RC Early Sexual Memories Workshop Notes/Reminders/Helpful Hints for Support Group Leaders (and all other counselors)
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Joan Karp
Here are some specific counseling suggestions and information on leading groups which ESM workshop support group leaders and other counselors have found useful. Leaders of ESM support groups outside of workshops and other counselors can adapt the information on groups to their own situations.
1. I HAVE CONFIDENCE IN YOU. You know how to counsel people well. Counseling people on their earliest sexual memory is just like counseling people on anything else, except that sloppy counseling generally doesn't work very well. Feel free to use everything you know about how to counsel people (and how to lead groups) ñ you are not limited to the few ways I will have a chance to demonstrate.
2. I expect you to keep people discharging the distresses of their earliest memory connected to sex. They can work on other things at other times, and may need to, but require your persistence to work on this. While working on the earliest memory, many later memories will come to mind. This is just right. Ask the client to share the later memories (with discharge) and then return to the earliest one. If the client remembers an earlier memory, switch to working on that one.
3. Clients new to this work usually do well to start by repeatedly telling the story of the memory. New details will emerge and bursts of discharge will occur at different points in the retelling. The counselor needs to actively encourage and provide appropriate contradictions throughout. Soon it becomes more useful to pay attention to a specific aspect of the memory at a time, using all possible counseling tools to assist discharge. However, it is useful for all clients to periodically retell the incident in its entirety.
4. Effective counseling in this area will often require contradicting people's "general chronic stuff" at the same time you work with them on the content of the memory. (Feelings of isolation, that no one cares or is interested, hating attention, unimportance, guilt, etc.) Ask your client what life was like for them generally during the time of this incident. Tone of voice, facial expression, and posture of counselors and/or client, as well as what both say can be good counseling tools here.
5. Pointing people's attention away from the distress is usually a key aspect of counseling people well. Finding a positive point of view, using a cheerful tone of voice, reminding clients that the incident has been over for a long time, celebrating their survival, imagining a childhood or life without those hurts (their own childhood or someone else's), contrasting the present with the past, are some possible approaches. This will become even more important after the first couple of sessions. (Aware listening is often the place to start, especially if discharge is occurring.)
Clients will usually still need to feel and talk about the incident directly. This will happen spontaneously if you, the counselor start by pointing attention off the distress, thereby providing an effective contradiction to the distress. When it does, it usually makes sense to listen well, using your own caring as the contradiction at this point.
6. Clients will often remember only very small bits of a memory, with the rest being in occlusion. They can often discharge well using the piece of information that is available combined with the general feeling they get when directing their attention to it. The counselors need to keep their primary interest in the ability of the client to discharge, not in finding out exactly what happened. However, the counselor will often have to contradict years of denial by everyone in the client's environment by asserting that something very hurtful did actually happen to the client. A pleased announcement that "something happened" (to contradict the variety of possible pressures not to tell) and "it's over now" (to contradict the feeling that the danger is still present) can be useful directions for early work on occlusions. At some point, the client may also have to make an active decision to remember to undo the early decision not to remember. It is helpful for the counselor to keep in mind that it was an extremely vulnerable and hurting little one who originally occluded the incident, and that ultimately it is this little one who needs to be reached.
Clients can tell a variety of fantasies to promote discharge. Starting with fantasies about small, harmless animals can be surprisingly useful. (One day, a bunny rabbit .............) Ultimately, telling wild stories about sexual abuse which happened to some other child totally unrelated to the client can lead to much discharge and often to recovering more of what actually happened. Some clients find it useful to fantasize about what they think may have happened to them. The attitude of the counselor should be to assume that each story told about the client himself is true, but that the client may change it completely on the next retelling. Some clients and counselors may erroneously assume that a particular retelling which produces copious discharge is what actually happened. Clients should be encouraged to nuke up new fantasies about what may have happened after discharge has stopped. Eventually, the stories will merge. The bigger role of the counselor, however, is to assist clients to face the fact that something very hurtful did actually happen to them, regardless of what it may have been.
