10 Reasons to Choose Email Counselling (and 3 Reasons Not to)

The world is changing fast, and counselling is too. Below are ten reasons many individuals find that email counselling can be therapeutic during times of need. (Scroll down to find three reasons NOT to choose email counselling!)

  1. You can communicate with your counsellor when you need to, rather than waiting for their schedule to open. You can write a letter, or review a past letter. Your counsellor isn’t present, but taking the time and space to write to them means that you are reflecting and working on solving your own problems.
  2. You don’t need to set aside a whole hour all at once. You can write, read, review and reflect bit by bit over time. In fact, counsellors who do this work encourage it!
  3. Conversely, you can take longer than an hour if you need to! There is no need to fit your whole story, and all your complicated emotions, into 50-60 minutes. You can take the time you need to compose your thoughts before you press “send”.
  4. There is no parking, gas money, time off work, or travel time to worry about.
  5. If you are housebound or live in a remote community, online counselling can be an ideal option.
  6. Email counselling affords you increased anonymity; many people find it much easier to lower inhibitions and talk about difficult subjects in a letter.
  7. Email counselling is private. There is no chance that someone will see your car, or that you will bump into someone you know. No one will see you walk into a counselling office. Unlike video counselling, there is no chance that someone will overhear.
  8. You have the option of having a permanent written record of everything you and your counsellor have to say over time. It is like keeping a personal journal, except that you are communicating with a professional. This can be helpful to track changes, or as a source of encouragement when you are feeling low. Various parts of your letters might only become meaningful later.
  9. You save money. Even though you get to spend more time sharing your story, and the counsellor still spends an hour writing their reply, email counselling is often a bit cheaper, as there is less overhead involved in providing services to you. You may even save money as you may not have to return to your counsellor for a refresher if similar problems return – you just have to go back to your letters.
  10. By setting aside the time to sit down and write (rather than attend an appointment at a certain time) you are forced to take ownership over your own healing process. You aren’t doing it because it’s what your counsellor expects, you are doing it for yourself!

Still wondering if counselling by email can really help you heal and create change? Check out this blog posting.

Why NOT Counselling by Email?

Online counselling is not for everyone.

  1. If you may be at risk of violence (or of hurting someone yourself) or are feeling suicidal, you need to access more immediate face to face counselling in your local community.
  2. If you feel overwhelmed by strong emotions and unable to manage them on your own, you should not choose online counselling.
  3. You may require more specialist medical treatment than what online counselling can provide, especially if you have been diagnosed with psychosis or an eating disorder.

Keep in mind that my responses are not immediate. Typically, my commitment is to respond within two of my business days. For more immediate choices, keep an eye out for RSCC Resources page (coming soon).

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An Intro to Watching Movies as Therapy

I love going to the movies, don’t you!? Movies make you feel things. “Who has not walked out of a movie theatre feeling sad, scared, inspired, or otherwise moved? Movies can potentially open a person’s eyes to new solutions to any number of difficulties. … They might offer hope, provide role models, and reframe problems” (from goodtherapy.org).

Hmm. Kinda sounds like counselling, doesn’t it?

This post marks an introduction to an upcoming blog series on “Cinematherapy” (or movie therapy). In the series, I will be recommending and reviewing a different movie each time. The only rule: the plot or theme of each movie will touch on something related to relationships, mental health and/or social issues.

I’m excited! Okay, let’s get started … (if you have come to this post just to see the directions how to watch a movie mindfully, please scroll down).

Background

The term cinematherapy has been used since the 1990’s, and is a close cousin of “bibliotherapy”. (Books make you feel things too!) According to Segen’s Medical Dictionary, “Cinematherapy can be a catalyst for healing and growth for those who are open to learning how movies affect people and to watching certain films with conscious awareness.”

Read those last words again. “… those who are open to … watching certain films with conscious awareness.”

How the heck do you do that?

Dr Birgit Wolz, a current guru in this field, acknowledges that it is easy to get caught up in the entertainment and forget to watch mindfully. She answers one viewer’s question: “What you are saying about movies is true for life in general. We often get “caught up” in things and become conscious only later when we look back. … Like in real life, your conscious awareness will increase and decrease at times. Learning to have control over this will benefit you greatly in life.”

