The Man With His Head in the Clouds

by Richard O. Smith

  My financial predicament is not good. I know that I need to seek counselling, and also that I can’t afford to pay much for it. Which is odd. We’re prepared to pay for all sorts of pills, treatments - and prescription charges couldn’t rise any faster if they were pumped with hydrogen - but not necessarily for the state of our mental health. After all, our mental health is the ultimate factor in deciding if we’re happy or not, content or otherwise - yet is rarely considered worthy of any maintenance expenditure. Mental health MOTs should be compulsory. Emotional intelligence should be on the syllabus. Really, it should.

  After much googling, networking, unreturned emails and phone calls, capped-off by dignity-eroding begging, I discover a training course of counsellors who require guinea-pigs. I can be a guinea pig. If the worst case scenarios play out when I’m in the role as the advert has proved to be ambiguous, I can expect carrots, a fresh supply of green leaves and a nice hutch. If so, it already remunerates better than full-time writing.

  I am allocated a pair of counsellors who have been, I am assured, fully trained. Although whatever their training incorporates is never voluntarily elaborated. They will conduct a session with me, which will hopefully expand into more sessions. An appointed senior counsellor will observe all or any of the sessions. Like a stalking, looming shadow, the Supervisor will ensure everything is conducted appropriately. That reassures me. With the junior apprentices, who have only counselled role-players before, not proper psychologically damaged real-world inhabitants like me, the Supervisor will surely be very much present. I see her once, mainly so she can reprimand me (“we don’t consider the term ‘fruitcake’ helpful, Richard”). Not to worry, who needs a qualified lifeguard, with me and two brand new counsellors splashing around in the deep end? Sink or swim, they say.

  I am offered a date for my first free consultation session.

  My twin counsellors are desperate to shed their counselling L-plates, but to achieve this they have to interact with a live client. This surely maximises my chances of getting the job. Sure enough, I receive a phone call from a counselling Supervisor. She asks me a number of questions to ascertain my suitability to receive training from the twin trainees. The interview is going well, until she asks me what sort of counselling I would be expecting. This is a surprisingly difficult question - I assume that answering “the good sort” will risk me not getting the position. “Ideally I would like a Rogerian person-centred empathetic approach, but would be content with any CBT.” Thanks, Internet.

  Rogerian is the eponymous Carl Rogers, while Cognitive Behaviour Therapy - although I convince myself shortly after replacing the receiver that I may have acronym malfunction and announced that I preferred CPT instead of CBT - CPT being the trade association for bus drivers. I am reminded of this later when given a pile of questionnaires to complete that are so lengthy and ominous that I progressively alter my response to the recurring question “might I consider suicide?” from “Strongly Disagree” to, fifty minutes of questionnaire mental health evaluation later, “Strongly Agree”. A few days later I receive a phone call. After his initial consultation they inform me I have been accepted “on the programme”.

  I am informed that there will be a lot of legal waivers to sign. Fine, I say. Having to sign so many waiver forms, whose numerous pages are equivalent to a Bodleian Library holding stack, can be tidily paraphrased: “if my counsellors are so incompetent that they convince an otherwise healthy client to kill himself within four minutes of the opening session, then it is Definitely Not Their Fault.” OK, I consent, choosing to focus entirely on the “I’m a journalist and it’s free” part of our agreement.

  Don’t look at me with that judging face, please. Journalists are often so badly paid that I know several who attend press launches and PR junkets, not because they are interested in some “exciting new shade of nail varnish remover” product launch, but merely to obtain a guaranteed evening meal - albeit usually comprised of Twiglets and Pringles accompanied by heroic amounts of cheap red wine whose painful after sting is eventually numbed by the sixth glass.

