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#14 Blind Spots, We all have them, what is important about them?

This time using the Gestalt lens, the foreground background aspect in particular, and the psychodynamic lens as it manifests within our relationships. Lets have a look at blind spots and how they participate in both our clinical work and our personal lives.

What is a blind spot? Typically a blind spot is something that others can see easily about our behaviour or attitudes that we do not see or notice ourselves. In this way of understanding it, we could consider it to be an unconscious piece of our own behaviour or attitude that shows up as we live our life. It would occur in both our personal life and also our professional life. It could also be considered as a personal preference or even a bias that we have that we may not notice that shows up in how we live our lives. The key point here is that it seems to remain either unconscious or perhaps pre-conscious, that is where the opportunity exists to increase our personal level of awareness.

Why might this be a desireable choice as clinicians? When we are operating as clinicians from within one of our own blind spots, we are not in full awareness of ourselves resulting our personal history leaking into our clinical relationship. This is problematic as it will both confuse the dynamics of whose issues these actually are, our clients or our own, and how that may significantly distort the forward progress underway with our client. Therefore it becomes important to know how to detect a blind spot and when it is in play in a session, or even in our personal life because it seriously distorts the dynamics within these relationships. There are a number of areas of one's life, when we choose to become a counsellor, that seem to conceal un-examined or unwelcomed examination. These are the areas that I have noticed that often get clinicians in this blind spot kind of trouble. It is called counter-transference in psychodynamic therapy.

I see two basic types of these occurrances: the first I will refer to as actual blind spots as they are personally held, the second I will refer to as more of a bias or preference, although they can still have the same effect, these are Models of Counselling.

Personal Issues: Many of these are very personal and will not require sharing the content with anyone else, but just some personal self-exploration within a case specific context as a counter-transference reaction. Sometimes these dynamics are shared with a supervisor to determine the best course of action with a client. Personal privacy can often be maintained about the content, the personal activation showing up in dynamic elements with a client or supervisee is why it would be important to identify as an element, and helping a clinician figure out what they will need to do to transform this previously un-identified blind spot into a known sensitivity they can see and appropriately adjust their practice to insulate the counselling process from this distortion. That would mean when they can see it actually coming, or possibly coming, they have found their way to eliminate their unconscious reaction ahead of time with a specific way of managing their reactivity to avoid their own activation and be able to stay tuned to the client's needs and state with their attuned response.

These are the areas I have seen clinicians often stumble on without intention or awareness:

  1. Their own personal attachment history from early in their lives in their Family of Origin;

  2. Their relationship histories: those chosen by them; those in which they found themselves;

  3. Their anxiety habits, what they typically worry about, for how long and at what level;

  4. Their relating to authority habits, including issues of their own self esteem or perfection;

  5. Their trauma history, if they have one, is it part of their identity or just part of their history;

  6. Their ability to be/become emotionally present in the presence of other's emotional intensity;

  7. Their abiltiy to set and hold professional boundaries when others are disregulated or anxious;

By privately considering the above issues within their personal contexts it is very possible to create a very specific preferred response when there is an overlap of personal clinician history with a client's history and thereby avoid the clinician's distortion into the counselling process. Converting a blind spot to a sensitivity is what I call this process. It is or can be done entirely privately. It consists of: 1. Identifying the area(s) of personal activation [e.g. say parents divorcing when age 12ish, resulting in some potential confusion, anger, anxiety, stress,] 2. Identifying a client overlap of histories, [resulting in a potential over-identification with a 12 year old client; or an unexplained dislocation etc..] potential anger at some adult who divorces when their child is 12ish.] 3. This overlap is identified as an area of personal sensitivity for the clinician and a specific adjustment reminder is identified and put in place by the clinician to help remind themselves, this is not my history it is the clients, so their reactions do not have to be what my reactions were, and stay curious about what their client's reactions actually are and stay with them as they process that, so you don't have to re-process yours again.

Regarding the second type that may be associated with a counselling model and a potential bias or preferrence, what I notice is we tend to go where we are looking (see blog #2) we tend to see that which confirms what we already think/know/believe and a possible outcome of that is we may miss anything other than what we like or expect to see. Using my preferred psychodynamic model which priveleges previous history over current situations, my preference there could easily have me miss the importance to the client of the current situation leading them to experience frustration or anger or disengagement when I ask personal history questions following my preferred model. So I have to hold room for BOTH their current situation and how important that is to them AND the potential that their personal history may also shed relevant light on their current situation too. But if I am rigid in my preferred model, I can close off certain information that is very important to keep included.

To consider another preferred model, privedging a strengths based approach, it can, especially at the start of a counselling process, confuse a client who does not experience why they are seeking counselling as strength qualities. They are trying to explain why they want our help with, not what is going well in their world right then. They need to have the room to have their challenges understood in order for us as counsellors to get a good idea of how we may be able to offer them help. Clients are sometimes confused by these strength based question too early in the intake process. Again it is holding space for other than what we are expecting or preferring to emerge that is also important.

In conclusion, my goal in speaking about blind spots is not to suggest we should not have them, it is to propose a way to convert them from an uncoscious unitended problematic dynamic in counselling, to become, through a conscious awareness as a clinician, to be able to avoid the negative effects occuring when our blind spots do hijack our best intentions as clinicians. Being perfect as a counsellor is not about having no blind spots, being competent as a clinician is about when you identify a blind spot, converting it to a known (to you) sensitivity and continuing to have your client's experience at the center of what you are focussing on in sessions. In my view perfection is not real or attainable as a counsellor, but ever increasing competence is.

That's it for this month, I hope you found something here that got you thinking and looking. I hope you will join me next month when I take a further look into Consent and when and how it is important in counselling, Ciao David

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