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#8 Perfection, does it actually exist in this counselling work?

This we can view through the client centered lens to start with because as counsellors, we all want to learn our trade well and become 'our best' at it from the very beginning. Does OUR PROFESSION actually require perfection from us to become proficient, and is that even possible in our profession?

Lets start from our professions beginnings. We did not come from the medical model of illness or infirmity like clinical psychology did. Medecine's model requires the practioner to cure the symptoms, or facilitate the containment of the symptoms to protect the public from having to see or manage the people who demonstrate infirmity or some other mental health problem. While it is true that we counsellors often do also help people identified with some psychiatric disorder, our approaches are decidedly different from curing them or removing them from sight, as it used to be with large psychiatric facilities that warehoused large numbers of people who found living amongst others to be very challenging. As the governments of the day and jurisdictions adjusted funding policies and programing to eliminate these large institutions, the people previously housed there were simply released into the communities from which they came.

That gave birth to much of today's Mental Health Crisis in B.C. and all of it's many complex multi-layered manifestations. For example, there were huge increases in addictions, homelessness, poverty, relational violence, isolation, un-attended to mental health issues, inproperly trained police responses to marginalized populations. These are only a partial list. But my point is, counselling as a profession began as a problem solving approach to a stated or observed problem brought forward by the person themselves seeking help. The skill sets were largely centered around active listening models of effective communication by the counsellor to someone seeking their help.

As the profession matured and the issues people brought in got more complex, the skills used also had to develop to address these more complex issues. They were still very client centered in their responses and most of the post modern models of counselling are considered to be short term and not reliant on medications or hospitalizations unless they require extreme medical interventions.

Counsellors work in primarily relationally driven relationships which are highly personal and trust based. While continuity of care is an important aspect of how we work, it is not the same as it is in a medical practice where a physician can simply bring in a locum, they use your notes to follow through with any procedures or test required to diagnose ailments and perscribe the appropriate cure or fix for it. Counsellors do not generally do this, instead, we negotiate with our clients how they will manage while we are away, using the skills we have already shared with them.

All of this is to show how, in my view, perfection is inconsistent with our delivery model. There are just too many relationally held variables in play. However, what I believe we can and should strive for is to bring to our clients our best clinical self every time we work with them.

There are so many ways to accurately conceptualize an issue brought by a client and many aspects that can be approached in so many different ways, all of which can be effective in the highly subjective practice of counselling. This does not mean we should just make things up as we go. We have extensive training in the models we choose to practice and get expert clinical consultations on tricky cases as needed. The problem I have with perfection in counselling is, perfection implies there are only a limited number or responses that would/could be appropriate and the execution of what these responses would require is also finite. That is not my view of the world of clinical counselling. There are so many alternative ways to approach a client and their issues, even using just 'evidence based' strategies, there are very few situations requiring just one way to proceed.

I am of the opinion that achieving perfection in counselling is not possible, nor even helpful as a goal for clinicians, newer or vetrans alike, bringing our best clinical selves each session is a worthy and achievable goal for clinicians. Because as soon as we notice that we are not doing so, that awareness is the start of our re-focus to do our best in that new moment. It is self awareness driven practice, which is not static or ever achieved as a fact, it is a process that is on going. Practicing continual renewal through increasingly directed self awareness is a central componant of competent counselling practice.

Another big problem of the achieving perfection in general, mostly in the eyes of others, is once you have achieved the 100% on a test of some kind, the expectation typically seem to require 100% from then on. If the 100% is not reached, then the message is clear that there is something wrong with you, and you had better fix immediately. You find then that their approval of perfection is in fact conditional on on-going perfection. That is a great deal of unhelpful and uneeded pressure to live under. The work that we do as counsellors is already hard enough, we do not need to be adding this false 'Perfection' as a constant expectation.

I also want to say that there are many situations and professions where perfection is a preferred goal. In medicine, I want a neurosurgeon to be perfect in their technique when operating on my brain. I want an engineer to be perfect in their load calculations for a bridge I am driving a heavily loaded truck across, But those are precise calculations driven by objective data, not in the subjective context in which counse3lling occurrs.

I must leave this here, as I have just received some very sad news. But next month I will be outlining something I call PROXIMAL DISTANCING. I hope you will stop by next month and have a look, Ciao, David

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