Understanding Dunblane and other Massacres: Forensic Studies of Homicide, Paedophilia, and Anorexia

Understanding Dunblane  outside the Cathedral on 13/3/1996I have always been intrigued by what makes people commit murderous acts of rage.  This is not a morbid reflection on man’s inhumanity to man, on my part,  or indeed an attempt by me to gain vicarious pleasure from learning of the gory details of forensic events.  Rather, it is my way of exploring and seeking to challenge the two way dyadic that produces a rhetoric in seeing good and evil when seeking to make sense of murderous events.  I watched Trevor MacDonald’s Death Row interviews on ITV1 last year and again I was intrigued with the motives and the mindset that makes people, mainly men, commit the most heinous of crimes when they can appear so civil and engaging on camera.

Understanding Dunblane and other massacres was published in 2012 by Karnac Books. I was told about the book by a colleague who had been very impressed by its theoretical content. Peter Aylward FPC, is a psychoanalytic psychotherapist. Peter’s previous police career in the detection of major crime (a Metropolitan police special branch officer between 1977 and 1992, he worked in anti terrorism for the Met), led to him specializing in forensic psychotherapy at the secure Broadmoor Hospital.  Peter also consults with clinical teams in a variety of other NHS settings including eating disorder, personality disorder, self harm and child care assessments. “The parent whose child shares the same birth order (e.g. is like the parent in being the youngest child) can provide a greater intensity of (self) projective identification”. Helped by the work of Averil Earnshaw, Aylward argues that crucial events can occur on those dates, (such as death or serious illness) but also ones of great creative change. These become critical dates.

The book is essentially an exploration of the psychic histories of patients who through their forensic acts display their trans generational conflicts and trauma. The author maintains that it is critical that alongside the thinking that addresses “what have you done” there is also the equally important reflective thinking question “what has happened to you”? The author claims that this enables a full understanding of such events by embracing history, again, for both society (particularly the victims) as well as for the offender.  The author seeks to establish the essential need to consider the finest details when taking patient history if we are to understand the patient both within the therapeutic encounter and the treatment team milieu. It is my experience that therapists often take lean notes at the assessment stage (believing that the core material will come out in the wash, so to speak, eventually). However, I agree with Aylward that it can be beneficial to take the most comprehensive personal history as possible at the start of therapy so that the map can be most useful guiding the therapeutic journey.

it is the job of the analyst to become aware when something unconscious is being acted out in the therapy room

The core of psychoanalytical work is where the relationship between the client and therapist (transference) provides a way of understanding how the internal world (past relationships) affects current relationships.  It is the job of the analyst to become aware when something unconscious is being acted out in the therapy room. This is what it means to work with the transference when past memories of relationship dynamics start to occur in the relationship between patient and analyst.

Aylward also draws on the work of Juliet Mitchell and her publication on sibling relations and hysteria Mad Men and Madusaa (2000).  Aylward refers to a “critical date” when offences can occur at the same time that matched a traumatic event in the parent’s life.  This is what Freud called “compulsion to repeat” – an innate tendency to revert to earlier conditions (Freud  1920 p 18-22). Aylward uses the clinical tools including Klein’s (1946) projective identification, Segal’s (1978) symbolic equation, and Freud’s (1900) Ideas on the characteristics of the unconscious.

the importance of taking a meaningful account of history can often be the forgotten past

Aylward finds great theoretical inspiration from the work of Chilean Psychoanalyst Agnacio Matte Blanco which he says helped him with his capacity to think about emotions, using the concepts of “symmetry” and “asymmetry”.  He emphasizes the importance of taking a meaningful account of history, which he says, can often be the forgotten past. For Aylward, this can be indicative of the psychological process of pushing away (repressing) the unconscious.  I have been a fan of the work of Alfred Adler and was, therefore, intrigued when Aylward placed huge importance on taking particular note of the family order from one generation to the next.

So what makes someone become a mass killer? After all, there are many so called misfits who suffer from early family breakdown and who grow up without the father figure as a healthy triangulating influence. But not all of them turn out to be mass killers.  Aylward answers this by offering an analogy of a combination lock.  He does this “to explain the sequence of events that are required for a murderous act to be unleashed, not unlike the exact sequence of numbers for the lock to snap open.”

the traditional three Rs should be expanded to include a  fourth, namely relationships

What can we learn about these findings?Aylward believes that the teaching of the traditional three Rs should be expanded to include a  fourth, namely relationships. Aylward states “I believe we need to educate the next generation of mothers and fathers, starting at the earliest place of schooling and continuing it right up to the sixth form and on to university, about relationships … Inoculating future parents with insight is, I believe, the key.”  Whether Education Secretary Michael Gove will take any notice remains to be seen.

