Feedback for Kath Bromley re counselling 22/11/16 to 3/10/17
I first spoke to Kath when I phoned her on 8th November 2016 to offer her Counselling for depression, as her scores plus her presenting symptoms suggested that she would benefit from this model. We arranged our first session on 22/11 and initially Kath agreed that she would be happy to have our sessions recorded.
However when she arrived on 22nd November she had discussed this with her Psychiatrist and felt anxious about being recorded, so we agreed that we would not do so. Over the next x20 sessions as I got to know Kath well it became obvious to me that she was correct in deciding that this would be too distracting for her, and could in fact trigger her bipolar.
Kath’s honesty on this very first session about how the recording might affect her was an indication for me that not only did she feel comfortable enough to challenge me but also that she had great insight into her mental health condition and what would, and would not work for her.
for me – I was a little apprehensive, having not worked a great deal with bipolr, and being aware that she was still seeing her Psychiatrist, but felt that with honesty and openness on both sides we could manage this.
Kath had come for Counselling as she was aware that her beloved dog Tess had some serious health issues, and that she would need to prepare herself for her inevitable loss.
Kath recognised that to prepare for future trauma / distress she needed to look to her past, at the loss and trauma she had experienced, and understand how and why she had reacted to those events.
Kath explained that she wanted to ensure that she had sufficient time and sessions to explore her past in detail, but also to allow her time for planning the future post Counselling, and so had prepared a timeline of past events, with the help of her close friends, family and her extended support network, to fill in any gaps in her memory about timescales and sequence of events.
she then drew up a session plan which we followed at our fortnightly sessions – (we decided on fortnightly as we both felt that Kath needed sufficient ‘recovery time’ after a session, plus ‘down time’ between sessions, where she could try to re-establish her routine, plus some planning / preparation time for the next session). Fortunately, my Supervisor and Case Manager were both in agreement that this was the most effective and safest way forward for Kath.
Initially I wondered what my role in these sessions would be, as Kath came to each session fully prepared, and with a clear picture in her head of how the session would proceed. However, it soon became clear that my role was one of empathetic listener – one which I feel that as Counsellors we are sometimes pressured to abandon, in this era of results / goal driven therapy, and it was a wonderful reminder of how effective real ‘listening’ can be for an individual (Kath, I have attached a favourite poem about Listening).
As Kath explored her past, it became more and more obvious that not only had she always been extremely driven and passionate about her work, but that she had always taken on the role of ‘carer’ or ‘fixer’ within her family, and so when the family was in crisis she would automatically assume that it was her role to ‘sort it’ .
I shared with Kath that even without the Bipolar diagnosis I would have been astonished if anyone that had been through what she had been through did not end up with a stress disorder, at the very least. The fact that she coped for so long before breaking down is a tribute to her strength.
One of the earliest issues to emerge from our sessions was Kath’s need to feel in control of her life and her environment – which she recognises stems from times in her life when she felt she was not in control, and how feeling out of control can trigger a bipolar episode. Initially I struggled with this, feeling that it was not necessary or even possible to have control of all aspects of one’s life. However, as I came to understand Kath’s Bipolar I realised the significance of control and the sense of balance that this gave Kath, and realised that it is actually the balance rather than the control that is Kath’s ultimate goal.
We explored Kath’s support network, and how important it was to Kath to have trusted friends and family around her, and to be able to call on other significant support from her extended support network, including her Psychiatrist and mental health team. We looked at individual friends and family members, and the significance of them in her life, and how Kath uses her Journals and photography to inform / educate them about her life, her condition and her needs.
We also explored the huge part that sport has played in both her private, family and professional life, and the advantages and disadvantages of continuing to engage with sport.
Outside of the loss of both her parents, another distressing area of loss that we explored was the loss of her professional role as a Teacher, and the enormous ‘gap’ that this left in Kath’s life. For someone who had worked all her life, and who had been immensely driven by the need to be the best that she could at her job,it was a huge shock and left Kath with a void that she struggled to fill. However, we explored how Kath has used photography as the focal point in her search for a way to be ‘heard and understood’ – and to give her new focus. We also explored the danger of Kath getting consumed by these ‘projects’ and letting her Bipolar tendencies take over – so again balance became a significant issue when planning these projects.
Kath has worked really hard to develop ways of maintaining balance – and at times it has been extremely difficult for her. When things got too difficult for Kath, and her mental health became unstable so that she did not feel safe to drive, we used telephone sessions and even emails to maintain the ‘balance’ that the sessions were giving her.
Throughout our work together, Kath was able to identify any ‘wobbles’ and has taught herself not to be too hard on herself, allowing that it is okay and normal to have bad days, and has now also developed her own tools to monitor her life ‘balance’, which helps her to spot the early warning signs that the balance is slipping.
When between sessions 16 and 17 Kath lost Tess, she was able to focus on ensuring that Tess did not suffer, and on remembering the wonderful times she had with Tess, rather than dwelling on losing her, and although of course she was saddened by having to say goodbye to Tess, she was able to maintain her ‘balance’, using the knowledge that she was preventing Tess from suffering, and allowing herself to depend on the support of close friends and family.
Kath’s garden has also been a source of strength for Kath, and she feels it will serve to provide future pleasure and fond memories of both her Mum, who shared her love of plants, and Tess, who she spent so many hours with in the garden.
Our last few sessions focused on the way forward for Kath – on what she wanted to do not only in the next few months, but also in the coming years, and on acknowledging that her life may not be the same as it has in the past, but on the possibility that it can be wonderful and fulfilling in a very different way, and Kath realises that she has to focus on herself first, and that in doing so she has much to offer others, in helping others to understand Bipolar, but more importantly to understand Kath.
It has been a pleasure working with Kath, and I hope that with her 60th birthday imminent she recognises that she is ready to move forward to the next stage in her life with optimism and great self awareness.
Barbara Lamb – Counsellor 17/10/17