Maintaining an ethical online presence ...

As a counsellor, I appreciate the importance of not sharing too much of myself and my life with my clients.  When clients come for counselling, it's vital that the therapy is about them and not about the therapist.  The counsellor engages with their whole Self at a deep level, so that the client experiences a powerful and healing human connection, but they don't talk about any of their personal lives.

We also try to ensure our therapy rooms give none of our personal lives away.  To ensure the neutrality of the therapy and so that the client can engage with us as a 'therapist' with no 'baggage' we keep ourselves our lives separate.

We're trained to only disclose personal information when it is deemed to be helpful for the client.  It's often a difficult line to balance though.   For myself, I aim to be fully me in the room with each and every client, which means that I respond to their words and bodies in a congruent way.  I voice my feelings, emotions, thoughts and images which arise in response to my clients, as and when they arise.  This ensures that human connection I mentioned above.  So, I'm fully me, but clients get to find out very little about who I am outside of the therapy room.

Or at least that was the case, until I started writing this blog.  And also my PhD.  And this is where the lines can become blurred.  I enjoy sharing my knowledge and experience ... especially if I think it might help someone, or might start a debate.  I also think that sharing information can be helpful for people to ensure that they don't feel completely alone in their personal pain.  It can be surprisingly comforting to know that you're not the only person in the world suffering.

I know that through the writings on this blog, I give more of myself away than I would in the therapy room.  Any disclosures made with the therapy room are focused and said specifically towards a particular client.  Writing on here, means I'm sharing my thoughts, feelings and experiences with anyone who chooses to read them; and amongst that audience may be clients, past, present & future.  Is that entirely ethical?

I'm sure there'd be people who would say it wasn't.  I know that there are many therapists who refuse to engage in any kind of online presence.  And that's okay if that works for them and is congruent with their way of working.

For myself though, I believe that making myself a little more human makes me more real in the therapy room.  I'm careful to never give away any specific personal information and I sometimes disguise some of the facts to keep me, my loved ones and my clients safe.

We live in a time when the online world is becoming increasingly important and I believe that as therapists, we should be looking at ways to embrace this and use it in a beneficial way for ourselves and our clients, rather than simply dismissing it.  After all, isn't this how theory and practice develops and moves forward?

It's something I've given a lot of thought to throughout my PhD.  When I first starting researching it, I intended to leave my personal eating disordered experiences out of it.  But as I engaged more deeply with the literature etc, I realised that my personal experience was invaluable and should be brought into it.  It's helped my personal acceptance and understanding, and I know that my self-reflection has very positively influenced my thinking.  And I've followed this through into my practice. If clients ask, I tell them a little bit about my history.  It's there on my website and in this blog.  My openness hopefully helps take away some of the shame and stigma that's still experienced around eating disorders and other mental health issues.  It also seems to help clients to know that I've had that experience and so have my own understanding.

Again though, I don't disclose personal information; just enough to inform my clients of my understanding, experience, and also, to offer them the hope of recovery.

And I attached the above photo of Elsie my cat sitting in front of my computer because Elsie is a personal self disclosure.  But again, she's one that I have to disclose.  I need to let clients know of her presence incase they're allergic to cats.  And she's also sometimes visible or audible in my home!  And she has her own blog (museandmewsings.blogspot.co.uk), so I have to ensure that she remains aware of any ethical considerations.

I've also set up a Facebook page.  I've had a personal profile page for a few years now and enjoy using it.  I've struggled with how best to use it though as I've not wanted to blur the boundaries between my personal and professional lives.  I think I've finally found the balance.  My friends have, up until now, had to put up with my therapeutic ramblings and I've not shared them with anyone else.  But I've just set up a 'Therapy with Sharon' page where I'll post anything therapy, research, eating disorders related and that page is open to everybody.

It is difficult line to balance.  I'm not sure I always get it right; but I always try to ...

Conference presentations ...

