helped
him/her set the goal. Both the counsellor and the counsellee could review the goal and modify it if
necessary so that the goal is workable.

6) MODIFYING STRATEGIES

It is possible that what the client set as the goal may be all right and appropriate and within
his/her capacity. But the means he/she adopted to work for the goal may be defective. The strategies
may not be practical. The client is likely to think that it is the goal that is deficient without realizing that
it is the strategy that he/she has to modify rather than the goal. Hence a discussion with the counsellor
by way of evaluation will help the client modify the means which are strategies to the goal.

7) GETTING STRENGTHENED

When everything is all right and working well the client proceeds fearlessly towards the
achievement of the goal. But in the middle he/she may get frightened or may have midcourse
difficulties for which a talk with a counsellor will go a long way in dispelling his/her fears and he/she
 Principles and Techniques of Counselling-7 202

will feel encouraged to proceed further undaunted. This periodical strengthening is a boost to the
counsellee.

8) LEARNING PROCESS

Evaluation in itself is a learning process. It may also be a time for the client to go over all the
process of the counselling interview he/she had with the counsellor at times making reference to some
salient insights and thus it becomes a learning process. When going over a matter again and again one
learns it well.

9) ACKNOWLEDGES LEARNING

A lot of learning is simply lost and becomes useless in our lives just because we did not revise it.
We did not realize that we have learned quite a bit. In conducting sessions if no evaluation is had, the
participants go away thinking that they learned hardly anything but on the contrary when we make them
sit and take stock of the things that they have learned making an assessment both positively and
negatively they become aware that they have learned very much. Therefore evaluation takes stock of
the things learned already by the counsellee.

10) MOANING FAILURE

Both the counsellor and the counsellee hope that everything will turn out to be good. But it can
happen that the result seems to be a failure for the client. When confronted with a failure one naturally
moans. When sorrow is shared it is halved. Naturally the counsellor would be the fitting person with
whom he/she could moan and the counsellor because he is also skilled in being effectively with a
moaning person, will be of support to him/her in his/her grieving.

11) FAILURE IS A LEARNING

We are living in a success-oriented society. All that matters is success and people shudder to
think of failure. Society has failed to teach the youngsters that like success, failures too are equally
enabling. For example, if a course of action did not work, the implication is a great learning. The client
now learns that such and such a course of action does not work. To know what works is definitely a
learning, and in the same way to know what does not work is equally a learning. The client learns this
lesson in evaluation.

12) CELEBRATING VICTORY

It is not only in grief that you would like to share your sorrow with someone but also when you
are victorious and successful. When joy is shared it is doubled. When the client really succeeds he/she
wants to share with someone who had been caring for him/her during the counselling interview and was
encouraging him/her to take the necessary steps, being supportive all the time. Therefore at the time of
his/her victory the counsellor will be one of the persons to rejoice with him/her by looking back and
evaluating the process.

13) ENHANCING RELATIONSHIP

 Principles and Techniques of Counselling-7 203

We know that in counselling interaction transference takes place, which is mostly a positive one.
It will be there if not on a high level at least to a minimum level. That relationship need not die out.
Every relationship is beautiful. After the counselling is over, the clients may not visit the counsellor
frequently. Once in a way the return of a counsellee to the counsellor will also enhance their warm
relationship. But one should not think that counselling is meant for relationship and if you as a
counsellor were to crave for it you have some unmet needs which you need to work out. But if a lasting
friendship were to blossom between the counsellor and the counsellee it is something welcome and
noble.

For the above mentioned advantages you will endeavour to facilitate the client to make ongoing
evaluations during the counselling sessions and later periodically to make sure that your facilitation is
really effective in the life of the client.

5. REVIEWING

In the last stage of evaluating it is not the counsellor who takes a major share but it is the client.
He/she looks back on all that had happened, what he/she learned, how the strategies worked and how
the goal has been achieved, or not achieved. If necessary he/she makes the necessary modification in
the goal set. If modification will not work he/she will altogether alter the goal so that it is workable and
satisfying to him/her. If the strategies need modification he/she modifies the strategies. He/she
becomes mindful of the contracts he/she has made and wants to be faithful to his/her words. All these
are done by the counsellee at the last step of reviewing.

