This account focuses on my experience of relationships within
and bio-medical models of healing. The complementary model that
was experienece was that of co-counselling and my own experiences
and interactions within this.
Co-counselling is described by Dryden and Feltham (1995, p11)
as, "...a form of reciprocal counselling
or therapy. It is learned in classes, and then practiced by people
by agreement, without payment. In pairs, one person agrees first
to counsel his or her partner, and then the other person counsels
This is compared with my bio-medical experience with my general
practitioner. Both focus on the components that promote and hinder
these relationships, identifying their similarities and differences
and the importance the relationship has as a healing component.
When reflecting on my co-counselling experience, one particular
encounter that happened in the sixth session with myself in the
role of counsellor accurately identified the need for clear boundaries.
Towards the end of the clients time I gave them a five minute
warning so they could come to a close. The client was clearly
emotionally engrossed in what they were talking about and I felt
it would do more harm that good to stop them speaking, therefore
I let them continue and this took up most of our overall session
time. Ground rules at the start of the session should have been
negotiated to help avoid this.
(Feltham, 1995, p9) when discussing counselling backs this up
by stating, "Counselling is viewed, therefore as principled
(an ethical endeavour with strict boundaries);.. which none the
less includes the values of practical, personal experience and
This raised the issue of the need for clear boundaries and
has identified how important they are to help avoid problems
like this, so individuals know where they stand and understand
the boundary setting. This helps avoid confusion.
In contrast to this lack of boundary setting on the eighth session,
ground rules were agreed upon between myself and my partner.
These included confidentiality, use of appropriate language,
pauses were wanted for reflection purposes and to tell the client
if they started to ramble.
Agreeing on the ground rules proved to be extremely helpful
when developing trust. I felt able to speak freely, this was
quite a surprise as the thought of being open and expressing
myself to someone I did not know scared me. Thus identifying
the importance of ground rules. (Culley, 1991, p14) when commenting
on the early stages of the counselling relationship highlights
trust as an important characteristic, stating, "To create
a trusting counselling relationship, therefore, you will need
to behave consistently towards clients with regard to such issues
as time keeping, confidentiality and personal boundaries."
Trust can also be seen to help disclosure. Brammer (1979,
p48) comments on this by stating, "The helpee experiences
the relationship as a shared and confidential effort to achieve
growth, as a mutual problem-solving and learning activity."
When reflecting back on the co-counselling sessions one particular
concept that I can identify as being developed throughout this
period of time was personal responsibility. I learnt to take
responsibility for myself and my actions. This was identfied
by the facilitator, she helped me take ownership for what I was
saying made me realise the differences in the language I used.
Correcting me when I used words like, can't instead of won't.
(Nelson-Jones, 1988) when addressing personal responsibility
describes it as a liberating process, involving people making
appropriate choices in the way they feel, think and act and to
be aware of their wants and wishes. In response to this, taking
personal responsibility helped me become better self-aware and
helped me realise what was appropriate in co-counselling sessions.
Working in the here and now as opposed to talking about the
past is also linked to responsibility. How certain issues from
the past affect me now compared to discussing how I felt then.
I learnt how important this is as I can not go back and change
When in the role of client, I choose my own direction for
the conversation, this is linked to empowerment. The role of
counsellor should be to empower the client; to help them take
control of their lives, get what they want and to overcome the
feelings of being stuck and unable to change. Manthei (1997)
In response to this, during the fifth session an example of empowerment
can be identified, with myself as counsellor and the client,
who for confidentiality I will call Molly. Molly was discussing
her relationship with her partner and kept repeating herself,
going around in circles. She paused and gave a sigh, at this
stage I felt I could intervene by asking her what she was feeling,
she responded, confused. I then asked her why she felt confused,
she replied, she did know what to do. I went on to ask her what
did she want to do. This sparked off the issue of her own needs
and desires, allowing her to acknowledge them and take them into
Thus, helping her take responsibility for her own feelings
and helping her to find solutions to her problems. (Berg, !994)
as cited in Manthei (1997, p54) describes empowerment as, "A
basic belief of the finding-solutions-to-problems model of counselling
is the notion that 'clients need to feel in control of their
lives as much as possible'."