I've been preparing a presentation for a Conference I'm going to on Tuesday; Mental Health and Young People; Promoting a Positive and Healthy Body Image."  It's been organised by the Public Policy Exchange
 (click here for more info Public Policy Exchange) as a follow up from an All Party Parliamentary Group on Body Image last year.

Central YMCA played a big role in this APPG Body Image group, and a colleague and myself became involved via the YMCA.  We developed and facilitated some workshops for Key Stages 1 & 2 pupils in primary schools.  We fed back our experiences to YMCA and they were included in the published report:  'Reflections on body image'.  More details can be found by visiting  www.ymca.co.uk/bodyimage/

This conference is a bit of a first for me.  I've presented at a number of conferences over the last 3 or 4 years as part of my PhD, but each of those has been one which I've had to apply to present at.  This is the first one for which I was approached by the organisers and invited to attend.  I'm sure it comes from the work I did last year as part of the APPG Body Image inquiry; but it's a privilege to be invited to present.

It feels like a recognition of my developing expertise and all of the research I've engaged in over the last few years.  And that feels good; especially as I head towards the end of my PhD.

It also got me thinking about just how many conferences and events I've presented at.  I used to be absolutely terrified of public speaking, and yet now, I gladly put myself forward for it.  I still feel some nerves, but I'm sure that's normal.  My research and what I'm learning from it, excites me so much, that I want to share it with others ... at conferences, and hopefully, eventually, in print.


This is the list of conferences I've attended & titles I've presented over the duration of my PhD to date ...

2010   BACP Research Conference, London
Poster Presentation: “The impact of working with eating disordered clients on the counsellor’s sense of self: a pilot study”

2010   VITAE Public Engagement Event, Newcastle Poster Presentation:  “Working with eating disordered clients: Might it eat away at the counsellor?”

2010   York St John University; Research Methodologies Conference
Paper:  “The evolution of a methodology: An exploration of counsellors’ embodied subjectivities when working with clients presenting with eating disorder symptomatology”

2010  Newcastle Counselling Association
Workshop Presentation:  “Dispelling fears: The importance of research in counselling”

2011   BACP Research Conference, Liverpool
Poster Presentation:  “Changing the researcher, changing the research:  The impact of  exploring the embodied subjectivities of counsellors working with clients with eating disorders”

2011   VITAE Public Engagement Event, Durham
Petcha Kucha Presentation:  “The effects on counsellors of working with clients who have eating disorders”

2011   York St John University; Research Methodologies Conference
Paper:  “Giving the researcher a voice: Autoethnography as a vehicle for reflexivity”

2011   NCCCTC Conference, Newcastle
Paper Presentation:  “Embodying change work and eating disorders”

2012   BACP Research Conference, Edinburgh
Paper:  “The embodied counsellor: Exploring the counsellor’s embodied subjectivity when working with clients presenting with eating distress”

2012   VITAE Public Engagement Event, York
Poster Presentation:  “How amazing is your body?!  From the counselling room to you … “

2012   Newcastle Counselling Association
Workshop Presentation: “The embodied counsellor: Reflections on the therapist’s body and relationship with food”

2013   York St John University Faculty of Life & Health Sciences; Faculty Research Seminar
Presentation:  “An exploration of the counsellor’s embodied subjectivity when working with clients presenting with eating disorder symptomatology: Methodological progression and key findings to date”

2013  Mental Health and Young People; Promoting a Positive and Healthy Body Image; A Public Policy Exchange Symposium, London
Paper Presentation: “Embodying change: An embodied approach to working with body image”

Another tale to tell ...

Another book with its own tale to tell!

I've just received this book in the post this morning.  It was published in 1975.  It's still in excellent condition & its inner page has a stamp from, who I'm assuming to be, its previous owner ... Eric E Goranson, MD, from Portland, Oregon, USA.