He/she needs to realize that reviewing is not a waste of time but it is a great learning process.
He/she co-operates with the counsellor for his/her own good because of the advantages of reviewing
his/her performance. Reviewing could help him/her be bold in meeting situations that once seemed
insurmountable. Here all that I recommend to a client is that he/she should be willing to review the
performance and continue to grow. It is not only for solving problems that one approaches a counsellor
but also for growth. The fact that you worked out your problem is not reason enough why you need not
grow. All through our life we should be committed to our growth. In our growth process we could
avoid the pitfalls we had met earlier. And that can be done only when one is able to look back and take
stock of the past experience.

Thus we have reached the end of the counselling process concentrating in every step on the
skills of the counsellor and the tasks of the counsellee. Each one had something serious to do and the
work of both of them was needed. But the greater responsibility was taken by the counsellee. Both of
them learned quite a bit in the process and that is worth continuing in their lives.

Here ends the Microskill Model of Counselling.

BIBLIOGRAPHY

Adams, Henry E. & Patricia B. Comprehensive Handbook Of Psychopathology. 3rd

Sutker (Eds.). ed. New York: Kluwer Academic/Plenum
Publishers, 2001.

AmericanPsychiatric Association. Diagnostic And Statistical Manual Of Mental

Disorders. 4th ed. Washington: American
 Principles and Techniques of Counselling-7 204

Psychiatric Association, 1994.

Bhatia, Hans Raj. General Psychology. New Delhi:

Oxford & IBH Publishing Co., 1981.
Bhatia, Hans Raj. Abnormal Psychology. New Delhi:
Oxford & IBH Publishing Co., 1981.

Carkhuff, Robert R. The Art of Helping IV. Massachusetts.

Human Resource Development Press,
Inc., 1983.

Cohen, David. Body Language in Relationships.

London: Sheldon Press, 1992.

Egan, Gerard. The Skilled Helper. California: Brooks/

Cole Publishing Company, 1994.

Fast, Julius Body Language. New York: Pocket

Books, 1971

Fuster, J.M. Personal Counselling. Bandra : The

Bombay St. Paul Society. 1986.

Gabbard, Glen O. & Sarah D. Synopsis Of Treatments Of Psychiatric Disorders.

Atkinson (Eds.). 2nd ed. Washington: American Psychiatric Press,
1996.

Hales, Robert E. & Stuart C. Textbook Of Clinical Psychiatry. 4th ed.

Yudofsky (Eds.). Washington: American Psychiatric Publishing,
2003.

Hales, Robert E., Stuart C. Textbook Of Psychiatry. 3rd ed. Washington:

Yudofsky & John A. Talbott (Eds.). American Psychiatric Press, 1999.

Hurlock, Elizabeth B. Developmental Psychology. New Delhi: TATA McGraw-Hill

Publishing Company Ltd., 1987.
 Principles and Techniques of Counselling-7 205

John Antony, D. Dynamics of Counselling. Nagercoil: Anugraha

Publications, 1994.

John Antony, D. Emotions in Counselling. Dindigul: Anugraha

Publications, 2005.

John Antony, D. Psychotherapies in Counselling. Dindigul:

Anugraha Publications, 2003.

John Antony, D. Skills of Counselling. 2nd ed. Dindigul: Anugraha

Publications, 2003.

John Antony, D. Types of Counselling. Nagercoil: Anugraha

Publications, 1996.

Kaplan, Harold I. & Benjamin J. Comprehensive Textbook Of Psychiatry/VI.

Sadock (Eds.). Philadelphia: Williams & Wilkins, 1995.

Kurt., Ron & Prestera, Hector. The Body Reveals. New York:
Harper & Row, 1976.

Mc Hugh, Dick Mind with a Heart. Borivli:St.Francis

Technical Institute Press, 1992.

Nelson-Jones, Richard Practical Counselling and Helping

Skills. Bombay: Better Yourself
Books, 1994.

Pease, Allan Body Language. New Delhi: Sudha

Publications Pvt.. Ltd., 1990.

Tagore, Rabindranath. Gitanjali. Madras: Macmillan India, 1974.

Van Kaam, Adrian. The Art of Existential Counselling.

Pennsylvania: Dimension Books,1966.

Vaughan, Richard P. Basic Skills for Christian Counsellors.

