Counselling and Intimacy - A talk given to the Natural Sciences Society - December 2002

Dave Robson

Abstract

Counselling could be described as a professionally intimate activity. This session will explore some of the issues in this area and how counsellors are trained to handle such issues.

Dave Robson qualified as a counsellor in the 90s and undertakes counselling outside of the University. He has been involved with couple counselling with Relate, and is currently counselling within the NHS and also in private practice.

Me and my background

I could probably be described as a good candidate to look after Natural Sciences. I started liking Geography at school, but found I was good at Maths and as you could not take both at our school (because of the timetable !!). I did a year of computing at University and hated it. I then taught Maths for three years and then went back to University to take Statistics and Computing. I eventually emerged with a Ph.D. in Computer Science and then started a lecturing career in Computer Science. So how did I end in counselling ? Well I guess it was a general feeling of dissatisfaction with what I was doing. It had become very impersonal, too much focus on the machine. You could call it a mid-life change of direction.

What made it easier to make the jump was that my wife trained as a counsellor about four years earlier, but I still couldn’t see myself doing it. Could I write essays ? Could I handle clients telling me unpleasant events and feelings ? Well I put my toe in the water and did a one day course. Fascinating – not only the material, but the way it was taught. No lectures, practical work, videos, discussion groups – like nothing else I had seen before. Yes, it was hard to handle difficult events – I guess if it ever became easy, then I would worry.

So I trained (different but not easy) part-time and came out with an M.A. six years ago. I took on some work in a GP surgery and also started training from scratch at Relate who specialise in couple work. I had to give up Relate about a year ago and I miss it. I am still working in the NHS and in private practice.

What sort of issues come up in my work – depression, bereavement, sexual difficulties, abuse, relationships, self-esteem issues.

I think I lead a compartmentalised life – my family, my counselling, Natural Sciences, Cuths, sailing and running – they don't overlap very much, so it feels a bit strange to show one compartment to another group.

Intimacy

It is important to define intimacy before considering its place in the client-counsellor relationship. Unfortunately, there is no widely agreed definition of intimacy (Register and Henley, 1992):

One problem most central to advancing our psychological understanding of the experience of intimacy has been in defining or circumscribing the phenomenon itself. While much has been written on the topic of intimacy in a variety of contexts by both academic and 'popular' authors, paradoxically, there exists less research (and even less concurrence) on essential matters such as the definition of intimacy.

Monsour (1992) also discusses the wide interpretations of intimacy. He describes some delineations of intimacy as more central than others and self-disclosure is one widely used definition. The amount of self-disclosure in a relationship is frequently used as a measure of intimacy (Duck, 1988), (Derlega and Margulis, 1983). A number of studies have shown that one person strategically releasing more personal information can lead to the other person responding with equally increased levels of intimate response (Duck, 1988, p57). Duck describes various expectations about intimate communications:

1. you self-disclose if you want to be liked and approved;

2. the amount of self-disclosure must not be too much in the circumstances, particularly to start with;

3. self-disclosure should be matched to the intimacy level of the relationship (which could be changing, therefore self-disclosure can be used to escalate or de-escalate relationships)

4. one person reciprocates the other person's disclosures (and likewise can influence the growth or decline of the relationship);

5. self-disclosure changes and expands as the relationship grows.

Derlega and Margulis (1983) describe a classification of self-disclosure by (Morton, 1978) into descriptive and evaluative intimacy. Descriptive intimacy refers to the disclosure of unknown factual material, for example, that you have two brothers and a sister. Evaluative intimacy refers to the disclosure of personal feelings or judgements, for example, that you are feeling very angry after an examination failure. Evaluative intimacy, or emotional expressiveness as it is sometimes known (Monsour, 1992), is seen as an important component of intimacy.

Self-disclosure can also be communicated non-verbally. For instance, the paralinguistics, the relative positioning of the people involved, the body language all contribute to revealing the feelings of one person to another (Argyle, 1983). However, unlike verbal self-disclosure, non-verbal self-disclosure cannot be effectively withheld.

Physical contact is another important aspect when considering a definition of intimacy. Monsour (1992) describes a study by Helgeson et al (1987) which found that sex and physical contact played a central part in the description of intimate behaviour in opposite sex relationships, though in same sex relationships physical contact was rarely mentioned and sex was not specified at all. Other aspects of intimacy that Monsour's study revealed were trust, unconditional support and the sharing of activities.

Register and Henley (1992) reported on a small phenomenological study of peoples' experiences of intimacy. They identified seven themes within the descriptions. Non-verbal communication was seen as an important theme. The presence of the individuals or entities (two of the experiences of (non-sexual) intimacy were with entities other than people) was seen as necessary. Time was a theme which raises the question as to whether intimacy is a state which is entered for only for a period or whether it is a trait (Acitelli and Duck, 1987). The concept of boundaries being involved in the encounter was the fourth identified theme. The theme of body and physical encounter was also relevant. The destiny/surprise theme represents the reconciliation of two apparently opposite extremes. Finally, transformation represents the movement from one state to a different richer state and this theme was seen by some subjects as the aspect that gave intimacy a powerful quality.

