“Come have a seat,” I walk them into our counseling room.

“You can leave the room at any moment and if you don’t want to answer any questions I won’t force you. I’m just glad you both are here. So, why are you here?”

Both look at each other, with the wife silently urging her husband.

“I’m Steve and we’re here because my wife thinks there’s something wrong with our marriage. I think we are doing fine. We have a nice home, there is food on the table, the house is clean – well mostly clean – and we get along, pretty good,” he nods emphatically to his wife.

“I’m Betty and things are not fine. My husband drinks, gets angry, breaks things, has driven our children away, and now they don’t want to see him, which leaves me out. I am tired of the promises, the lies, and the swings in his mood, and I refuse to sleep in the same bed with him. I’d rather sleep in my daughter’s room, or with the dogs, so I don’t have to listen to his snoring, his sweating, and smell his farts.”

“Now wait a minute. You fart too.” The man snapped back. 

“Thanks for being so open,” I cut in with a smile.

“So Betty, what would you like to get out of these sessions?” I asked.

“He has to stop drinking or I am gone. I am tired of all the day-to-day nonsense, and it is every day. He comes home from work, already stinking of booze, drinks a few beers before dinner, then during and after dinner. The more he drinks the more pissy he gets. We don’t talk. We don’t do anything together. It’s like we just tolerate each other.”

“And you Steve? What do you want to get out of these sessions?”

“Just that. I want to get out of these sessions.” He replied with a smirk.

Betty gives him a frustrated look.

“Fine,” he shrugs. “I know she doesn’t like my drinking but it gets me through.”

“Gets you through, what?” I ask.

Now the treatment begins. In order for therapists to help, they need to learn about each client. Their background, the way they were raised, and especially what has been going on recently which has them running for help.

Therapists need to look for what we refer to as the “Red Flags” which are the serious issues that can lead to serious harm. Are they using drugs? How much and how often? Are they driving under the influence? Do they have medical conditions that need immediate care? Sometimes panic attacks are cardiac issues and need to be explored. Are they taking prescribed medication? This is very important for people with Diabetes. Lastly, it is important to find out if they have a mental health diagnosis if they are taking medication, and how consistent they are in taking it.

“Steven, what was it like growing up in your family? Did anyone have a mental illness, was there any substance use?”

This question tells a therapist a lot of information. Because we grew up in a “Family System”, the way our family operated is often how we operate and in this case, it can clue the other partner into why they act certain ways. So when dealing with couples, it is important for both to understand that they come from different upbringings which are normal to them, and changing will be a process if they are motivated to do so.

My father told me I had two ears and one mouth so I should listen twice as much as I talk. This is an excellent guide for therapists. The client is the expert on them and it is important to fully grasp what they are saying. If the therapist is more interested in controlling the session and making clients act the way they want to, well, seriously would you want to be treated in this manner? Each session moves and builds in a natural manner and it is important for the client to take the lead – plus be heard.

The most important part of counseling is praising the client for spilling their guts to you. We can’t make people feel safe enough to purge something they have been hiding for sometimes decades and to me, it is such an honor when they do.

“Thank you for being so honest. That was incredibly brave and my heart goes out to the part inside of you that went through that experience.”

The above statement will gently let a person know that compassion is important for the healing process.

For those who want to be a therapist, go through therapy first to see how it is conducted. Do your research first, find out the methods a therapist uses, and read their reviews. Success in counseling boils down to feeling comfortable with your therapist. Do you trust them? Do you like spending time with them?  I tend to be more of an educator and teach people self-help tools because I cannot afford to spend a lifetime with clients, otherwise, I would be seeing 500 people a month!