New York: Paulist Press, 1987.
1

ENDNOTES
B. INTRODUCTION

Adrian Van Kaam, The Art of Existential Counselling. Pennsylvania: Dimension books, 1966, pp.19-20.
2
Ibid., p.16.
3
Gerard Egan, The Skilled Helper. California: Brooks/Cole Publishing Company, 1994, pp. 5-6.
4
Joe Currie, The Barefoot Counsellor. Bangalore: Asian Trading Corporation,1988, p.107.
5
Ibid., p.106.
6
Adrian Van Kaam, op.cit., p.20.
7
Rabindranath Tagore, Gitanjali. Madras: Macmillan India, 1974, pp.3-4.
8
Adrian Van Kaam, op.cit., p.23.
9
Gerard Egan, op.cit., p.263.
10
D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, p.5.
11
Richard Nelson-Jones, Practical Counselling and Helping kills, Bombay: Better Yourself Books, 1994, p.2.
12
Ibid., P.3; D. John Antony, op.cit., p.6.
13
Richard Nelson - Jones, op.cit., p.2.
14
Ibid., p.3.
15
Gerard Egan, op.cit., p.5.
16
Richard Nelson-Jones , op.cit., p.3.
17
D. John Antony, op.cit., pp., 6-7; J.M. Fuster, Personal Counselling. Bandra: The Bombay St.Paul Society, 1986, p.47.
18
Richard Nelson – Jones, op.cit., pp. 2-3; D. John Antony, op.cit., p.7; J.M. Fuster, op.cit., p.47.
19
D. John Antony, op.cit., p.7.

I. PACING
FACILITATIVE DIMENSION

1
WELCOME THE CLIENT WITH A SMALL TALK

20
Allan Pease, Body Language. New Delhi: Sudha Publications Pvt. Ltd., 1990, p.139.
21
Gerard Egan, The Skilled Helper. California: Brooks/Cole Publishing Company, 1994, p.48.
22
Ibid., p.93.
23
D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, p.13.
24
Allan Peace, op.cit. pp. 32-39.
25
Ibid., p.14.
26
Ibid., pp.14-15.
27
Ibid.,PP.15-16.
28
Ibid.,P.16.
29
Ibid.
30
Richard Nelson-Jones, Practical Counselling and Helping Skills. Bombay: Better Yourself Books, 1994, P.66.
31
Ibid., p.68.
32
J.M. Fuster, Personal Counselling. Bandra: The Bombay St. Paul Society, 1986 , p.104.
33
Adrian Van Kaam, The Art of Existential Counselling. Pennsylvania: Dimension Books, 1966, p.36.
34
Gerard Egan, op.cit., p.6.
35
Ibid., p.47.
36
Ibid., p.79.
37
D. John Antony, op.cit., p.107.
38
Ibid., p.108.
39
Gerard Egan, op.cit., pp.79-81.
40
Ibid., p.148.
41
Rabindranath Tagore, Gitanjali. Madras: Macmillan India, 1974, pp.16-17.
42
Gerard Egan, op.cit., p.147.
43
Ibid., p.149.
44
D. John Antony, op.cit., p.110.

2
OBSERVE THE BODYLANGUAGE OF THE CLIENT

45
Robert R. Carkhuff, The Art of Helping IV. Amherst, Massachusetts: Human Resource Development Press, Inc., 1983,
p.47.
46
D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994,p.18.
47
David Cohen, Body Language in Relationships. London: Sheldon Press,1992, p.2.
48
Ibid., p.6.
49
Hans Raj Bhatia, Abnormal Psychology. New Delhi: Oxford & IBH Publishing Co., 1981, pp. 68-69; David
Cohen, op.cit., p.7.
50
David Cohen, op.cit. p.2.
51
Ibid., p.5.
52
Ron Kurtz & Hector Prestera, op.cit., p.3.
53
Ibid.
54
Richard Nelson - Jones, Practical Counselling and Helping Skills.Bombay: Better Yourself Books, 1994, p.64.
55
Ibid., p.123.
56
Ron Kurtz & Hector Prestera, The Body Reveals. New York: Harper & Row, 1976, p.1; D. John Antony, op.cit., p.17.
57
Dick McHugh, Mind with a Heart. Borivli: St.Francis Technical Institute Press, 1992, pp. 23-34.
58
Ibid., p.35.
59
Allan Pease, Body Language. New Delhi: Sudha Publications Pvt. Ltd., 1990, pp. 40-47.
60
Ibid., pp. 48-58.
61
Ibid., pp.59-73.
62
Ibid., pp.78-81.
63
Ibid., pp.91-97.
64
Ibid., p.84.
65
Ibid., pp.76-77.
66
Ibid., pp.98-99.
67
Ibid., pp.103-106.
68
D. John Antony, Dynamics of Counselling, op.cit., pp.20-27.
69