I wonder if he was its only owner, or has it had many?  I wonder who Dr Goranson is, or was?  In holding what was once his book, I can 'sense' the ghosts of his eyes & fingers on the pages. 

My sense is of an older man, gentle and compassionate. An intelligent man who loved his work and his books ...

I could be completely wrong!  This image I've created could simply be my wishful thinking ... my own fantasy or phantasy (unconscious) image of the kind of man I want to think of having previously owned this book.

I can't imagine a time when I will ever get rid of my collection of therapy / eating disorders related books ... but I do wonder what will happen to them in the fullness of time when I'm no longer here to love them ...

Hopefully they can all rest assured that they have a loving home for a few decades yet ... 

The tales a book could tell ...

I received 4 'new' books in the post today that I'd ordered in relation to my research.  I never fail to feel excited when I buy or receive a 'new' book.  I can't wait to open the book and start reading it; to consume the knowledge, or stories, written in there.

My four 'new' books

I've highlighted the word 'new' because only one of the books I received was actually a new book.  The other 3 were used books.  Two of them had come from Connecticut Library; you can still see their library tickets on them.  These books were both written in the 1980's, but they're still well respected in the eating disorders literature field.  In the twenty-plus years of their lives, I wonder where they've been and who's read them?

If only those books could speak ... or write their own story ... I suspect they'd have a few interesting tales to tell.  Stories that have absolutely nothing to do with their subject matter but instead, the people who read them.  Or the people who took them out of the library, and never read them.  Whose houses have those books visited?  Whose bags have those books sat in? Whose essays and dissertations have those books played a part in?  Whose ideas, knowledge and thoughts have those books inspired? Whose hands have held those books?  ...

Endless questions.  Questions that I'd love to ask those books; but questions that I'll never receive answers to.  But wouldn't it be fascinating to know?!

Before I began my PhD research I very rarely bought second-hand books.  But due to the sheer volume of books available, the fact that many of them are now out-of-print and the cost of brand new books, I was 'forced' to begin buying pre-read books.  My whole outlook on them has changed since then.  I love second (maybe even, third, fourth, fifth, etc.) - hand books now!  I love thinking about their history and story.

I love receiving books which have annotations written in them.  It's fascinating to read other peoples' thoughts and ideas.  I feel privileged to read them sometimes.  It's like a little glimpse into someone else's thinking.  And it's  a privilege to share that little bit of intimacy ... even though I'll never know the person who thought it, and wrote it.  Even highlights and underlinings in books are fascinating; just to see what the previous reader thought important enough to highlight.

My own underlining & highlighting in a book only I have owned

Prior to my PhD, I never wrote in books.  Now, whenever I'm reading a book (non-fiction and especially related to my research or therapy), I always underline, highlight and annotate!  I can't read now without a pen in my hand!  It feels like a much more engaged way of reading and assimilating the knowledge.  Reading becomes more like a conversation between myself, the book and its author; and sometimes the previous readers.

I've read some really interesting annotations in some of the books I've got; and some of those have helped me develop my own thoughts and ideas.  Without those previous readers' thoughts, my own thinking might have taken a different turn, or I might have missed something.  Writing this, it makes me want to thank all of the previous readers and annotators; they've all, unknowingly, played a role in my thinking, development and research.

I wonder just how many previous readers there are who've owned, or just borrowed the books that now sit on my bookshelves.  The ghosts of hundreds (I suspect, bearing in mind how many books I have!!) of previous readers lingering and contributing to my thinking and writing ...

Sending a big, big thank you to you all; whoever and wherever you may be ...

A life can change in an instant ...

This post has been inspired by my recent burn injury to my hand.  Although it was a relatively minor injury, it's made me think about how quickly life can be changed.  And also how even losing full use of a small body part (even just on a temporary basis) can impact someone's life.

In less than a second, two of my fingers were quite severely burned.  My middle finger has now fully recovered (other than a red scar), but six weeks on, my index finger is still causing me pain and limiting some of the things I can do with my hand.  I'm also still visiting the hospital for regular physiotherapy to ensure the developing scar tissue doesn't restrict my finger's movement.