Other authors approach the definition of intimacy from a perspective which emphasises the self. One example of this is the following definition of an intimate relationship by (Lerner, 1990, p3):

An intimate relationship is one in which neither party silences, sacrifices, or betrays the self and each party expresses strength and vulnerability, weakness and competence in a balanced way.

Amodeo and Wentworth (1986, p15) argue that genuine intimacy is only possible after an individual has become autonomous to some degree. They describe the importance for an individual to become acquainted with themselves, to know their feelings, affirm their needs and to have the ability to communicate them in a responsible way. Erikson (1950) has made a similar argument in his model of the eight ages of man.

Counselling and Intimacy

Two poems about counselling:

Counselling Condemmed
Request from a Client

At a recent funeral of a counsellor, somebody who wasn’t a counsellor who was paying tribute to the counsellor said that she had the ability to detach herself from the client material. I don’t think counsellors do this – if they did I don’t think they would be very good counsellors.

The client-counsellor relationship is a highly specialised relationship quite unlike most relationships between two people. Assuming the counsellor uses Rogers' core conditions (Rogers, 1957), at least as a foundation, the counsellor will be exhibiting a presence which invites intimacy. The three core conditions of empathy, unconditional positive regard and congruence assist the client in feeling valued and listened to non-judgementally. Thus, the counsellor is providing the unconditional support that was seen as one aspect of an inmate relationship (Monsour, 1992).

The two participants come to a session with certain preconceptions and this affects the degree of intimacy in the relationship. The counsellor expects to listen attentively to the client and the client expects to talk about themselves and their problems. With these expectations and with the counsellor using the core conditions, the client will self-disclose and will be encouraged to explore themselves at a deep level. It is probably inevitable that the client will view this as an intimate relationship.

The client-counsellor relationship is frequently governed by explicit boundaries which can have a powerful effect on the degree of intimacy in the relationship. For instance, the provision of confidentiality can help the client self-disclose more easily. Confidentiality helps to provide an atmosphere of trust, which has also been described (Monsour, 1992) as another aspect of an intimate relationship.

Rogers argues that the client often comes to a counsellor because of an incongruency between the client's self image and their ideal self (Rogers, 1957). The counsellor can facilitate the client to resolve this incongruency by either changing the self image or ideal self or both. The result is that the client can come to know themselves better. This helps to fulfil a necessary precondition for intimacy that is proposed by some writers (Lerner, 1989) (Amodeo and Wentworth, 1986). As the client-counsellor relationship develops, the client learns more about themselves and this can lead to a more intimate relationship with the counsellor.

Kottler argues that the level of intimacy in the client-counsellor relationship may reach a higher level than any other relationship (Kottler, 1993, p3):

Confidentiality, and therefore privacy, is an implicit part of the encounter, as is a level of intimacy that sometimes reaches, if not exceeds, that of parent and child or husband and wife. We are privy to the secrets the client is barely willing to share with himself.

The client-counsellor relationship could be perceived as an inmate relationship in only one direction, namely from the point of view of the client. Clients expect their problems and themselves to be the cornerstone of the discussion and as they feel safe, they reveal more and more of their inner selves. It might be expected that counsellors would reveal very little of themselves. However, counsellors cannot help but disclose (Strong and Clairborn, 1982, p173) in (Egan, 1986, p228):

The counselor communicates his or her characteristics to the client in every look, movement, emotional response, and sound as well as with every word. Clients actively construe the personal characteristics, meanings and causes behind the counselor's behaviors in order to evaluate the personal significance of the counselor's remarks.

If the counsellor is being congruent then self-disclosure may also take place. Rogers argues (Rogers, 1957):

... the therapist should be, within the confines of this relationship, a congruent, genuine, integrated person. It means that within the relationship he is freely and deeply himself, with his actual experience accurately represented by his awareness of himself. It is the opposite of presenting a facade, either knowingly or unknowingly.

If a counsellor is being congruent then this may lead to the counsellor self-disclosing feelings. However, the objective should not be for counsellors to talk out their own feelings, but to ensure that the client is not deceived by a facade built by the counsellor (Corey, 1991, p213):

This does not mean that therapists should impulsively share all feelings, for self-disclosure should also be appropriate.