3
ATTEND TO THE CLIENT PHYSICALLY

Hans Raj Bhatia, General Psychology. New Delhi : Oxford & IBH Publishing Co.,1981 , pp. 106-107.
70
Ibid., pp. 107-113.
71
Julius Fast, Body Language. New York: Pocket Books, 1971, p.18.
72
Allan Pease, Body Language. New Delhi: Sudha Publications Pvt. Ltd., 1990, pp. 20-21; Julius Fast. op.cit., pp. 20-23.
73
Julius Fast, op.cit., p.43; Allan Pease, op.cit., p.21.
74
Robert R. Carkhuff, The Art of Helping IV. Amherst, Massachusetts: Human Resource Development Press, Inc., 1983, pp.
38-39; Gerard Egan, The Skilled Helper. California: Brooks / Cole Publishing Company, 1994, pp. 91-92; D. John Antony,
Dynamics of Counselling. Nagercoil : Anugraha Publications , 1994, p.29.
75
Allan Peace, op.cit., pp. 115, 124-126, 132-134.
76
Ibid., p.89; Robert R. Carkhuff, op.cit. pp.41,92; D. John Antony, op.cit. pp.4-5, 21; Julius Fast, op.cit., pp. 140-142;
Allan Pease, op.cit., pp.86-89.
77
Gerard Egan, op.cit.,p.92; D.John Antony, op.cit.,pp. 22,30.
78
Gerard Egan, op.cit.,p.92; Robert R.Carkfuff, op.cit., pp. 40, 38; D. John Antony, op.cit., p.30.
79
D. John Antony, op.cit., pp.26-27, 30-31; Hans Raj Bhatia, op.cit., pp.108-109, Richard P. Vaughan, Basic Skills for
Christian Counsellors. New York: Paulist Press, 1987, p.51; Robert R. Carkhuff, op.cit., p.42; Gerard Egan, op.cit., p.92.
80
Dick McHugh, Mind with a Heart. Borivli: St.Francis Technical Institute Press, 1992, p.150-159;
D. John Antony, op.cit., 31-32; Allan Peaceop.cit., pp. 107 -109; Richard P. Vaughan, op.cit., p.40.
81
D. John Antony, op.cit., p.31; Richard Nelson - Jones, Practical Counselling and Helping Skills. Bombay: Better Yourself
Books, 1994, pp.35-36.
82
D. John Antony, op.cit., pp.46-47, 110; Richard Nelson-Jones, Practical Counselling and Helping Skills. Bombay:
Better Yourself Books, 1994, P.71.
83

4
LET THE CLIENT TELL THE STORY

D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp.48-50;

Richard P. Vaughan, Basic Skills for Christian Counsellors. New York: Paulist Press, 1987, pp.82-83.
84
Robert R. Carkhuff, The Art of Helping IV. Amherst, Massachusetts: Human Resource Development Press, Inc.,
1983, p.60.
85

5
REFLECT THE CONTENT OF WHAT THE CLIENT SAID

D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp.53-55; Richard P. Vaughan, Basic
Skills for Christian Counsellors. New York: Paulist Press, 1987, pp.90-92, 99-103.
86
D. John Antony, op, cit., pp.55-56.
87
Ibid., pp.56-57; Richard P. Vaughan, op. cit., pp.94, 120-124.
88
D. John Antony, op. cit., p. 57; Richard P. Vaughan, op.cit., pp.85-86, 110-111; Gerard Egan, op.cit., pp.126-127;
Richard Nelson-Jones, Practical Counselling and Helping Skills. Bombay: Better Yourself Books, 1994, Pp.73-74.
89
D. John Antony, op.cit., pp.58-61; Richard Nelson – Jones, op.cit., p.15.
90
D. John Antony, Dynamics of Counselling. Nagercoil : Anugraha Publications , 1994, pp.61-64.
91
D. John Antony, op.cit. pp.64-72.
92
D. John Antony, op.cit. pp.72-73.
93
Richard Nelson-Jones, op. cit., p.71.
94
6
REFLECT THE FEELING OF THE CLIENT