Hospital visits and physio exercises all take up time and emotional energy.  They can be extra things to fit into  an already busy life.  Not knowing how the injury is going to heal creates its own uncertainties.

Depending on the location or severity of the injury, scarring can be a real cause for concern for some people.  And some injuries can prove to be life changing as a result of scarring and any resulting injury.  I was thinking here mostly about physical injuries to external body parts.  But there's also head injury to consider.  A serious head injury can cause a person's personality or cognitive ability to change irrevocably.

I'm also mindful of internal injuries, which maybe aren't visible to other people, but can have a devastating impact on the quality of life of the person who has experienced it.  And sometimes, these injuries are most difficult for other people to comprehend.  It's easier to commiserate with someone who has a visible injury.

Most accidents occur in a split second.  And yet the consequences, of serious accidents, can last a life time.  They're things we don't plan for, and so are completely unprepared when they do happen.  We have to cope with the shock initially, as well as the physical pain.

I also think that sometimes, the emotional consequences of serious (and not so serious) injuries and illnesses get neglected or forgotten about.  Externally, the person may look well again, but maybe emotionally, they're still suffering.  Even if they're not fully healed or well, other people quite often tend to focus on the physical well-being and healing process.  And if this is going well, it's easy to assume that everything is okay.  But maybe the individual is still experiencing emotional pain, which isn't so easily seen.  Any physical trauma our bodies go through can affect our emotional well-being.

As a counsellor, I've always been mindful of checking out how the client I'm working with is experiencing their injury or illness.  I always recognise that it's important to enable them to share and explore their own experience to help them recognise the implications of it for them.

This is also an example of how I, as a counsellor, reflect on my own personal life experiences and consider what I can learn from them which might be of benefit for clients I work with.  Anything that happens to me, can potentially happen to someone else ... if not in the same way, then in a similar way.  Consequently, there's always something that I can learn from my own life and its experiences which will help others.  Reflecting on myself and my experiences allows me to develop my own self understanding, which I can then turn back out onto helping other people understand themselves better.

In this way, counselling is a very reflective and reflexive way of working and understanding oneself, others and the world; and helping others to understand themselves and their world.  And as I help my clients improve their self understanding, I take things away from each encounter to reflect upon, which further help me to understand myself, and my world ... and so the process continues ...

Our bodies are from where we experience our selves, our lives and the world, and so any injury or change to our body can have a huge impact on how we experience ourselves and how we live our lives ...

Bodily self-disclosure as a counsellor ...

I've had an interesting week ... personally & professionally.  And all caused by a silly accident with a candle and a match last weekend, which resulted in nasty burns to two of my fingers.

One of the main strands of my PhD research is the idea of the counsellor's body as a form of self-disclosure. As therapists, we are trained to not disclose any of our personal information or circumstances to our clients.  This is to ensure the neutrality of the therapy and to ensure that the experiences and feelings which occur in the therapy room are essentially those of the client.  As a result of my research, I'm increasingly recognising the therapist's body as a form of self disclosure which it is impossible to hide or deny. It's there in the room for the client to see.  It's there in the room for the client to relate to, to think about, to make judgements about, to think about ...

In terms of my research, I've considered the potential effects on the client and the therapy of the therapist's bodily shape and size.  Our bodies do say a lot about us; through their shape and size, through how we use them, hold them, how we express ourselves through our body language, even how we dress them.  We disclose a lot about ourselves, quite often unconsciously, through, and by, our bodies.

The bandages I've had on my two fingers this week have been impossible to hide.  And it's been interesting to note how different clients ... and also different people outside of the therapy room ... have responded to that.  Some people comment straight away; sometimes out of curiosity, sometimes out of concern.  I've seen other people notice my fingers, but then not say anything.  Others simply haven't noticed because they've been too immersed in their own thoughts and feelings to notice my hand.  And for me, all of those different responses are okay; it's just interesting to note the differences.