Egan also makes a case for self-disclosure by the counsellor (Egan, 1986). He argues that self-disclosure is a challenging skill and can be seen as a form of modelling for the client. The client can observe a method of self-disclosure and be encouraged to do so themselves. Secondly, he argues that counsellor self-disclosure can help clients develop new perspectives for goal setting from hearing the experiences of the counsellor. However, care needs to be taken with this aspect of self-disclosure as it needs to be appropriate (Egan, 1986, p230) and should not frighten clients (Weigel et al., 1972) in (Egan, 1986, p229).

Thus the view that the client-counsellor relationship consists solely of one-way intimacy or solely client self-disclosure, appears too simple. Other authors take this point of view further and argue that the intimate relationship can affect the counsellor (Kottler, 1993, p254):

Our clients do indeed change us almost as much as we change them. Even though we know, understand, and enforce the rules and guard against infection by clients, and even though they are amateurs at influence, befuddled and distracted as they are with their own concerns, we cannot remain completely unaffected. We are touched by their goodness and the joy and privilege we feel in being allowed to get so close to a human soul.

Deurzen-Smith discusses whether intimacy is always genuine and whether the quality of the relationship is best assessed from the point of view of the lowering of personal barriers (Deurzen-Smith, 1994). She argues for a relationship which is a dialogue, rather than duologue or monologue. A dialogue occurs when the participants open themselves inwardly for the other, whereas a duologue occurs when the participants do not genuinely lower their barriers. She focuses on the ground between the participants:

When I put myself at the service of my clients from this perspective, I achieve a twofold movement away from self-absorption and away from client-absorption. I am no longer self-centred or client-centred. I am instead centred on what lies between us. On the one hand I become aware of what the other brings in terms of our shared humanity and I can get a bird's eye view of it and see it in perspective. On the other hand, and at the same time, I recognise some of the issues that I grapple with for myself and I discover our shared human condition, even though it is lived somewhat differently by each of us.

She argues that approaching the client-counsellor relationship to create intimacy does not mean exposing the inner self of either party, but to enter a relationship to discover what can be created in the space between the two parties:

If I come to the relationship with a willingness to see what there is that you and I can learn about life through the experiences that you are struggling with, then neither I nor you will stand in the way of recognizing what there is for us to see. ... The intimacy I create with you is about daring to come into a place that we share, that we both know and that we can learn to shape and alter. It I do this I shall be moved and touched in my work with you and yet I shall not burden you with my own sorrows or desires.

Rogers does not state any clear limits to the non-sexual intimacy that can take place in the client-counsellor relationship. However, there are dangers if the counsellor becomes severely affected by the relationship. This happened to Rogers when, as reported by Kottler, a client pierced his defences and triggered his feelings of inadequacy (Rogers, 1972, p5) in (Kottler, 1991, p2). Continuing this relationship led to a psychotic breakdown for the client and nearly a nervous breakdown for Rogers, which was averted by him undertaking counselling. This supports the principle that supervision is important for all counsellors

How counsellors handle intimacy

• Training – self awareness aspects
• after training – Supervision – explain what is it

Can things go wrong ?

A discussion of the limits to the level of intimacy that can be reached in a client-counsellor relationship needs to include physical touch or sexual contact. As described earlier, these elements are frequently thought to be part of intimacy. Physical touch is an important aspect of intimacy. Argyle has described the importance of physical touch in relationships and how this varies for males and females and between cultures (Argyle, 1983). Russell argues that counsellors need to be very careful in using physical touch, especially if it is not initiated by the client, as the boundary between sexual and non-sexual touching can be perceived as very narrow.

Thorne, in a controversial case of physical, non-sexual touch, has described a case where he and a client had a nude embrace (Thorne, 1987). Thorne describes the risks as follows (Thorne, 1993):

Without doubt there was a risk involved in all this but I would submit that there are few therapeutic relationships of depth where risks are not involved. In this instance our shared Christian allegiance, the involvement of Kenneth (the client's husband) and the deepening sense of mutuality between us were, I believe, more than adequate safeguards.

In this case this physical non-sexual embrace appears to have had a beneficial outcome, but in general it may be very difficult to avoid sexual touching in such circumstances.

Sexual contact between counsellor and client is now generally acknowledged to have a detrimental effect on clients and is forbidden by the codes of ethics of professional counselling organisations (BAC, 1990). Rogers makes his own position against such contact in a transcription of a session with a client who wishes to have sexual contact with him (Rogers, 1951, p211). However, there is wide evidence that such contact does regularly take place (Coleman and Schaefer, 1986), (Rutter, 1989) and (Russell, 1993).

Rutter gives an American perspective (Rutter, 1989) and concentrates on the situation where the counsellor is male and the client female. Russell includes a less restrictive view of the possible sexual orientation of the participants and details the effects on clients of such intimacy (Russell, 1993, p20). In all the cases that she investigated, the clients felt that a betrayal of trust had taken place. Other common feelings by clients were guilt, anger, frustration, ambivalence, distorted self-concept and isolation. Behaviourally, these feelings often manifest themselves by destructive behaviour to the self or others.