D. John Antony, Emotions in Counselling. Dindigul: Anugraha Publications, 2005, pp. 25-30.
95
http://en.wikipedia.org/wiki/Feeling
96
Robert R. Carkhuff, The Art of Helping IV. Amherst, Massachusetts: Human Resource Development Press, Inc.,
1983, p.81; D. John Antony, op, cit., pp.59,86; J.M. Fuster, op, cit., pp.123-134.
97
http://www.healthyplace.com/Communities/Abuse/holli/healing/feelings_chart.htm

7
REFLECT THE DEEPER FEELING

98
D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, p.90.
99

8
ALLOW THE CLIENT TO SPEAK SUFFICIENTLY ON THE FEELING

D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, p.89.

9
FACILITATE THE CLIENT TO RELEASE STRONG NEGATIVE FEELINGS

100
D. John Antony, Emotions in Counselling. Dindigul: Anugraha Publications, 2005, p.140; D. John Antony, Dynamics of
Counselling. Nagercoil: Anugraha Publications, 1994, pp.89, 90, 168-169; Richard P. Vaughan op.cit., pp.53-54.
101
D. John Antony, Emotions in Counselling. Dindigul: Anugraha Publications, 2005, p. 223; D. John Antony, op, cit.,
pp.167-168; Richard P. Vaughan, op, cit., pp.51-52.
102
D. John Antony, Emotions in Counselling. Dindigul: Anugraha Publications, 2005, pp. 208-209.
103