  Reporting for my counselling session, I ring a doorbell. After enduring a delay so long it can only be explained by someone having to destroy evidence, I am buzzed in. I feel surprisingly nervous. No one checks who I am, or indeed allows me to verify that I have the right address. Ironically, I face two flights of steep stairs. I don’t like this, but walk slowly, leaning forward to ensure my centre of gravity remains in front, therefore permitting me to fall safely forward on the carpeted stairs. Since there is no one around I use the handrail. Social convention decrees that only the very young and very old are allowed to use handrails. Passing public often express a “oh, aren’t they cute” look at young children deploying a handrail, but a dismissive eye-roll of “coffin-dodger” when seeing the elderly climbing stairs. This is the logical culmination of a society that chooses to fetishise children while ignoring the elderly. Whatever you do in this country, don’t get old.

  According to Relate’s own website, where there is also an opportunity to discover your personality type “as featured in Cosmopolitan” by completing an online quiz, and then sending £19.99 to receive the answer in an emailed PDF file (and presumably receiving a one word report back: “gullible”), a counsellor is quoted torpedoing the myth that clients expect to be told what to do. This surprises me, as I predict (wrongly or rightly) that grappling any sort of direct advice out of their tightly closed hands will be well nigh impossible. Hold a loaded gun to a CBT practitioner’s head, and ask them “should I pull the trigger?” and they’ll reply “But, what do you think you should do?” So I am intrigued to see whether modern counselling sets exercises, makes practical interventions into destructive behaviour and, crucially, says “you need to stop doing that - and here’s how you can stop”. Maybe my prejudices are, like so many prejudices, constructed on an uneven base of ignorance. The confirmation bias Dr. Hannah had foretold.

  My counsellors are called Steve and Claire (or at least they are for the purposes of this book - the legal profession are rich enough without taking my paltry assets). Are my suppositions and prejudices about to be destroyed or justified?

  Claire and Steve are skilful counsellors; good, noble, world-improving people who help me enormously, enabling rational emotional behaviour to occupy parts of my cognitive processes that only anxiety had previously inhabited. That’s another point I would like to chalk up early on, to enable any reading lawyers to circle it. The world would be an undeniably better place to hang around in if there were more Steves and Claires populating it. I would dearly like to mention them in the thanks and acknowledgement section of this book, but can’t do so as it would palpably reveal their identities. They pointed this out to me, after thanking me for the kind thought. This confirms they are cleverer than their guinea pig client. But my first meeting does not start well. At all.

  “So,” Steve begins, “you said on the phone you suffer from agoraphobia.”

  I suspect he said “agoraphobia”, but doubt that a professional clinician

  would make such a fundamental error in the opening sentence of our first session.

  “Yeah, it’s a rather extreme fear.”

  “How did you feel about managing to get here today?” he enquires.

  “OK. I’m alright with stairs when I’m on my own nowadays, unless they’re really steep or exposed or transparent or you can see underneath or... maybe not that OK with stairs just yet. Exposed steep stairs with lots of daylight shining through are the worst.”

  “It’s exposure that triggers a reaction of fear?” asks Steve.

  Don’t do a flasher joke. That would be crass, unhelpful and misjudge the situation. They’ll also confiscate your right not to be considered an instant twat. “Exposure to heights, yes.”

  “That’s interesting,” announces Steve, “not just being outdoors or confronted by open spaces, then?”r />
  And a bell rings to signal idiot confirmation. I’m supposed to be the idiot here, and he’s the enlightened proper grown-up. And I am an idiot for not correcting him earlier. “No, that’s agoraphobia,” I correct.

  “Isn’t that your condition?” asks Claire.

  No. No, it is not.

  “No,” I say in the softest voice I can select. I don’t want conflict. I am not very good at conflict.

  Frankly this is the worst possible start. It is difficult to comprehend that a health professional is mixing ailments that sound a bit similar to other conditions. “Hello. I’m here because I’ve discovered lumps,” “OK, we’ll treat you for mumps.”

  “I suffer from acrophobia,” I announce. This comment prompts exactly the same response in the recipient as if I had just informed a tame bear of the same thing. Clearly this is not self-explanatory. Anxiety is readable on their faces. They are desperately running a “search for file: acrophobia” in their heads and their brains have just returned a “no matches found” message. Pausing any longer would risk callousness, so I impart: “Acrophobia is an irrational fear of heights.”