I found the book to be a great read. Aylward provides a coherent story that is both illuminating and a basis for further research and exploration.  His ideas on the psychological composition of offender behaviour is extremely thought provoking whilst his assertion that paedophilia can be treated by helping patients to a supportive, benign and authoritative intervention that they can introject will challenge many. 

 

Sexual abuse, erotic transference and how to deal with panic attacks

Our second weekend on sex involved discussing sexual abuse, erotic transference and how to deal with panic attacks. There were lots of opportunities to discuss the practical aspects of our client work which was very helpful. We also referred to the BACP Ethical Framework. It was perhaps an appropriate time to have this weekend when the BBC is discussing how to deal with the Jimmy Saville affair.  

The following definition for sexual abuse was tabled. Sexual abuse of children and young people occurs when any person forces, tricks, coerces or threatens a child to have any kind of sexual contact with him/her. Jan Sutton provides the following definition: the involvement of a young person, who has not reached intellectual and emotional maturity, in any kind of sexual activity that breaks the laws of the EU. Particularly any sexual activity that is imposed on a child by any person who is more powerful because of their age or position of authority that violates the sexual taboo of the family or of the community to which the child belongs.

Sexual Abuse includes:

1. Rape
2. Buggery
3. Forced sex with animals
4. Being bathed, kissed or cuddled in a way that makes a child feel uncomfortable
5. Made to have oral sex
6. Forced to listen to sexual talk
7. Penetrated by an object/fingers
8. Unwelcome sexual advances
9. Made to watch sexual acts
10. Being masturbated or forced to masturbate someone
11. Being involved in pornography
12. Made to eat/drink urine, semen, faeces
13. Child prostitution
14. Ritual/satanic abuse

An important exercise for anyone but particularly therapists is to get in touch with one’s own shame.  We did a lot of really useful role-play on intimacy. What are we ashamed about in our past?  Have we dealt with our baggage in order to be effective in the therapeutic alliance.

We had a valuable discussion on how to deal with someone undergoing a panic attack.  Clients might easily get in touch with early trauma when recollecting childhood memories in therapy.  It is critical to understand the physiology of panic attacks and to understand that deep slow breathing from the stomach is required in order to deal with the panic attack.

Erotic transference

We go into therapy because of some form of deficit of some description in our lives.  Therefore, when as therapists we practice unconditional positive regard, the potential for clients to feel loved and to mix these feelings up with actual love is high.  Infantile needs can be the foundation for the creation of erotic attachments.

We were given advice on how to manage erotic transference as therapists:

1. Check what is happening
2. Face up to it
3. What is my part?
4. Bring awareness to client
5. Conceptualise what is happening.

The best guideline for maintaining boundaries seems to be to have your own life as a therapist where your own intimacy needs are being met. Supervision should be a safe place to discuss all the feelings that get aroused in client work however uncomfortable.

According to Paul Croal, the psychology of our desire (or indeed lack of) often lies buried in the details of our childhood. Digging through this early history often uncovers its archaeology. Through this history we learn to love. I see sex as a narrative and part of the self. It’s similar to our image in that it contains the positive and negative aspects of the self. If for example Mum was distant and depressed how will that show up in our arousal template? Our sexual preferences arise from the thrills, challenges and conflicts of our early life. How these bear on our threshold for closeness and pleasure is the object of our excavation.

Resources

Click here for a self assessment tool if you are worried about your sexual behaviour. She is a trainer on the UK’s first Professional Certificate in Sex Addiction Treatment.

My extended interview with systemic psychotherapist, social worker and researcher DrMarie Keenan,  author of Child Sexual Abuse and the Catholic Church Gender, Power, and Organizational Culture. Dr. Keenan’s most recent research involves a study of Roman Catholic clergy who have sexually abused minors. Her research centres on the men’s accounts of how it came to be that they sexually abused minors and their understanding of the conditions of their lives that contributed to this problem. Click here to listen again to the Dr Marie Keenan interview.