Back in the mid-1990’s, I was a Drug Prevention Worker at a high school in northern BC. I didn’t know there was such a thing as cinematherapy, but I knew that teens liked watching movies! So I organized groups where they could come watch movies related to problem drug and alcohol use. When choosing the movies (before Netflix and Youtube) I looked for stories which were relevant to their lives. I also created suggested lists they could take home and use. My hope was that I could engage them in honest conversation about substance abuse, rather than teaching remote facts that did not connect with their everyday experiences.

How Can Cinematherapy Help?

While the research is still ongoing, here is a summary of what I and the current practitioners in the field believe:

  1. Watching a movie (or talking about a movie) with someone you don’t know very well can help build a rapport. It is an easy way to build a connection with someone (including your counsellor).
  2. How you respond to a character or a plot point in a movie can help you learn about yourself. Because talking about the movie is less threatening than talking about yourself, it’s a “way in” to the stuff you may find quite challenging otherwise. This helps to strengthen self-awareness. (*Note: most of the reflections questions below are designed to help in this area.)
  3. Talking about a movie with someone that you otherwise experience communication challenges with can help to build your communication skills.
  4. You’ve heard about feeling better after “a good cry”. Watching movies that make us laugh or cry can provide a cathartic emotional release. This can be a useful first step to therapy or counselling.
  5. Movies show us what is going on behind a character’s surface. We learn something about “why” they behave as they do. As viewers, we go along for the ride, walking beside them on a part of their journey. All of this helps to generate an empathic response – something we need a little more of in our everyday lives.
  6. Movies fight shame and stigma when they are about the lives of people who are marginalized or otherwise invisible. The recent popularity of transgender individuals in Hollywood is one example.

How to Watch a Movie with Mindful Awareness

Before you begin, find a comfortable spot. Pause. Take a moment to notice your breathing. It should be easy, and natural. Don’t force it. Do a quick body scan. Then if you notice any spots where you feel stress or tightness, acknowledge them. Dr Wolz writes, “Let your breath travel into these spots. To release tension you may experiment with ‘breathing into’ any part of your body that feels strained.” For now, set your judgements aside.

While watching, pay attention both to the movie and to your own physiological reactions. Observe whatever is happening – whether your heart is speeding up, or the pace of your breathing is changing. Do your best not to judge or analyze. Just “be fully present with your experience”.

The following are questions that cinematherapy.com suggests you ask yourself when the movie is finished. If you like, it can be useful to record your answers.

  1. Do you remember whether your breathing changed throughout the movie? Could this be an indication that something threw you off balance? In all likelihood, what affects you in the film is similar to whatever unbalances you in your daily life.
  2. Ask yourself: If a part of the film that moved you (positively or negatively) had been one of your dreams, how would you have understood the symbolism in it?
  3. Notice what you liked and what you didn’t like or even hated about the movie. Which characters or actions seemed especially attractive or unattractive to you? Did you identify with one or several characters? 
  4. Were there one or several characters in the movie that modelled behaviour that you would like to emulate? Did they develop certain strengths or other capacities that you would like to develop as well? 
  5. Notice whether any aspect of the film was especially hard to watch. Could this be related to something that you might have repressed (“shadow”)? Uncovering repressed aspects of our psyche can free up positive qualities and uncover our more whole and authentic self.
  6. Did you experience something that connected you to your inner wisdom or higher self as you watched the film?

I have to give grateful credit for these instructions as they have come from Dr Birgit Wolz, at www.cinematherapy.com. Although I struggled a bit with the layout, what a gold mine of content her website is! (She has in turn based portions of these instructions on Sinetar, Marsha (1993) Reel Power & Spiritual Growth Through Film. Ligouri, MO: Triumph Books.)

Finally … A Warning

Cinematherapy is an “add-on” therapy, much like art, music, or dance therapy. Similarly, it can be used as a self-help technique or with a counsellor. However, our problems show up in a spectrum. Self-help can be useful for problems that do not require a counsellor, but sometimes other expert eyes can be useful. If the problem is more severe, do not use cinematherapy in place of a trained counsellor!