10
PINPOINT THE PROBLEM AND ASK FOR A RECENT EVENT

Elizabeth B. Hurlock, Developmental Psychology, New Delhi: Tata McGraw- Hill Publishing Company Ltd., 1987, p
.14.
104
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. Washington:
American Psychiatric Association, 1994, pp.629,633; Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.),
Textbook Of Psychiatry. 3rd ed. Washington: American Psychiatric Press, 1999, p.795.
105
Harold I. Kaplan & Benjamin J. Sadock (Eds.), Comprehensive Textbook Of Psychiatry/VI. Philadelphia: Williams &
Wilkins, 1995, pp.1435, 1437, 1445; Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry.
3rd ed. op.cit., pp.801-805; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th
ed. op.cit.,pp.637-639, 641-642, 645.
106
D. John Anatony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp.10-12; D. John Antony, Skills of
Counselling. 2nd ed. Dindigul: Anugraha Publications, 2003, p.169; Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,
(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.806-812; American Psychiatric Association, Diagnostic And Statistical
Manual Of Mental Disorders. 4th ed. op.cit.,pp.647-650,654, 656-658, 660-661; Harold I. Kaplan & Benjamin J. Sadock,
(Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1440-1443, 1449, 1453-1454; Henry E. Adams & Patricia B.
Sutker, (Eds.), Comprehensive Handbook Of Psychopathology. 3rd ed. New York: Kluwer Academic/Plenum Publishers,
2001, pp.445-479, 491-502, 517-521.
107
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp. 1447-1448, 1451,
1455-1456; Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.812-
816; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.663-
673;Henry E. Adams & Patricia B. Sutker, (Eds.), Comprehensive Handbook Of Psychopathology. 3rd ed. New York: Kluwer
Academic/Plenum Publishers, 2001, pp.521-527.
108
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.817; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,p.733; Harold I. Kaplan &
Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., p.1458.
109
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., p.1459; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,p.734.
110
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.818.
111
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.898-899; Robert
E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.429,431; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.285-286.
112
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.287-288;
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.440-442;
113
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1019-1028, 1044,
1046; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.291-292,
294-296, 301-308, 314-315; Glen O. Gabbard & Sarah D. Atkinson, (Eds.), Synopsis Of Treatments Of Psychiatric
Disorders. 2nd ed. Washington: American Psychiatric Press, 1996, pp.450-452; Robert E. Hales, Stuart C. Yudofsky & John
A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.245.
114
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed.
op.cit.,pp.323,325,327-329,331-335,337-338.
115
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., p.1068; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.334-335, 345-347,349.
116
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.351-
353,356-358, 360-368.
117
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.394-396,
402-407, 410-411, 416-417; Henry E. Adams & Patricia B. Sutker, (Eds.), Comprehensive Handbook Of Psychopathology.
3rd ed. op.cit., pp.140-147; Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed.
op.cit., pp.589, 591-593; Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit.,
pp.1204-1217.
118
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1218-1226;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.422-423.
119
Glen O. Gabbard & Sarah D. Atkinson, (Eds.), Synopsis Of Treatments Of Psychiatric Disorders. 2nd ed. op.cit., pp.137-
142; Henry E. Adams & Patricia B. Sutker, (Eds.), Comprehensive Handbook Of Psychopathology. 3rd ed. op.cit., pp.183-
203; Harold I. Kaplan & Benjamin J. Sadock, (Eds.),Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1227-1235;
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.610-612; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.427-429.
120
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1236-1248;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.430-432.
121
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1285-12892;
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.719, 722, 228; Glen
O. Gabbard & Sarah D. Atkinson, (Eds.), Synopsis Of Treatments Of Psychiatric Disorders. 2nd ed. Washington: American
Psychiatric Press, 1996, pp.677-689, 691-696; Henry E. Adams & Patricia B. Sutker, (Eds.), Comprehensive Handbook Of
Psychopathology. 3rd ed. op.cit., pp.263-272; Michelle Morrison Valfre, Foundations Of Mental Health Care. 2nd edition.
Op.cit., pp.278, 280; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed.
op.cit.,pp.428-429,481,484,487,490.
122
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. Washington: American
Psychiatric Press, 1999, pp.773-774, 778, 780-783; Harold I. Kaplan & Benjamin J. Sadock (Eds.), Comprehensive
Textbook Of Psychiatry/VI. Philadelphia: Williams & Wilkins, 1995, pp. 1409-1412, 1415-1417; American Psychiatric
Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit., pp.612, 613, 615, 618, 621.
123
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.667-668, 677,
683-686; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.449-
452, 457, 461-462, 465, 468; Henry E. Adams & Patricia B. Sutker, (Eds.), Comprehensive Handbook Of Psychopathology.
3rd ed. New York: Kluwer Academic/Plenum Publishers, 2001, pp.220-243; Alan Stoudemire, Barry S. Fogel & Donna B.
Greenberg, (Eds.), Psychiatric Care Of The Medical Patient. New York: Oxford University Press, 2000, pp.465-470; Harold
I. Kaplan & Benjamin J. Sadock, (Eds.),Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1252-1258, 1261-1269.
124
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.959, 961-965;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.557, 562, 567,
573, 578; Harold I. Kaplan & Benjamin J. Sadock (Eds.), Comprehensive Textbook Of Psychiatry/VI. Philadelphia: Williams
& Wilkins, 1995, pp.1376, 1385.
125
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.967-968;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,p.583, 587, 591;
Harold I. Kaplan & Benjamin J. Sadock, (Eds.),Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1386-1387.
126
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.748; Harold I.
Kaplan & Benjamin J. Sadock (Eds.), Comprehensive Textbook Of Psychiatry/VI. Philadelphia: Williams & Wilkins, 1995,
pp.1302-1304; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed.
op.cit.,p.498-500.
127
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.748-750;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.502,504;
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1304-1305.
128
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1307-1310;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.506-507, 509,
511; Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.750-751.
129
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.751; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,p.513, 515; Harold I. Kaplan
& Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1310-1311.
130
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1340-1343;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.525-532.
131
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1347-1355; Robert
E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.739-740; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.537-538.
132
Henry E. Adams & Patricia B. Sutker, (Eds.), Comprehensive Handbook Of Psychopathology. 3rd ed. New York: Kluwer
Academic/Plenum Publishers, 2001, pp.642-650; Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook
of Psychiatry/VI. op.cit., pp.1361-1363; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental
Disorders. 4th ed. Washington: American Psychiatric Association, 1994, pp.544-545, 549-550.
133
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.1421-1423;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. Washington: American
Psychiatric Association, 1994, pp.626-627.
134
Glen O. Gabbard & Sarah D. Atkinson, (Eds.), Synopsis Of Treatments Of Psychiatric Disorders. 2nd ed. Washington:
American Psychiatric Press, 1996, pp.755-760; Henry E. Adams & Patricia B. Sutker, (Eds.), Comprehensive Handbook Of
Psychopathology. 3rd ed. New York: Kluwer Academic/Plenum Publishers, 2001, pp.243-250; Harold I. Kaplan & Benjamin
J. Sadock (Eds.), Comprehensive Textbook Of Psychiatry/VI. Philadelphia: Williams & Wilkins, 1995, pp.1271-1276; Robert
E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. Washington: American Psychiatric
Press, 1999, pp.695, 701; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed.
op.cit., pp. 474, 727.
135
D. John Antony, Types of Counselling. Nagercoil: Anugraha Publications, 1996, pp.231-232; Harold I. Kaplan &
Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.755-774; American Psychiatric
Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.181-185, 197-199; Robert E. Hales,
Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.365-367, 376-385.