Paula Hall is a UK based sexual and relationship psychotherapist. Paula has been specialising in the field of sex addiction for over 10 years and has trained withThaddeus Birchard in the UK and with Dr Patrick Carnes in the US. Paula is a founder member of ATSAC (Association for the Treatment of Sex Addiction and Compulsivity).  In the interview we discuss the nature of sex addiction, the treatment models for sex addiction, 12 step recovery programmes,  psychotherapeutic modalities and her plans for book on sex addition and treatment. Click here to listen again to the Paula Hall interview.

NSPCC: Advice and support for adults concerned about a child
Police: Emergency and non-emergency police services
Mosac: Support for non-abusing parents and carers
Sex Education Forum: Information about sex education
Stop it Now: A campaign for preventing child sexual abuse

Where do we draw the line as therapists on who we see?

I feel rested and ready for the new term of my course following my return from holiday having enjoyed the sunshine in the south of France. I always find the power of now to be easier to achieve in hot and sunny climates, where every day feels like a holiday.

It seems that there are many unpleasant news stories around at present from hit and run cases involving children visiting their sweet shop to unsuspecting pensioners being duped of their savings by con-men posing as utility inspectors. It is a constant ethical challenge for me when I assess which type of client I would refuse to work with.  Some colleagues draw the line at paedophiles whilst others refuse to see murderers. I am reassessing these ethical issues after watching some disturbing television documentaries on serial killers.

Endgames of a Psychopath

The first, Endgames of a Psychopath,  concerned the life and times of one Ian Brady.  Ian Brady was born in a Glasgow slum in 1938, to single mother Peggy Stuart and he never knew his father’s identity. Known as the Moors murders the crimes were carried out by Ian Brady and his accomplice Myra Hindley between July 1963 and October 1965.  The murders took place in an area now known as Greater Manchester, North West England. The victims were five children aged between 10 and 17, Pauline Reade, John Kilbride, Keith Bennett, Lesley Ann Downey and Edward Evans. At least four of whom were sexually assaulted. These crimes became known as the Moors murders because two of the victims were discovered in graves dug on Saddleworth Moor. A third grave was discovered there in 1987, over 20 years after Brady and Hindley’s trial in 1966. The body of a fourth victim, Keith Bennett, is also suspected to be buried there, but despite repeated searches it remains undiscovered.

The killer’s mental health advocate Jackie Powell  was interviewed in the programme and she talked at great length about her relationship with Brady. Keith Bennett’s mother, Winnie Johnson, died at the weekend oblivious that Brady was apparently ready to reveal the whereabouts of the remains of her son. Quite apart from realising the horror suffered by Winnie Johnson for the past 50 years what also struck me whilst watching Endgames of a Psychopath was the dilemma of seeing a client such as Ian Brady in a therapeutic environment whilst striving for the unconditional positive regard. How could I remain open minded, patient, non judgemental and empathic with such a client?

I felt challenged by assessing how I could stay committed to unconditional positive regard knowing the horror of his past

Similar concerns were raised in my mind when I watched last night’s programme on serial killer Colin Ireland.  This individual tortured and then killed 5 gay men in 1993 in London and died in prison earlier this year.  His victims were Peter Walker, Christopher Dunn, Peter Bradley, Andrew Collier and Emanuel Spiteri. In May 2007, a report by the independent Lesbian Gay Bisexual Transgender Advisory Group found that the Metropolitan Police inquiry was ‘hampered by a lack of knowledge of the gay scene in London and the special culture of S&M bondage’.

In the programme last night there was an opportunity to witness his total lack of remorse as he chillingly described how he killed his victims in a confession captured on video by the police.  Again, I felt challenged by assessing how I could stay committed to unconditional positive regard knowing the horror of his past.  However, when discussing these concerns previously with a psychiatrist, she pointed out that it can be further compounded when a violent client can even be directing their aggression against you in the consulting room.

issues spanning wide pendulum

The crucial issue here is where does it stop if as therapist we begin to lay down conditions on who we will see.  Invariably clients present with issues spanning a wide pendulum. So, whilst at one extreme end of the pendulum of violence, for instance, there may be multiple murders whilst at the other end there may be a history of street brawling.  Where does one draw the line if you start laying down conditions on who you see? This will always be a personal matter for each individual. It is perhaps crucial that we have a robust awareness of transference and counter-transference issues and to be as knowledgeable as possible about our own areas of emotional vulnerability and unresolved emotional issues.

