Processing grief

So far the coping response has referred to the management of fear and anxiety. The different ways of processing of grief will now be discussed. In processing grief there is a similar pattern to that seen in the management of anxiety. Some individuals process their grief and move towards resolution others have a prolonged experience or get stuck at a particular point. These two paths parallel the mature and defensive management of anxiety whilst in the symptomatic group individuals become very...

Countertransference issues

In its broadest sense countertransference refers to all the feelings arising in the counsellor as a result of working with a particular individual. Our humanity and compassion allow us to be emotionally connected with others and to share their joys and pains. The positive side of being affected is that it enables us to help our humanity enables us to reach out to one another and emotionally share by our empathic and compassionate responsiveness. However, in the world of medical genetics there...

Exploring and clarifying the nature of the request and motivation for a consultation

In the initial meeting the thoughts and questions in a genetic counsellor's mind include, 'Who is asking what question ' 'Why now ' 'Can an answer be given ' 'How useful would an answer be ' 'To whom ' and 'What are the consequences ' In addition, the way the family disorder was first noticed, or how information about it was exchanged between family members is considered. These thoughts and questions not only focus the aim of the consultation, but also ensure that the counsellor and patient...

Debating the possibility of nondirectiveness

The earlier chapters have presented a theoretical underpinning for genetic counselling (stress), a framework for understanding differences in individual behaviour (attachment theory) and various micro-skills (empathy, etc.) to furnish the counsellor with an appropriate repertoire. This final chapter returns to looking at the overall picture, using a wide-angled lens to explore 'the culture' of genetic counselling. The terms genetic counselling and non-directiveness have become synonymous and...

Secure base and individual behaviour

Attachment theory begins from the basis that we all need to interact and explore the outside world - we need to investigate and take part in the social context in which we exist. To do this it is important to have a confidence in ourselves and our ability to express ourselves effectively in the social world. This confidence begins to be formed in the first few days of an infant's life. As we are vulnerable at this time, we need to be able to feel secure, especially when under threat. Attachment...

Other emotions frequently experienced in genetic counselling

Guilt and shame are emotions which are frequently felt by individuals in genetic counselling. In everyday life they are often fused and confused. Erikson (1950) has pointed out that the confusion happens because there is a developmental tendency for shame to be submerged by guilt, as both develop as part of conscience and are experienced in the context of having done something wrong. In the psychoanalytical theory of development, conscience develops around the resolution of the oedipal complex...

The use of metaphor

We use metaphors in our everyday speech there are metaphors that we live by and invariably the meaning is understood. It is use of a particular kind of language which brings with it pictures, colours, stories and seems to be immediately understood by everyone. Metaphorical language is a poetic language, very different from logical or scientific speech, one which we seem programmed to understand. It is a language which is often used in psychotherapy. Metaphor language can be important in the...

Dysmorphology clinics

The problems in these clinics can be very varied but usually take the form of a diagnosis of an unusual-looking child. When there are associated disorders, the function of the diagnosis is clear and clarifies what specialist medical or educational help is needed. In contrast, where there are no associated problems, the function of the diagnosis is questionable and will be determined by an assessment of parental attitudes. The diagnosis can either act as a container of anxiety or, in contrast,...