Remember Your Context

I distinctly remember a class back in university; we were talking about being aware of our triggers and areas of sensitivity so that we could be prepared for when these topics arose in session, or to avoid certain client presentations. It made sense at the time; I took the advice on board, jumped into the reflection activity and considered my own history, biases, and preconceived notions, and identified certain presentations that I thought I would struggle with. In my case, one of the identified areas was aggressive, angry and/or violent males.

Looking back, you could say I got it wrong. I left university and jumped straight into an internship at a men's prison as I was desperate to start my career. I also now work with many clients that would fit in those boxes in private practice and have little to no trouble with compartmentalisation, treatment planning or engagement. It could be that my reflection had been inaccurate, or that I was growing as a person and psychologist by challenging myself, or perhaps the time was just right to sit with this type of presentation.

However, 8 years on from that class, wouldn't you know it I am sitting across from a new client who was referred due to "anger issues" that rocked me. Going into this initial appointment, I was going to complete it like I had the hundreds prior. I was going to obtain their history, discuss their concerns and set up a collaborative plan for treatment.

What actually occurred was a values clash that hit me like a truck. The reason for the client's anger, like many before them, was a perceived loss of control, coupled with frustration and vitriol towards minority community members, all stuff I've heard before, but this time it stopped me in my tracks. I was disgusted by the language I heard, the contempt for others and the lack of insight; I thought to myself that I want to refer this client to someone else as I don't want to sit through 50 more minutes of this in 2 weeks. I felt my own frustration rise. I finished the session and began to grapple with why I couldn't shake the discomfort that sat upon my shoulders and in my heart.

I questioned myself heavily. I knew I could work with anger, even face bigotry, but why did I feel like I couldn't work with this client? Was this a personal failing to engage in proper reflection? Have I misjudged my ability? Do I know myself well? or am I just looking for an easy way out to working with a difficult client?

I took this case to supervision. I outlined the values clash, the frustration, the desire to refer on, my worries about my own inability in this area, all of it. My supervisor, whom I've been working with since the start of my 5+1 internship many years ago, and who knows my work well, just said to me:

"Brayden, is it possible that your capacity has changed since you have a 4-month-old at home?"

Oh. Duh. Stopped in my tracks once again because that question and revelation struck me to my core for the second time this week. My skill hasn't diminished, I'm not a bad psychologist for wanting to refer on, or for not wanting to work with a tricky client, I'm exhausted and my care is being pulled in multiple directions. What is and isn't important, what is easy and difficult, what I enjoy and don't, has fluctuated without me being aware of it because my mind is still learning this new frame of being. The context of my life has been through one of the biggest shifts I've experienced, and I need to allow myself to adjust and be flexible.

Give me this client 12 months ago, or sometime in the future, and it is likely that I could work with these themes. But for now, my context has changed, I am changed, and I need to adapt to this and go with the flow of my life.

This is your reminder that if you begin to question yourself after a tricky session, try not to get sucked into the content of your thoughts, and try to zoom out to focus on the wider context of your life. You're an ever-evolving person and clinician, each day, week and month is different to the last so we must be flexible as well. We help clients to do this, but as always, we can forget to apply this to ourselves.