The questions for reflection above encourage you to open yourself up to those uncomfortable thoughts and emotions that you might be closed off from. But watch out for negative triggers! Sometimes it can be too much. Make sure you have access to emotional support if necessary. If you end up feeling overwhelmed, is there someone you can talk to about it? (Or even get a hug from?)

Finally, there are no known contraindications for cinematherapy among most people. However, it is not advisable or helpful if there is a history of psychosis.

Further Reading

E-Motion Picture Magic: A Movie Lovers Guide to Healing and Transformation Birgit Wolz (2005)

Rent Two Films and Let’s talk in the Morning: Using Popular Movies as Psychotherapy John W. Hesley; Jan G. Hesley (2001)

Advanced Cinematherapy: the Girl’s Guide to Finding Happiness One Movie at a Time Nancy Peske; Beverly West (2000)

The Motion Picture Prescription: Watch This Movie and Call me in the Morning Gary Solomon (1995)

A Peek Inside My Email Counselling Office: A Role Play

Today, you get to be a fly on the wall, and peek inside my email counselling office!

Email counselling seems to inspire strong feelings. Most people I talk to are very intrigued. There are a few who have said: “that would NEVER work for me!” (If this is you, please read this.) As I say below (to my fictional client Sandra), email counselling can feel very out of the box. I have created this role play both for the curious and for the doubters.

Setting the stage: As you drop in to observe, Sandra has already written me for the first time, telling me a little bit of her situation. To find her letter, scroll down and look for the italics. You might want to start there, just reading the italics. You are dropping in at the point where I am responding to her. I start with an introduction at the top and then respond to her specific concerns below.

Dear Sandra:

Congratulations on taking the first step to look for a counsellor! For some people, especially those in a caregiver role, it can feel very out of the box. You have recognized that it is not just your mom who needs care (not to mention your grandchild). But in order to be there for them, you need to care for yourself. Counselling is a form of self-care. It’s so easy to put yourself last, and you have courageously stepped outside that.

Email counselling is also something that is very out of the box! I have responded to your concerns below. You can see I have also attached my welcome and consent forms. These forms explain more about my approach and how this whole thing works. In the meantime, keep reading to learn a little more about what to expect.

Our letters are meant to be a conversation, just as if we were meeting in person. The approaches and techniques I use have been designed to facilitate that sense of face-to-face communication.

  1. For example, when I reply to your letter, I hit return in key sections, and type my comments there. I preface my comments with my initials so that it’s clearer who is saying what. When you read it, you will see how it reads as a conversation between the two of us.
  2. Have you ever noticed how easy it is to misinterpret what is said over email or when texting? I avoid this by using square brackets [ ] to convey some of the non-verbal parts of communication (e.g., body posture, facial expressions, or tone of voice). If you want to try using square brackets yourself, please feel free! It can be therapeutic, in that it forces you to increase your own self-awareness of what you are feeling. And it will help me to better understand you.

When you want to reply to me, go ahead and continue our conversation! I invite you to click on my message at the appropriate point. Hit return, and insert your response, starting with your initials.

Then, I also ask that you also compose a new message, as you normally would respond to a regular email … with a letter at the top. In this letter please let me know any updates since the last “session”. What’s changed? Anything new you want to share?

Take your time in composing your response. This is important work. I also suggest that you don’t hit send immediately. Sleep on it. Come back the next day. Inevitably, there will be things you will want to change. In this process of writing, reflecting, revising, and writing some more, you are reflecting more deeply, and moving closer to achieving your goals.

Okay. On to your letter …!

 

Dear Kirsten,

I’m writing to you because I am way too busy to see a counsellor, and in the small town where I live, there’s no one really appropriate anyway. I am at my wit’s end with my 92-year-old mother. All she does is complain and criticize, and she won’t accept any help from anyone except me. She is driving me crazy! I don’t know whether this is something you can help with or not?!

 

KM: Welcome, Sandra. If you were coming to see me in my home office, I would be greeting you at the door [warm smile and extending my hand to shake yours]. I have a sign on my door with my business name that invites you to, “walk in”, so you know you are at the right address! (I know it can feel a little weird going to an office in someone’s home for the first time.) In my office, I have a comfortable futon for you to sit. I also have a lot of art on the walls. I’ve made a cup of herbal tea ready to offer you. Perhaps you’d like to make yourself your favourite hot drink while you read this? Don’t worry, I’ll wait! 😉

From this brief introduction, it is evident that this situation with your mother is really distressing. Refusing to accept help, and constant complaints can be a common problem I hear about from adult children. You are not alone. Although it can be common, every situation is unique [leaning forward in my chair with interest]. I’m looking forward to hearing more about the details of your family life.