Resources

Motivating treatment-resistant clients in therapy
Safety issues for counsellors who work with violent clients
Therapeutic issues for counsellors
Experiencing a horrific crime can be hugely traumatic
Living with and creating a spirituality of loss in a forensic context

Being ‘psychotherapeutically correct’


I believe I can be ‘psychotherapeutically correct’ a lot of the time

I have now finished my 16 weeks of group process culminating in a weekend residential retreat in the Kent countryside.  For the past 16 weeks I have been part of a group process on my course involving weekly unstructured 90 minutes sessions.  What started off with impatience on my part on the apparent slowness of the process quickly became fascinating as I began to see the impact of projections, transference and identification.  Being unstructured meant everything that happened in the group had a significance of some value. Seating configuration is also very important and some groups operate a spiral formation although ours was one circle.

We had been split into three groups for the 16 weeks but we came together as one group at the residential. The smaller group had seemed big at the time but having over 50 students sitting in one circle with no agenda for the whole weekend really felt big. Going for walks in the beautiful grounds facilitated my reflective practice.

The blueprint for how we operate in groups is our experience from being in a family

I would recommend group process work as you will invariably find out a great deal about yourself.  The blueprint for how we operate in groups is our experience from being in a family. That is effectively our first group. Examining your family background can be challenging as well as exciting.  It can be challenging in that an examination of your family background can throw up projections in groups but getting to grips with your personal history can be very rewarding. Therapy takes place by the group not the facilitator.  In fact, the best functioning groups make the job of group facilitator redundant.

It is interesting to note the current debates in the transpersonal movement pertaining to participatory consciousness to do with the whole.  Some in the community are asking, for instance, if psychotherapy can create a narcissistic split. Sometimes I find that I can be concentrating on my own individual experience at the expense of the group experience.  I like what my group work facilitator said: that it is sometimes better to engage with our own material in groups and see where that takes usI believe I can be ‘psychotherapeutically correct’ a lot of the time whereas I could be more willing to share my shadow material and see what transpires. Maybe it would be more fruitful if we explored our shadow material more often in groups instead of saying “oh sorry that is my stuff” when we have encounters with others. Is it my stuff?  How do I know?

I am now tired. It feels very much time for a breather and to enjoy the summer break. I have also finished my essay on early life theory and how this relates to integrative psychotherapy. More about that in a subsequent post.

See also my previous post on group process.

The relevance of early life and psychodynamic ideas in transpersonal integrative psychotherapy?

the journey in transpersonal integrative psychotherapy is to seek one’s essence, one’s real self

I often wonder if early life experiences are important in shaping adult character and whether unconscious communication such as transference and counter-transference is integral to transpersonal integrative psychotherapy.  Perhaps transpersonal integrative psychotherapy presupposes psychoanalysis or, rather, include it as a first and necessary stage in helping us to name what is going on in the therapeutic relationship.

Whilst unconscious communication is important in psychotherapy, is it that we need to go further than psychoanalysis to understand the client?  Yes, we all have early life issues and we perhaps might have early life developmental ruptures, and thus an analysis of these issues can be a useful insight.  However, such analysis can ultimately limiting as the journey in transpersonal integrative psychotherapy is to seek one’s essence, one’s real self. Therefore, we need to understand the client in a more holistic manner, the assumption being that we are more than the sum total of our personal history whether in families, schooling or working situations.  The journey in therapy is to uncover our inherent soul nature, that which gets blocked through our lived experience, whilst we are struggling to build a healthy ego.

I believe that early life experiences are indeed important in shaping adult character and that non-verbal and unconscious communication such as transference and counter-transference is integral to transpersonal integrative psychotherapy. I accept that transpersonal integrative psychotherapy presupposes psychoanalysis or, rather, include it as a first and necessary stage in helping us to name what is going on in the therapeutic relationship. However, I believe that we need to go further than psychoanalysis to understand the client. Indeed, we all have early life issues and we perhaps might have early life developmental ruptures, and thus an analysis of these issues can be a useful insight. The nigredo stage is necessary in the alchemical journey or we risk a spiritual bypass.

Psychodynamic therapy can, however, be limiting as the journey in transpersonal integrative psychotherapy is to seek one’s essence, one’s true self. Therefore, I believe that we need to understand the client in a more holistic manner, the assumption being that we are more than the sum total of our personal history of being in families, schooling or working situations and of being in our various relationships. To this end, we need to uncover soul qualities in our search for our true selves.