  “Right,” he says, nodding his head pensively. This can’t have been the start he wanted either. “I also suffer from bathmophobia.” I allow a slightly cruel wait. “And can you just remind me what that is?” - the word “remind” loaded with a previously unused meaning of “tell me for the very first time ever”. At least he didn’t then proceed to treat me for siderophobia - that’s the fear of stars, which sounds very similar to fear of stairs.

  His co-counsellor Claire gets up and treads out a lump in a mat. If she’s a counsellor with OCD tendencies then this is decidedly odd. Five minutes later she does it again. “Rug problems?” asks Steve. If he was being translated with subtitles it would read: “Stop fixating on the rug!”

  “Bet in a career in psychotherapy you’ll see a lot of patients with rug problems,” I say with my most non-threatening smile.

  “What?” asks Claire.

  “You know... rug related problems, lots of rug addicts!” I say to the sound of a windswept, empty plain.

  Nothing.

  “Tough consultancy room,” I say. Claire smiles. Not laughs, but I’ll take a slight smile. I’m grateful to her for that.

  “Er... you know, rug problems, rug related issues, rug addiction... sounds a lot like, a bit like, nothing like... rug problems. Tough couch,” I continue unwisely.

  Steve’s expression displays unrelenting dour discontentment. It’s left to Claire to orchestrate the next key part of the session. In response to her questions, I tell her about all the height restrictions imposed on my life. Discovering I was bathmophobic when eight years old at Tattershall Castle, my infatuation with Charlotte Jones, the girl who always went upstairs on the bus while I could only ever sit on the lower deck. And how a schoolgirl had recently outed me as bathmophobic, revealing that my condition was not as hidden as I formerly hoped. Then I reveal my interest in James Sadler and the intended upcoming balloon trip.

  “And you want to tackle your acrophobia?” Claire establishes. “Yeah. I want to rugby tackle it.” “Why?” she says, like a personal trainer geeing me up and raising my shouted commitment to overcome an upcoming challenge ahead. “Because I want to send it crashing to the ground.” OK, bad metaphor for someone terrified of doing a balloon flight.

  “Let’s get to work then,” promises Claire.

  ***

  My counsellors conform to an ethical code of practice, so they won’t divulge any information about previous clients. Therefore this necessitates having to finesse out subtle anecdotal stories about clients Claire has encountered in training, without naming names, revealing locations or breaching patient confidentiality. “Out of the extreme anxiety cases I’ve dealt with, you appear to be by far the best-adjusted,” she later informs me. Initially I find that a comforting compliment, although it is like pointing out Sneezy is the tallest of the seven dwarves. Then she qualifies the remark by adding the portentous statement: “But that is no indicator of the depth of your anxiety.”

  I make the observation that the majority of clients here must be female. “And what makes you assume that?” Steve asks. Good, we are yet to start the session properly, but already they are asking open not closed questions. “Because all the magazines in the waiting room are for women,” I answer. “Oh, we should get some men’s magazines,” announces Steve, then realises this may be open to misinterpretation. Don’t say anything funny, Richard. “Yeah, that would be nice,” I say in the most neutral tone I can muster.

  “Richard’s right. Counsellors probably see slightly more women than male clients,” Claire announces, mainly to stop Steve or me having to verify that we did not mean top shelf men’s magazines. “Probably quite a lot more female than male clients, actually.” Her unexpressed “that’s because women have to put up with a lot” is relayed by tonal implication. But she does this for good-humoured intentions, not spitefully. This turns out to be the first moment in our professional relationship where she allows a chink of comedic light to illuminate her personal life, before quickly drawing the curtains tightly back again after revealing a teasing personal insight. Gravitas is added by the accompanying look she arrows me with her eyes, which is basically screaming: “Men, eh!”