7. "Role-exchange" is an effective contradiction to early abuse and other hurts, and can be quite helpful in discharging distresses from occluded incidents. The roles are "exchanged," with clients threatening to abuse their counselors generally and in specifically sexual ways. Counselors can also ask their clients to flu-eaten to abuse them in a way which would leave them feeling the way the client feels about themselves generally or in the area of sex in particular. There is no need for the threatened abuse to have any relationship to the actual abuse which occurred, although the more that is known about the early incidents, the more related it tends to be.
8. Clients can work on masturbation fantasies instead of earliest memories. This may mean telling the story of the fantasy, thinking about it, telling only parts of it, or saying the word "blank" for each word of the Story. The amount of discharge and the ability to stay in contact with the members of the group are your guides. Watch for undischarged shame and humiliation, especially on the part of someone who moves too quickly to tell the details of the fantasy. It can be helpful to form special men's and women's groups to discharge sexual fantasies. (Many workgroups have optional groups before breakfast.)
9. The nature of the material people are working on may affect how they relate both to the group and what they are working on. They will probably not realize that this is happening. For example, heavy discouragement about ever getting help from you, the group, or the workshop, is likely to be the discouragement about ever getting help which they experienced during the incident. Not feeling that they like anyone, wanting to stop, or "needing" to leave, is probably how they felt back then. And any attempt to resist you and your counseling of them is almost always due to the urge (arid need) to resist the perpetrator of hurt. (Some of these early hurts may still be occluded). As long as you are clear about what is going on, you can you can let them work on how it feels in the present for a while, but it is usually best to relate it to the early memory before too long.
10. The nature of the material YOU are working on may affect how you relate to the group and how you feel about leading it. Get someone to listen to you for a few minutes outside of the group, and ask yourself how these feelings relate to the feelings from your early memory. (Your group may not be able to stay dear about the source of your feelings, so you need to use your judgment about being negative about the group with the group.)
11. A big challenge is to, reserve the bulk of your group time for discharging on the earliest memories connected to sex, while taking the time you need to make that work go well. Get to know each other, stay on top of the difficulties at the workshop, and help people keep their attention out There is sometimes a pull NOT to get to work, which you will need to contradict (ie. get people down to work) once people have enough attention to make that work productive./
Suggestions for handling other needs:
- A brief go-around on what's going well at the workshop and any difficulties; if there are difficulties, arrange for the person to get help with the difficulty OUTSIDE OF THE GROUP, whether by you or some-one else. Usually, that will be enough. If not, give them a couple of minutes on the "present time" upset, then guide them (gently or otherwise) to work on the early memory - they will be related.
- Give everyone a chance to share brief information about themselves and how they feel different from others in the group You may want to spread this out over several groups.
- Depending on your particular group, you may need to leave a couple of minutes in between each person's turn for major "'attention out" activities,
12. The late afternoon groups are sometimes "harder" than the morning (Support groups usually meet two times each day at ESM workshops.) People may be bred, have less energy, less attention, etc. YOU may be tired, etc. Try to think about this and set a direction for yourself before the group, so you can, provide a tone that will contradict any of the other feelings. (A five-minute group cuddle/nap can work well, or sharing about people's lives, singing, etc.)
People may require better, different, and/or more active counseling in the late afternoon groups than in the morning. They have had a session since you saw them last, and a break. If dim went well, they may be ready to work on things from a different angle. If those times didn't go well, you may need to provide more of a contradiction to discouragement or other feelings, and pay more attention to their balance of attention.
13. For some people, long turns work best. You may want to divide up the group time to make that possible, but make sure everyone gets some kind of a turn at least each day. Sometimes it will make sense to keep a session going longer than planned, with that time being taken off a later turn.
14. There is at least one other person in your group who we thought could think about the group and you well. You are encouraged to consult with someone else from your group about counseling people, and to tell that person ahead of time what you need from him or her as your counselor.
15. You should assume you will do all the counseling, unless you think there is a good reason not to (which is fine). You will have a chance to get help with your difficulties as a counselor during the leadersí meetings each day.
16. Get someone else in your group to take leadership for any work responsibilities your group may have.
17. Thank you for taking on this leadership. I depend an you to watch out far the people in your group and to assist them to have a useful workshop. Get help from someone in their community or me if you are concerned about anyone.
18. ENJOY YOURSELVES. You were chosen because we knew you would do a good job and because we thought the challenge of leading a group would be good for YOU.
- Present Time No. 84, p. 26
- The Central Importance of "Contradiction"