Ultimately, I agree with Jacobs when he says that in psychotherapy clients make theory rather than theory making therapy. I need, therefore, to remain open-minded and use early life theory as a map which might be helpful in the navigation rather than as a set of rules. Pattern recognition is essential to good therapy. The primary difference between talking to our friends or Aunt Dorris is that counsellors are trained to look for patterns.

Resources

Transpersonal interventions
Explanation of therapeutic approaches
Transpersonal techniques
Transpersonal psychology

 

Transference when seeing clients in prison

I have previously discussed the issues surrounding transference and indeed pre transference where I wondered how the circumstances and location of the therapy session affected the minds of both the counsellor and the client. This week I attended a ward round in a health-care setting in a prison as part of psychiatric placement.

The unit serves the prison community which is comprised of adult men, with no upper age limit and accepts patients who have mental health problems. It incorporates those suffering from acute psychotic episodes and/or other mental health illnesses, patients with a personality disorder and some patients with a learning disability. Occasionally a patient with a mental health problem and a substance misuse problem may be admitted. It excludes those patients who primarily have a substance misuse problem.

I was speculating with myself about the type of patient that would present at the ward round. Some of the patients were lifers and seemed resigned to their sentence, others were on remand awaiting a court date.  Seeing patients with suicide ideation can be draining especially when some talk at length and in great detail about how they would seek to end their life.  I felt helpless and powerless, was this my counter transference?  It is also frustrating to hear the evident need for talking therapy resources in such institutions at a time of cut backs and limited resource. However, I was there in an observing capacity and actually witnessed an upbeat and cheerful psychiatrist who seemed to take the ward round very much in his stride.

Resources

RAPt delivers drug and alcohol services – in prisons and in the community – which help people move away from addiction and crime.
Mental Health Care in Prisons a guide to mental ill health in adults and adolescents in prison and young offender institutions.
CARAT (Counselling Assessment Referral Advice and Throughcare) is a drug service that is available in every prison in the UK. CARAT teams were introduced in 1999 as part of HM Prison Service’s strategy to tackle drugs in prison.
Prison Reform Trust a registered charity that works to create a just, human and effective penal system. The organisation was established in 1981 in London by a small group of prison reform campaigners who were concentrating more on community punishments than on traditional prison reform issues.
Evaluation and Treatment of Patients with Suicidal Ideation  

How big a factor is pre-transference in the therapeutic relationship?

A lot has been written about transference and counter transference from the therapeutic relationship between counsellor and client.  Of course we do not approach people in any walk of life as a blank sheet but rather we ‘transfer’ what we have already learned from the past to the present.  However, in psychotherapy it is more intense and potentially more powerful that which we transfer.  This is due chiefly to two reasons.  Firstly, the therapist adopts comparative anonymity.  The refusal by the therapist to correct the client’s misconceptions can offer the opportunity to explore and discuss these misconceptions.  Secondly, the clients are asking for help and this can create a useful parental authority figure dynamic in which to work with.

But what about pre-transference when seeing clients?  Clients will have preconceived ideas about the therapy as well as preconceived ideas about the therapist before they arrive at the first session. They might already have had dialogue with the administrative staff before the initial consultation if the sessions are to be held within a counselling centre or they might have had telephone contact with the therapist before the first meeting.

Pre-transference is not, of course, restricted to the client.  The therapist will also have pre-conceived notions about the client based upon the preliminary discussions that have taken place before the initial meeting. For example, a client could perhaps have outlined a brief summary of the presenting issues before the initial meeting.  Or they might have revealed their expectations of therapy and this might tempt the therapist to fantasise about the client before they meet.

How can you deal with your pre-transference as a therapist? It is essential to be aware of what is happening in the room. You need to stay conscious.  As a therapist we ask ourselves who does the issue belong to? Is it mine or someone else’s? Are we in touch with our own centre and in touch with our essence? If we are truly in touch with our own baggage, then we can be better protected from bringing our own agenda into the therapeutic relationship.