 

I should mention that she lives in our basement suite. It’s actually a contained ground level suite, in a home that my partner and I co-own with her. This has been a long-standing arrangement, and it may be that we have all outgrown the situation. She finds it difficult now to even go out to the mailbox to get the mail on her own, let alone do anything else out of the house.

 

KM: [concerned expression] It sounds like she has become somewhat housebound. And if she is refusing help, that puts quite a burden on you.

 

I am constantly worried about her having a fall, and me not noticing until the next day. She is lucky to have a scooter, which should be helping her get out of the house. But she refuses to use it because it scares her (even though she won’t admit it).

 

KM: That is true – she is lucky to have a scooter. They are very expensive. Some older adults have a difficult time feeling dependent on scooters, walkers, and the like. I like to say that these are tools to facilitate independence for the people that need them. NOT to create dependence and frailty. And when you are comfortable and confident using them, then you don’t feel so scared to leave the house! [voice rising slightly with enthusiasm]

Hmmm…. As you can tell, this is something I feel strongly about!

The trick is … like most new skills – learning something new takes time and outside help. [sitting back] From what you have shared, this does sound like a situation where an assessment from your local health authority may be a good idea. They would be the appropriate party to teach her how to use her scooter, for example.

 

Really, she’s the one that needs the help, not me. But as I said, she refuses to accept it. I’ve talked to our local health authorities, but there is little they can do without her consent unless I am abusing or neglecting her, or she is neglecting herself!

 

KM: That is so frustrating isn’t it!? [feeling curious] Correct me if I’m wrong, but are you feeling a bit angry at the system? At your mom?

Actually, I’m planning to write a whole blog post on the topic of how to handle it when your parent won’t accept outside help. There is a lot of general information and ideas I could share that would be outside the scope of this letter. If you like, I can also point you towards resources to help with this.

For now, here is a quote from psychologist and author Donna Cohen. “Many older people see themselves as proud survivors. They think ‘I’ve been through good times and bad, so I’ll be fine on my own.’ Plus, they don’t believe their children understand the physical and emotional toll of age-related health declines.”

Do you think this applies to your mom? Or not? [hesitating with uncertainty.] Please let me know if I’m on the right track.

In the meantime, I would love to talk more about the details of your situation. Can you tell me more about your mom? Has there been a time when the two of you gotten along well?

 

More about me: I have a chronic condition that causes pain in my hip and so I walk with a cane. I am the primary caregiver to my 8-year-old grandson, who also lives with us. He is a handful. Actually, he’s the only one who can make my mom smile – she brightens up when he is around, and they are close. I work almost full time, and (as I mentioned) I have a common-law partner. My partner works full time, contributes to finances, and is busy a lot.

 

KM: WOW. [eyes grow big] Sandra, you have a LOT on your plate! [feeling concerned for you] Anyone would feel overloaded with all of this, but chronic pain adds an extra burden, making it difficult to cope. What do you do to take care of yourself? When do you get a break?

 

I’m not sure what I am hoping for in writing to you. I guess I thought this might be a way to find support and a place to vent. I can’t talk to well-meaning family or friends because I often get too emotional (and I don’t want them to worry about me). Or they try and tell me what to do to fix it, without really listening or understand how I’m doing.

 

KM: It sounds like you are running into some roadblocks finding support in your day-to-day life. Your comments remind me of my favourite quotes from a relationship expert named John Gottman is “understanding must precede advice”. You have echoed this in your reference to well-meaning friends.

[leaning forward] When you get “too emotional”, what does that look like? Can you give me an example? Please tell me more about what you are feeling.

 

I also thought you might have some insight into what was going on with my mom and our relationship. Why she is so critical and angry, for example. We weren’t always this way. We used to be close.

 

KM: Ahhh. [smiling with hope] Earlier I asked if you two had ever gotten along well. I see you have begun to answer it. I would love to hear more about when you used to be close!

