Reflections on the problems and ethics in counselling

Sat, 20 Aug 2016 Source: Osei, Nana Yaw

Just as one does not need to suffer from a physical malady or chronic disease to be a medical doctor, one does not need to marry in order to become a good couple counselor or therapist. Couple and family counseling is a combination of sociology and psychology. The Jewish psychiatrist and the founder of psychoanalysis, Sigmund Freud, defined love as a confluence between two currents erotic and affectionate. Therefore, love issues bother on emotions with serious mental health implications and as such families, counselors and pastors must avoid interfering in love affairs of couples or would be couples. Counselors must always raise the bar of competence. Any professional counselor must eschew ascribing or assenting to solipsism. Solipsism is the view that "I am the only mind which exists," or "My mental states are the only mental states." The purpose of this article is to elucidate on ethics of counseling using some utterances of a certain counselor in Ghana as a case study.

A marriage counselor in Ghana is noted for controversial statements. For example, a counselor asserted as follows: “Never marry a poor man”, “The age difference between couples must not be less than three years and more than seven years”, “Never marry someone who is not prayerful” (the mindset of certain pastors) and so on. Well, as for the age difference, it is a matter of subjectivity. I remembered in 2003, at the National Pentecostal Church, Berea, Johannesburg, in the Republic of South Africa, a female physician from Australia presenting on HIV prevention and based on evidence-based research stated that the maximum age gap must be 12 years. Some people also marry their age-mates and they have successful marriages. We are even told of Anna Nicole Smith, an American model, actress and television personality who at the age of 26 married 89 year old Texas oil Tycoon, J. Howard Marshall (63 years difference). For the prayerful partner, God himself commanded prophet Hosea to marry Gomer, a harlot (Hosea Chapter 1). This is because our ways and thoughts are different from that of God (Isaiah 55:8). Besides, every saint has a past and every sinner has a future, example is an apostle Paul. For a poor man’s marriage, there is a Ghanaian proverb that says no one knows the beginning of a great man. God also said: “For I know the plans I have for you," declares the LORD, "plans to prosper you and not to harm you, plans to give you hope and a future” (Jeremiah 29:11). Thus, such ignoble comments like never marry a poor man must be consigned to a trash bag. Counseling is both therapeutic (curative) and prophylactic (preventive). Must counselors take decision for their clients? The answer is no.

In his psychodynamics and psychoanalytic theories, Sigmund Freud propounded two terms known as transference and countertransference. These two terms are universally applicable to counseling and psychotherapy. Transference is the process whereby clients project onto their therapists past feelings or attitude they had toward significant people in their lives. Transference is understood as having its origin in early childhood and constitutes a repetition of past material in the present.

Countertransference is any projections by counselors that distort the way they perceive and react to a client. Simply put, counselor’s response to transference. This phenomenon occurs when there is inappropriate affect, when the therapist or the counselor respond in highly defensive ways, or when they lose their objectivity in a relationship because their own conflicts are triggered. For example, a counsellor who does not talk a lot may perceive a talking client as a terrible chatterbox, without recourse to personality differences. A counselor who does not drink or smoke may perceive clients who drink and smoke as irresponsible. To state in a simple language, the counselor’s reaction to the client is intensified by the counselor’s own experience. For instance, the counselors’ cognitive distortion or thinking error on living in a single room or living under hardship might compel him to say: never marry a poor man. A prime example of over generalization.

Ethically, therapists are expected to identify and deal with their reactions through supervision, consultation or participate in their own therapy in order not to interfere counseling with their personal problems or convictions. However, countertransference is like our ancestors’ “SANTROFIE bird” if you take it, you take lamentation, if you leave it, you are deprived of a fortune. To put into perspective, countertransference is both constructive and destructive in the therapeutic relationship. A counselor’s countertransference can elucidate some significant dynamics of a client. A client may actually be stimulating reaction s in a therapist by the ways in which he or she makes the counselor into a key figure from the past.

Gerald Corey is a professor emeritus in counselling psychology. He is institutionally affiliated to California State University, Fullerton. He is a member of American board of professional psychology. Marianne Schneider Corey is a counseling consultant and Patrick Callanan, a psychotherapist in private practice. In their book: Issues and Ethics in the helping professions 8th, edition, they asserted that counselors must be guided by moral principles to influence decision making. These principles include:

• Autonomy: the promotion of self-determination, or the freedom of clients to be self-governing within their social and cultural framework. Respect for autonomy entails acknowledging the right of another to choose and act in accordance with his or her wishes, and the professional behaves in a way that enables this right of another person. My dear Rev. Counselor in Ghana, should a cocoa farmer in the western, eastern, Brong Ahafo, or Ashanti region rent an apartment in his village before he could marry?

• Nonmaleficence: avoidance of harm, which includes refraining from actions that risk hurting clients. This includes emotional damage meted out to the client. It is not a duty of a counsellor or pastor to impose a partner or take decision for their clients. Motivational interviewing skills could be explored to ascertain the comfort zone of the client. The counselor must conduct self-introspection and ask like: how would I feel if my wife or my partner is asked to divorce me? Counselors and church leaders must be neutral because many individuals are psychologically fixated in anxiety due to relationship issues.

• Beneficence: doing what is good for others and to promote the wellbeing of clients. This includes doing a good thing for society. Ideally counsellors must contribute to the growth and development of their client within their cultural settings. Counselors must respect the religion and culture of their client.

• Justice: meaning to be fair by giving equally to others and to treat others justly. Counselors have a responsibility to provide appropriate services to all clients. Everyone, regardless of age, race, ethnicity, disability, socio-economic status, cultural background, religion, or sexual orientation is entitled to equal access of counseling. If a counselor asserts that never marry a husband who lives in a single room, is he insinuating that there should be a divorce as soon as the economic status of one partner changes?

• Veracity: means truthfulness, which involves the counselor’s obligation to deal honestly with clients.

I think it is about time that Ghana government and all stakeholders must come out with evidence-based interventions to address the issue of marriage counselling. Some of the pastors lack the skills to counsel but they counsel. Who suffers? The venerable in the society. We all saw how the Self-acclaimed Bishop, Obinim was flogging two teenagers in his church coupled with faux pas. It is imperative counseling is factored into our national policies and programs. An Irish playwright and novelist Oscar Wilde, asserted that “Society exists only as a mental concept; in the real world there are only individuals.” A good counselling prevents social vices such as arm robbery. “I know that I am intelligent because I know that I know nothing.” (Socrates)

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Nana Yaw Osei (Padigo), PhD Candidate, Psychology

Arizona, USA

Columnist: Osei, Nana Yaw