  “I didn’t mean we get porn mags for the waiting room, obviously,” says Steve - unnecessarily. “I did know that,” confirms Claire.

  My counsellors continue to repeatedly ask open questions. There is certainly a keen agenda to establish how I feel. Those who experience counselling often report a frustration at not receiving direct answers yet alone direct advice - although direct debits are never missed.

  This approach can generate feelings of frustration. For example, if a counsellor ever appears on Mastermind their approach would be of limited use: “Who won the FA Cup in 2014?””Who do you think won the FA Cup in 2014?” “I’ll repeat the question...” “Why is knowing who won the FA Cup in 2014 important to you?” “How does wanting to know who won the FA Cup make you feel?” Bleep, bleep, bleep. “I’ve started, but I’ll never finish.” “At the end of that round you have scored £90 off me, and passed on no actual advice.”

  They ask if I have any other diagnosed anxieties. “I partially suffer from achluophobia.”

  “Achlu...” Steve begins to repeat, but stalls half-way through.

  “Bless you!” I interject spontaneously.

  Claire laughs. Steve fires her an admonishing “I’m very disappointed” look, as though she’s been discovered chewing in class.

  I explain achluophobia is a fear of darkness. I do not usually admit this to anyone, since the associated embarrassment is a main part of the condition. But it is a low-level anxiety compared to my main phobias and general state of twitchy perturbation.

  “Have you diagnosed yourself on the Internet?” he enquires, in a tone implying he is already sure of the answer, hence his question was for display purposes only.

  “No. I’ve had this condition since the late 1970s, so that might have been difficult to do then.” I really didn’t mean that to sound sarcastic.

  Claire unsuccessfully represses a smirk. For this she receives That Look again from Steve.

  These two must be having a work place affair. They must be. No two people of different genders could possess such an irrational dislike for each other unless they were in a permanent relationship. They cannot resist subtly undermining each other’s comments, often starting sentences with “thinking has moved forward since then...” to nullify each other’s points. They evidently believe their comments are buried underneath sufficient coded subtlety to avoid detection to outsiders, but I might as well have caught them rutting like rabbits on the waiting room sofa, it’s so obvious they’re a couple.

  Suddenly, after spending nearly all the opening session misun
derstanding, mishearing and misdiagnosing, the female counsellor leans forward and actively provides me with what I predicted to be that rarest of contributions in psychological clinical consultancies: direct practical advice.

  “The best approach to overcome an extreme fear of heights is to focus on what aspect causes you the most restrictions in day-to-day life. I assume stairs must be a strong contender for being addressed first?”

  “Yes,” I manage to reply from my startled state of something actually happening to help cure me. “Yes, thank you. That would be a good thing to address, to help cure me,” I say clumsily.

  “We don’t like the term ‘cure’ here. We prefer a less judgemental description of your condition we’re currently addressing,” corrects the male counsellor loftily.

  Claire and I join together as teammates in giving him a deserved “shut up!” look, before she continues. “There are various therapeutic techniques we can draw on to help you manage anxiety. You need to challenge your looped thought processes that incorrectly signal danger. One approach is to gently introduce yourself to an environment that triggers irrational fear responses. So go with a friend, and then allow them to accompany you to some stairs - the steep sort.”

  “Open-ended ones, with no banister, and you can see daylight underneath the steps?” I suggest. She nods. “God, I hate those.” “I know you do,” she confirms, in a reassuring, quite maternal way.

  “Stand on the first step. Practise breathing mechanisms. It could well be that your breathing rhythms are subconsciously tripped when confronting trauma patterns - reacting to, and pattern matching, the source of your tension and thereby increasing encountered stress. This could cause stress levels to spike, cortisone manufactured, increased heart beat, which in turn self-sustains irregular or shallow breathing. That alone could be a large contributing factor to the fear. Anxiety can be a self-breeding beast, constantly replicating itself. Your anxieties and phobias could be connected, in that your self-esteem is lessened by knowing you’re unable to deal with stairs as an otherwise successful adult.”