Empathy and compassion can create a safe environment in order to allow difficult issues to rise to the surface.  If we explore the fantasies of the client then they could lead us somewhere. It is important for a therapist to remember that resistance is not malicious ill will but a coping strategy on the part of the client to avoid pain. In other words the defence systems are there for a reason and you are advised to ensure that the client has a healthy ego before you engage in challenge.  You must avoid the temptation to take client resistence personally. It can be argued that transference and “acting out” are at one when the client is acting in a way that repeats “the cycle” with the therapist, thereby exploring the core issues.  A lot of the material with a client is pre verbal and pre conscious.

Related posts. 

The 1-1 relationship between psychiatrist and patient
The importance of challenge in the therapeutic relationship 
Transference and counter transference
Resistance in therapy
Dr Marie Keenan interview
Why some patients trigger stuff and not others

It is intriguing how some patients can invoke certain feelings and not others.

It was good to get back to my psychiatric placement at an NHS Mental Health Trust today and to a ward review meeting.  I have been sitting in on clinic sessions at a university hospital with consultant psychiatrists covering new assessments, outpatient follow up appointments as well as team meetings discussing the management of care. It was two weeks since I was last at this ward review and it was heartening to notice the visible improvement in some patients in the intervening period.

There were a couple of patients who had regressed and this was producing some feelings in me (what is called counter transference). One patient, a middle aged man suffering with severe depression, was continuing to present with anxiety and helplessness.   I felt like wanting to hug him.  However, his depression is so severe that he has been prescribed a course of ECT. It is intriguing how some patients can invoke certain feelings and not others. Perhaps counter transference is when our own stuff and issues have been triggered and when we identify with the personal circumstances. I was particularly taken by the love and support of his partner (who was present in the session) and who appeared to be a rock of support in spite of very challenging circumstances.  The experience made me aware of the vital role that carer groups undertake in the management of support networks for families and friends of those suffering from mental illness.

Related posts. 
The 1-1 relationship between psychiatrist and patient
The importance of challenge in the therapeutic relationship 
Transference and counter transference
Resistance in therapy
Dr Marie Keenan interview

My extended interview with Dr Marie Keenan, author of Child Sexual Abuse and the Catholic Church Gender, Power, and Organizational Culture.

Dr Marie Keenan UCD

My extended interview with systemic psychotherapist, social worker and researcher Dr Marie Keenan, author of Child Sexual Abuse and the Catholic Church Gender, Power, and Organizational Culture. The interview was conducted at UCD in November 2011. Specialising in the area of crime, sexual abuse and sexual offending, Dr. Keenan’s most recent research involves a study of Roman Catholic clergy who have sexually abused minors. Her research centres on the men’s accounts of how it came to be that they sexually abused minors and their understanding of the conditions of their lives that contributed to this problem.

Click here for the interview link.

Resources

University College Dublin
Systemic Psychotherapy
Roman Catholic Clergy abuse
Recovery from abuse
Helping victims

The importance of challenge in the therapeutic relationship

We have been working on our receptive skills for the main part of the year thus far, how we hold the work of clients. It is important to remember that it is critical to cultivate a degree of restraint in order to be able to reflect back appropriately. Trainee therapists quickly realise that you don’t need to effectively do anything in the therapeutic relationship. We resist the urge to step in but rather just listen. We are building a containing space around the client to help them develop and to become independent.

We are robbing the client if we step in too quickly. We are providing a steady (constant) relationship that allows them to see their ideal in themselves. The relationship will begin to change through the transference. Receptivity is the basis of clients trust. It can, however, be ruined by an inappropriate and untimely comment. There is a place to step in but this must be judged very carefully. We can’t challenge before we have learned to listen.

Defences serve a purpose with clients and we must tread carefully but challenge we must or we will risk collusion with the client. Clients can remain in the unconscious so challenges could be around what is happening in the room (payment issues, lateness etc.). Clients are not our mates. They might like to see us becoming friends, but we are not their friends.

Conditions for challenges

Are they ready? It is important to work with the material to gain an assessment of the right time to intervene.

Can they hear? Clients might have intense shame and feelings of worthlessness. There might be a shock of being confronted by the shadow. Clients might act out rather than work through the difficult material. Research has shown that negative transference is best to establish bond.

There is no magic wand. This is one of the great realisations a client can have. The ideal is self-challenge. What is the story behind the story that the client is bringing? Bodywork and meditation only give us images and these must reflect the client narrative.

Further reading:
The therapeutic relationship
Transference and counter transference
Positive transfer and Negative transfer/Anti-Learning of Problem Solving Skills
Counselling Skills
How to help the client understand the problem