Tuesday, October 27, 2020

What is BUTectomy in the context of counseling and relationships


In counseling, we often have to balance the validation and acknowledgement of our patient’s experience, with the “challenge” of new ideas and strategies to move our patients forward. 

Sometimes we over validate, and sometimes over challenge. It’s a very sensitive dance indeed, and if in doubt,  go back to more validation. 

The challenge of new ideas and strategies may be met with some resistance in the form of defensiveness, anger, or “excuse giving”.  This is often unintended. 

Resistance may indicate that we have to shift back to more validation, acknowledgement, and defusion before moving forward again. 

With acknowledgement, careful not to acknowledge, and then follow with a “but”. “But” negates acknowledgement in many context.  

Try “And at the same time, I wonder” instead. 

For example. 

“I can see where you are coming from, and at the same time, I wonder if there is another way to look at that.”

May be more effective than...

“I can see where you are coming from, but there is another way to look at that.”

Simply think “BUTectomy”. This is of course, useful in our relationships as well.  Try and shift from a “but” user, to more of an “and” user. 


Sunday, October 25, 2020

Counseling can be like being a “gymnastic coach” metaphorically speaking


In counseling, we sometimes explore the emotional literacy around “judgement”, and the function of that. 

Many folks we see may “judge” that judgement is “bad”, but without judgement, it’s harder to take action.  So judgement can be good and bad, based on the quality of that judgement. 

Judgement is our assessment based on our past experiences, or inference/extrapolation from our past experiences. It’s like autotext. It can be very useful, or it can be completely incorrect and misleading. It depends on the quality of that past database, and its relevance to the current context. 

So part of counseling is to help our patients step back, and observe their thoughts, beliefs, values, “filters”, and judgments, more and more over time. It may give them more psychological strength, flexibility, and agility to “shift gears”. 

So counseling (especially ACT based), is more like training people to be a flexible and “strong” gymnast (metaphorically speaking), rather than a “strong” but less flexible weight lifter. 


Friday, October 23, 2020

Helping parents to find alternatives to “accidental rewards” in the context of parenting


One of the most common mistakes for the parents we see in Family Medicine is, the “accidental reward”. 

Think of a child’s tantrum. Parents may give them an ipad, a toy, or a treat to stop that tantrum. This is the classic “accidental reward”.  It is something that all parents tend to do from time to time, especially when tired or unwell. It’s normal, and we need to do it for survival from time to time, but short term gain can lead to long term pain. 

The problem with accidental reward is of course, we are rewarding a behaviour that we don’t want, and with a reward, the behaviour will continue. 

So what is the alternative?

Parenting counseling/training helps to address this issue through awareness of accidental rewards, defusion, and strategies like quiet time, time out, active ignoring, and 123Magic. 

Having said all that, it’s important to acknowledge the challenges for parents who have children with special needs. It is super tough for them. They may require extra support and more specific strategies relevant to their particular context.