As a therapist, it raises a much bigger question for me though ... just how much do our illnesses, personal tragedies, pains and injuries impact on our clients and the therapeutic relationship?  Major injuries are plain to see and can't be denied.  Our personal pains and tragedies may not be so visible, but maybe they too, play out via our bodies ... lack of sleep, worry, concern etc., often show as tiredness, dark eyes, lethargy, maybe even changes in how we dress and present ourselves.  I wonder how aware our clients are of these minor bodily manifestations?  And how it does impact the therapy.  Does the client comment on what they see?  Or do they keep it to themselves, but then spend their session wondering about the counsellor's story?  Maybe, consciously or unconsciously, editing the things they talk about so as to protect the therapist from further pain?

It's a really interesting area for me; and one that's been brought to the forefront of my mind because of my injury.  But it also enables me to see that my research has much wider implications than just therapists' bodies in terms of working with clients with eating disorders ...

We all walk our own roads ...

"People take different roads seeking fulfillment and happiness.

Just because they're not on your road does not mean they are lost."

Dalai Lama

I had cause earlier today to think about 'what is success?'  And for me, the above quote from the Dalai Lama  which I've just stumbled across this evening, fits very nicely ...

Success means different things for different people.  For some people, it's about earning a high salary, having a prestigious job or title, having a lot of expensive material possessions.  For these people, perhaps success stems from external factors ... from possessions and achieving a status in society.

For some people, it's simply getting through a day, especially those who are ill or depressed.  For those with more severe forms of depression, sometimes just getting out of bed, or getting washed is a huge achievement.

For other people, success is a much more personal, internal thing. Achieving an inner sense of peace, congruence or satisfaction, regardless of external circumstances.  It often comes from a sense of being true to one's own inner self, own personal morals and ethics.

And this is where I would put myself.  My own personal measure of my success stems from feeling that I am being true to myself.  And in my life, this means doing the work that I love (counselling, therapy and writing about these things and my eating disorders research).  And I feel very fortunate that I've found my 'vocation' in life and am able to follow it.  Yes, it means I've maybe not achieved the financial and material rewards I could have earned had I followed a different path, but I experience a true sense of congruence, knowing that I am spending my life doing what I love doing.  I am able to use my personal past experiences to take my work forward and help others ... giving both meaning and purpose to my earlier life and helping other people through that.

It can be hard sometimes to follow a different path from that expected for you or to turn your back on financial or status progression, in a world which values financial measures of worth.  I originally achieved a Business Studies Degree and Postgraduate Diploma in Marketing, but quickly realised that that field of work couldn't fulfill me personally.  I was lucky to 'stumble' in counselling training when I was 27, and I very quickly recognised that that was where my life lay.  I've since turned down management posts, knowing that for me, managing people, money, figures and things doesn't fulfill me.

My passion comes from learning about people and humanity and immersing myself in that.  And this is where I feel fulfilled and what allows me to still enjoy my work with clients 13 years after I first entered the counselling world.  And to still experience the genuine passion I feel to learn more and more ...

For me too, I think it's important to find a sense of inner satisfaction from within.  If a person relies completely on external factors for their sense of fulfillment, happiness, success etc., whether that be a partner, work, wealth, status and material possessions, it can be very difficult if those things are taken away.  Then, a person can be left feeling adrift.  Whereas, if we can find our own inner fulfillment and satisfaction, then no matter what the external circumstances, that inner peace, that inner congruence remains.

It seems too easy for people to judge others and to view them as less successful than themselves if they're living their life in different way.  For me, it's important to understand and accept a person's way of living ... as long as they're happy with it and no one else is being put at risk or compromised.

We all walk our own paths, and for me, the true measure of success is that an individual feels that they are living a life true to themselves, to their own inner beliefs ... no matter what that life looks like ...