During the co-counselling relationship each participant has a
turn in both the counsellor and client role, creating equal power,
therefore, egalitarian. It is used to express feelings and can
be seen as a form of self-help. Although critics of co-counselling
would say that it is inadequate to help deep-seated problems
and can not help anyone in need of professional help. Dryden
and Feltham (1995)
During the same co-counselling session with Molly and myself
in the role of counsellor I experienced unexpected thoughts and
What I was hearing as opposed to what I was listening to,
her body language and tone, a total experience seemed to unleash
unexpected thoughts and feelings. At the time I felt ashamed
of these, thinking who am I to judge? Molly reminded me of someone
I knew, this caused me feelings of frustration and the use inappropriate
responses. To help explain this experience a concept known as
countertransference can be applied. Countertransference can be
seen taking place when the counsellor experiences feelings of
annoyance or discomfort towards the client. The counsellor may
not feel able to attend the sessions, sympathise with the client
or become argumentative. Becoming more self-aware and talking
through problems may help in this situation. Brammer (1979)
In contrast, the relationship between my general practitioner
and myself can be seen to differ from that of the co-counselling
The nature of power between us is distinctly one sided, there
is no balance. When I enter the room the environment and composition
is structured and impersonal, automatically affecting the relationship
by creating a divide. When I am acknowledged I begin to tell
my story, only to be interrupted by a scribbling pen and my general
practitioner handing me a prescription. My general practitioner
only ever asks me about my physical symptoms and does not take
into consideration my lifestyle and feelings. I have never had
any experience of empowerment with my general practitioner, to
help me take control over my own health. Although I do, now,
through being better self-aware.
(Kirby et al, 1997, p541) When discussing the power of the doctor
argue that many critics suggest, "..,the power inequalities
their position creates does leave open the possibility that medical
care is determined for the benefit of the doctor rather than
the patient." In response to this quotation, the limited
time I have with the practitioner and the set prescription with
no alternative, reflects this.
In contrast to the relationship being seen as an inequality
in power, Scambler (1997, p48) identifies Parsons (1951) as seeing
the relationship in the form of social roles, claiming, "Parsons
regarded doctors and patients as similarly occupying social roles
which facilitate interaction as they define the expectations
and obligations of each participant."
If I am not automatically given a prescription I am examined.
One experience I particularly remember was when I was a young
adolescent and I was given an internal examination that I did
not understand as nothing was explained to me and I remember
to be quite brutal. There was no sensitivity for my age and for
the fact that I had never experienced an examination of this
When reflecting on my experiences with my general practitioner
I see myself, the patient, as a machine with no emotions and
feelings. Scambler (1997, p51) discusses the practitioner/patient
relationship as, "Patients' satisfaction with the consultation
depends on both the doctor's clinical and interpersonal skills,
and may itself have a positive effect on the pain and other symptoms
experienced." Therefore, suggesting the importance of the
relationship for both the doctor and patient outcome.
Although acknowledging that different practices' and individuals'
attitudes and traits may differ from my experience. The relationship
between the practitioner and patient may also change over long
periods of time as the relationship develops. Mine changed for
the better as I changed to a great doctor.
One particular issue that can affect the relationship between
the practitioner and the client, that neither party can change
is that of policies and procedures.
One example of my own experience that illustrates this was
when I was suffering from eczema, I asked my general practitioner
if he could prescribe evening primrose oil to help the condition.
I was told that he was unable to do so as it was not their policy
to prescribe it.
On reflection, both the co-counselling and the practitioner/patient
relationship can be seen to be quite different models. It should
be acknowledged that they should be seen in their own context.
General practitioners are there to help improve the individuals
physical symptoms when illness occurs and co-counselling is a
form of self-help.
Although, this experience has identified that the relationship
can be enhanced by personal qualities, such as warmth and respect,
in order to help promote healing through the relationship. With
reference to intuition, a less obvious characteristic, (Munro,
et al, 1983) identifies intuitive skills as a personal quality,
a natural instinct and insight to saying and doing the right
thing at the right time. This may be used to explain why some
individuals are classed as 'good' helpers and healers. Although
it may be the training that encourages such traits.
Both models do share some similarities, such as confidentiality.
This is important when considering trust, as stated earlier.
The power relationship is the most distinct, differing between
the two models, although co-counselling empowers the individual,
offering the opportunity to be in both roles. The practitioner/patient
relationship creates distinct roles that are fixed. Whether this
is beneficial or not is debatable and future research needs to
consider the relationship in all models of healing and its impact
It should also be acknowledged that this is just one person's
experience and others will differ.
Brammer, L. (1979) The Healing Relationship: Process and Skills.
Second edition. New Jersey. Prentice-Hill. p48.
Culley, S. (1991) Integrative Counselling Skills in Action.
London. SAGE Publications. p14.
Dryden, W. and Feltham, C. (1995) Counselling and Psychotherapy.
London. Sheldon Press. p11.
Feltham, C. (1995) What is Counselling? London. SAGE Publications.
Kirby, M. et al. (1997) Sociology in Perspective. Oxford.
Heinemann Education Publishers. p541.
Manthei, R. (1997) Counselling: The Skills of Finding Solutions
to Problems. London. Routledge. p54.
Munro, A.E. et al. (1983) Counselling - A Skills Approach.
New Zealand, Methuen.
Nelson-Jones, R. (1988) Personal Responsibility, Counselling
and Therapy, An Integrative Approach. London. Harper & Row.
Scambler, G. (1997) Sociology as applied to Medicine. Fourth
edition. London. Harcourt publishers. p48 and p51.