136
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., p.738; Robert E.
Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.321,324-325; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.126-127, 129, 131-133.
137
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.740-741; Glen O.
Gabbard & Sarah D. Atkinson, (Eds.), Synopsis Of Treatments Of Psychiatric Disorders. 2nd ed. Washington: American
Psychiatric Press, 1996, pp.227-240, 247-249; Henry E. Adams & Patricia B. Sutker, (Eds.), Comprehensive Handbook Of
Psychopathology. 3rd ed. New York: Kluwer Academic/Plenum Publishers, 2001, pp.842-844; Robert E. Hales, Stuart C.
Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.332-334, 341, 344-346; American Psychiatric
Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.142-143, 146, 148-152, 154-155.
138
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.349-352;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.160, 162.
139
D. John Anatony, Skills of Counselling. 2nd ed. Dindigul: Anugraha Publications, 2003, pp.173; D. John Anatony,
Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, p.10; Melvin Lewis, (Ed.), Child And Adolescent
psychiatry. 2nd ed. Baltimore: Williams & Wilkins, 1996, pp.502-509; Robert E. Hales, Stuart C. Yudofsky & John A.
Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.883; Harold I. Kaplan & Benjamin J. Sadock (Eds.), Comprehensive
Textbook Of Psychiatry/VI. Philadelphia: Williams & Wilkins, 1995, pp.2207-2241; American Psychiatric Association,
Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit., p. 46.
140
Glen O. Gabbard & Sarah D. Atkinson, (Eds.), Synopsis Of Treatments Of Psychiatric Disorders. 2nd ed. op.cit., p.57;
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.869, 874-875;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,p.50-51, 53;
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.2251-2256.
141
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.875; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.54-55.
142
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.878-882;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,p.58, 60-61, 63;
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.2264-2268.
143
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.2283-2286, 2288-
2289; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.70-75,
77; Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.900-903.
144
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.2300-2303, 2311-
2315, 2317-2318; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed.
op.cit.,pp.83-85, 90-91, 93-94; Melvin Lewis, (Ed.), Child And Adolescent psychiatry. 2nd ed. op.cit., pp.564-571; Glen O.
Gabbard & Sarah D. Atkinson, (Eds.), Synopsis Of Treatments Of Psychiatric Disorders. 2nd ed. op.cit., pp.81-87; Robert E.
Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.855, 866.
145
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., p.911, 913-914,
916; Harold I. Kaplan & Benjamin J. Sadock (Eds.), Comprehensive Textbook Of Psychiatry/VI. op.cit., pP.2322-2323;
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.96,98,99-100.
146
American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.103-105;
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds), Textbook Of Psychiatry. 3rd ed. op.cit., pp.905-906.
147
Harold I. Kaplan & Benjamin J. Sadock (Eds.), Comprehensive Textbook Of Psychiatry/VI. Op.cit., pp.2337-2342;
Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds), Textbook Of Psychiatry. 3rd ed. op.cit., pp.918-921; American
Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed. op.cit.,pp.107, 109-110.

148
Harold I. Kaplan & Benjamin J. Sadock, (Eds.), Comprehensive Textbook of Psychiatry/VI. op.cit., pp.2345-2347, 2351-
2366; Robert E. Hales, Stuart C. Yudofsky & John A. Talbott,(Eds.), Textbook Of Psychiatry. 3rd ed. op.cit., pp.924-925, 930,
934, 937-938; American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders. 4th ed.
op.cit.,pp.113,115,118,121.
149

D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp.111-112.

