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Want my advice?

May 15, 2011
by Thomas M. Greaney, MED, LADC, CCDP
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Clinicians must tread carefully when giving feedback to clients


“Nothing is given so profusely as advice.”

-François de la Rochefoucauld

Growing up in the 1960s and ′70s, as the next to youngest in a blended family of eight children, à la the Brady Bunch, I was the recipient of plenty of “advice.” Until I reached my teens, which my father referred to as the age of ill reason, it felt as if I were subjected to mandates as opposed to suggestions. Shackled by poor self-esteem, I was eager to comply.

One such stern imperative of my well-intentioned dad was “don't cry.” When I repeatedly failed to adopt the “no water works” edict, it gave way to a warning: “If you don't stop crying, I'll give you something to cry about.” That seemed a rather odd and ineffective cure, which inoculated me with an insidious shame for expressing my pain in a way that achieved some relief. Little did I know that my education in cures would take an unanticipated turn more than 20 years later.

That radically different “cure,” which came with its own overtone of fear and self-doubt, ultimately made much more sense to me when I was 34 and exploring sobriety. Alcoholics Anonymous (AA), lauded as the greatest social movement of the 20th century, has clear, declarative and specific advice embedded in the 12 Steps: “Made a decision…Sought through prayer…Admitted to God…Humbly asked…Were entirely ready…Made a list…Continued to take…”

These so-called suggestions are intended to be a blueprint for living a more spiritual and better quality of life in recovery. Juxtaposing the two cures, AA has encouraged me to feel my feelings, vs. subdue and stuff my response to physical or emotional pain. No wonder I used the consumption of alcohol and unhealthy behaviors as an anesthetic to numb myself from the pain of the past and the stress of attempting to control every aspect of my life in unconsciously pursuing perfectionism in the present.

May I suggest a support network?

At its core, 12-Step recovery encourages me to “find God, clean house and help others” by doing the next right thing. It's imperative for the individuals with whom we work to identify and utilize their strengths to become physically and emotionally stable. This provides the opportunity to pass on the blessings in service to others.

As recovery, not addiction, counselors, we get the opportunity every day to hold a mirror up to our clients in emphasizing their strengths. In my private practice I use Motivational Interviewing techniques to help clients contemplate their own solutions to problems they identify. I supplement this with strategic advice when physical and emotional harm are likely to result.

In other words, I make suggestions vs. asking the stereotypical, “How does that make you feel?” After all, if I saw a person walking on train tracks with a high-speed Acela Express bearing down on him, I would be negligent if I were not to yell, “Get off the tracks, there is a train coming!”

But at times, advice giving can be a very slippery slope. Many of our clients suffer from a lack of boundaries in their primary relationships with partners, family, friends and co-workers. Fuzzy boundaries, like President Reagan's declaration that fuzzy math leads to fuzzy results, lead to unhappy, unfulfilling experiences. My family was typical in terms of a lack of boundaries, which led to a consistent receipt of confusing and mixed messages.

Dysfunction is as dysfunction does

Thomas m. greaney, med, ladc, ccdp
Thomas M. Greaney, MEd, LADC, CCDP

The Greaney family version of “Don't Ask, Don't Tell” was not telling anyone outside or inside the family about the actual goings-on. This was a devastating, oft-repeated, almost subliminal sentiment. It kept our family sick and steeped in dysfunction, like a huge cauldron of tea boiling over, with no acknowledgement of the likely harm of getting scalded.

But because it's unhealthy to be stuck dwelling too much on the past, here are some suggestions we can use in our counseling and personal lives to experience more harmony and satisfaction in our interactions with clients and others:

  • Before giving any feedback, ask for permission to do so. Oftentimes others merely want to be heard or are seeking the verbal opportunity to process a course of action with more than one option.

  • Avoid projection. It's not about us as helping professionals; it's about being an active listener and confidant.

  • Validate the core feeling being expressed and test its accuracy. Say, for instance, “What I'm hearing is that you are frustrated with your partner's consistent criticism of you for the relapses you've had. Is that correct?”

  • Encourage clients to be supportive of one another while avoiding advice giving. Suggest that clients share how they handled a similar situation. This should include the issues that had to be navigated before coming to a decision on how to move forward.

  • Model the use of “I” vs. “you” statements, in order to initiate and continue a dialogue. Using accusatory and critical statements beginning with “You are” or “You make me” present roadblocks to healthy communication.

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