Sexual attraction towards the client from the counsellor can occur. Thomas describes such a case with a client and illustrates how he dealt with the situation by being congruent, taking the case to supervision and undertaking his own therapy (Thomas, 1991). This again emphasises the importance of supervision.

Wrap up

Counselling is a powerful activity and it can affect both counsellors and clients.

Is it intimate ? Yes,

Because it is intimate, can that be dangerous ? Yes and care needs to be taken

I find it very challenging, often very emotional, but very very satisfying. You do get close to people and that is satisfying for me (although it can also be hard saying goodbye).

References

Acitelli, L.K., and Duck, S.W. (1987), 'Intimacy as the Proverbial Elephant', in Perlman, D. and Duck, S.W. (Eds.), 'Intimate Relationships', London, Sage.

Amodeo J. and Wentworth K. (1986), 'Being Intimate', Penguin, London.

Argyle, M. (1983), 'The Psychology of Interpersonal Behaviour', 4th Ed., Penguin, London.

British Association for Counselling (1990), 'Code of Ethics and Practice for Counsellors', BAC, Rugby.

Coleman, E. and Schaefer, S. (1986), 'Boundaries of Sex and Intimacy between Client and Counselor', Journal of Counseling and Development, Vol. 64, 341-344.

Corey, G. (1991), 'Theory and Practice of Counseling and Psychotherapy', 4th Ed., Brooks/Cole, Belmont, California.

Derlega, V.J. and Margulis, S.T. (1983), 'Loneliness and Intimate Communication', in 'Social Psychology', Perlman, D. and Cozby, P.C. (Eds.), Holt, Rinehart and Winston, New York.

Deurzen-Smith, E. van (1994), 'Counselling and Intimacy: Monologue, Duologue, Dialogue', Selected Papers from 2nd Int. Counselling Conf., School of Education, University of Durham.

Duck, S. (1988), 'Relating to Others', Open University Press, London.

Egan, G. (1986), 'The Skilled Helper', 3rd Ed., Brooks/Cole, Belmont, California.

Erikson, E.H. (1950), 'Childhood and Society', Penguin, London.

Helgeson, V.S., Shaver, P. and Dyer, M. (1987), Prototypes of Intimacy and Distance in Same-sex and Opposite-sex Relationships', Journal of Social and Personal Relationships, Vol. 4, 195-233.

Kottler, J.A. (1993), 'On Being a Therapist', Jossey-Bass, San Francisco.

Lerner, H. (1989), 'The Dance of Intimacy', Pandora, London.

Monsour, M. (1992), 'Meanings of Intimacy in Cross- and Same-Sex Friendships', Journal of Social and Personal Relationships, Vol. 9, 277-295.

Morton, T.L. (1978), 'Intimacy and Reciprocity of Exchange: A Comparison of Spouses and Strangers', Journal of Personality and Social Psychology, Vol. 36, 72-81, 1978.

Register, L.M. and Henley, T.B. (1992), 'The Phenomenology of Intimacy', Journal of Social and Personal Relationships, Vol 9, 467-481.

Rogers C.R. (1951), 'Client Centred Therapy', Constable, London.

Rogers, C.R. (1957), 'The Necessary and Sufficient Conditions of Therapeutic Personality Change', Journal of Consulting Psychology, Vol. 21 and reprinted in Kirschenbaum, H. and Land Henderson, V. (Eds.) (1990), 'The Carl Rogers Reader', Constable, London.

Rogers, C.R. (1972), 'My Personal Growth' in Burton, A. et al, 'Twelve Therapists: How they live and articulate themselves', Jossey-Bass, San Francisco.

Russell J. (1993), 'Out of Bounds. Sexual Exploitation in Counselling and Therapy', Sage, London.

Rutter P. (1989), 'Sex in the Forbidden Zone', Aquarian, London.

Strong, S.R. and Clairborn, C.D. (1982), 'Change through Interaction: Social Psychology Processes of Counseling and Psychotherapy', Wiley, New York.

Thomas, P. (1991), 'A Therapeutic Journey through the Garden of Eden', Counselling, 2, 4, 143-145.

Thorne, B.J. (1987), 'Beyond the Core Conditions', in Dryden W. (Ed.), 'Key Cases in Psychotherapy', Croom Helm, London.

Thorne, B.J. (1993), 'Body and Spirit' in Dryden, W. (Ed.), 'Questions and Answers on Counselling in Action', Sage, London.

Weigel, R.G., Dinges, N., Dyer, R., Straumfjorn, A.A. (1972), Perceived self-disclosure, mental health, and who is liked in Group Treatment', Journal of Counseling Psychology, 19, 47-52.