II. REFRAMING
ACTION-ORIENTED DIMENSION

150
Dick McHugh, Mind with a Heart. Borivli: St.Francis Technical Institute Press, 1992, pp. 195 -200.
151
Gerard Egan, The Skilled Helper. California: Brooks/Cole Publishing Company, 1994, pp.55-56; D. John Antony,
Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp. 113-116; Richard P.Vaughan, Basic Skills
for Christian Counsellors. New York: Paulist Press, 1987, pp. 8-9; Adrian Van Kaam, The Art of Existential
Counselling. Pennsylvania: Dimension Books, 1966, pp: 148-149.
152
Gerard Egan, op.cit., pp. 51-55; D.John Antony, op.cit., pp.116-120; Richard P.Vaughan, op.cit., pp. 9-10.
153
Gerard Egan, op.cit., pp. 106 -121; Richard Nelson-Jones, Practical Counselling and Helping Skills. Bombay:
Better Yourself Books, 1994, Pp.43-48; D. John Antony, op.cit., pp.120-124.
154
D.John Antony, op.cit., pp. 135 –139; Gerard Egan, op.cit., pp. 181 -184,191 -192.
155
Gerard Egan, op.cit., pp. 140-141; D.John Antony, op.cit., pp. 124-126; Richard Nelson-Jones, op.cit., pp. 69-70.
156
D. John Antony, op.cit., pp. 139- 143; Gerard Egan, op.cit., p.165, 167-170; Richard Nelson-Jones, Practical
Counselling and Helping Skills. Bombay: Better Yourself Books, 1994, p. 102; Richard Nelson- Jones, op.cit., p.76.
157
Gerard Egan, op.cit., pp.184 –186; Richard Nelson -Jones, op.cit., pp. 80-81; D. John Antony, op.cit., pp.143 -145.
158
D. John Antony, Self Psychology. Dindigul: Anugraha Publications, 2005, pp. 50-52.
159
Richard P.Vaughan, Basic Skills for Christian Counsellors. New York: Paulist Press, 1987, pp. 56 -57; D. John Antony,
op.cit., pp. 145 -149 ; Gerard Egan, op.cit., pp.186 -190.

11
PERSONALIZE THE CLIENT’S DEFICIENCY

160
Robert R.Carkhuff, The Art of Helping IV.Amherst, Masschusetts:Human Resource Development Press, Inc., 1983,
pp. 111-114; J. M. Fuster, Personal Counselling. Bandra: The Bombay St.Paul Society, 1986, pp. 156, 158, 169-175; D.
John Antony, Dynamics of counselling. Nagercoil: Anugraha Publications, 1994, pp. 127-129.
 12
FIND OUT ALTERNATIVE FRAME OF REFERENCE

161
D.John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp.130-132; Gerard Egan, The
Skilled Helper. California:Brooks /Cole Publishing Company, 1994, pp. 43, 145-147, 162 -163.

13
EMPLOY PROBLEM-SOLVING TECHNIQUES, BEHAVIOURAL STRATEGIES, AND ACTION
PROGRAMMES

162
Gerard Egan, The Skilled Helper. California: Brooks /Cole Publishing Company, 1994 , pp. 206-213.
163
Ibid.,pp. 266-272.
164
Ibid., pp. 278-280
165
Ibid., pp. 226-232.
166
14
INSIGHTS

D.John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, p.150-152.

15
DEFINE AND OPERATIONALIZE THE GOAL

167
Gerard Egan, The Skilled Helper. California: Brooks /Cole Publishing Company, 1994 , p.240.
168
Ibid., pp.254-266.
169
D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp.152-155.
170
D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp.155-156.

16
MAKE CONTRACTS AND EVALUATE

171
D.John Antony, Dynamics of Counselling. Nagercoil: Anugraha Publications, 1994, pp.156-157;
Gerard Egan, The Skilled Helper. California: Brooks /Cole Publishing Company, 1994 , pp.321-322.
172
J. M. Fuster, Personal Counselling. Bandra: The Bombay St.Paul Society, 1986, pp. 192 -193; Richard Nelson
-Jones, Practical Counselling and Helping Skills. Bombay: Batter Yourself Books, 1994, p.117; Gerard Egan, The
Skilled Helper. California: Brooks/Cole Publishing Company, 1994, pp. 39-40.
173
Gerard Egan, op.cit., p.155.
174
D. John Antony, Dynamics of Counselling. Nagercoil: Anugraha publications, 1994, pp. 215-218.