As I won’t get the opportunity to meet your mom, what I can do is present some possible paths for you to pursue. It may be that as we talk more, you will be able to connect some of the dots in your current relationship with her. I am hopeful that together we can make some progress.

 

Thanks for any help you can provide.

Sandra

 

KM: You are very welcome! [big grin] I have asked a number of questions in this initial response. My purpose is simply to highlight possible paths we might follow in working together. It is completely up to you where you want to go with this. In other words, take what is helpful, and don’t worry about the rest! If anything is confusing or doesn’t make sense to you, please send me a brief note in a new letter with the subject heading “clarification requested”.

We have not yet really discussed the frequency of our “sessions”. I would like to hear back from you within a week. In that letter, I would either like your response, or just a quick note to say that you have read my letter, and plan to respond in x time. Because of the nature of email, if I don’t hear from you, I start to wonder.

Okay, I don’t know about you, but my cup of herbal tea is empty! If we were meeting in real life, our attention would start to turn towards the rest of our day. As I walk you to the door, I notice some blue sky out there!

It has been a pleasure to meet you. I look forward to our next session. [warm smile, extending hand to shake]

Goodbye!

Kirsten

Communicating with your Counsellor Online: Ethical Concerns

Have you ever emailed your counsellor? What about your kid’s teacher? Last fall, I took an eye-opening course on Cybercounselling. In the process, I gained a much clearer understanding of the ethical concerns associated with communicating with your counsellor (or kid’s teacher) online. Twenty-three years ago, in 1994, the head of the school Lawrence Murphy founded Worldwide Therapy Online. In 1998, together with with the National Board for Certified Counsellors, he created a distinct code of ethics “to address the unique situations created by Internet technology”. (Wow. I didn’t even have a computer in my office yet!)

The Backstory

You’ve come a long way, Internet.

Way, way back in 1995, as a fresh young graduate starting out in addictions counselling at a non-profit society, I didn’t even have a computer on my desk. Rather than emails, we copied interoffice memos and stuck them in our colleagues’ mailboxes. Sometimes, when I tried to reach a client, they didn’t even have an answering machine. Remember those days?

Flash forward about five years later: I have a memory of sending a quick email to a colleague, hearing an email ding, then looking up from my computer and catching her eye. Turned out she and I both had our office doors open. (We were across the hall from each other.) We both burst out laughing at the absurdity.

In the last decade funding sources slowly dried up and caseload pressures grew stronger. And yes, I took shortcuts. As email found its way into almost every home, it also became a very efficient time-saving tool in communicating with clients. The purpose of emailing may have been to share a resource, book an appointment time, or even respond to a concern or question. I simply did not have the time to deal with all of these communication needs by phone.

The thing is, I am not alone. “It is more than hyperbole to suggest that the use of insecure email by professional clinicians may be the single most ubiquitous breach of ethics in the history of psychotherapy” (Murphy, Cybercounselling Level 1 class, Worldwide Therapy Online Inc., September 2016).

So, you and your counsellor are communicating online. After all, that’s the world we live in now! Maybe you are getting some counselling, or maybe you are just scheduling your next appointment. What are the ethical considerations you need to think about?

Communicating by Video 

Many sources equate online counselling with Skype. Many counsellors are offering Skype counselling as a way to make things easier on some clients. If your counsellor is using Skype, are you aware that Skype is licensed for personal use only, not for business? Check your terms and conditions. Both of you have agreed (when you first signed up) that Skype can review content at any time. Or, your counsellor may use Skype for Business (launched in 2015). If so, you may want to ask her how its integration with MS Office impacts how data is shared between the programs. For example, are contact names shared?

In addition to privacy concerns specifically related to Skype, there are other ethical considerations that stand out. I have seen a counsellor’s web page that advertises their Skype sessions as “just like real life”. This is a misnomer. For example,  you may have noticed that it is difficult to meet the eyes of the person you video chat with. How do you hold a therapeutic conversation when the other person is looking at your chest the whole time?

There are also space and lighting concerns to think about, as well as technical! When we meet over video, where am I in your space? What can I see and hear in the background? How does the lighting and/or video quality impact my impressions of you?

Communicating by Email

Further considerations unique to email exist, especially if you are going to communicate with your counsellor through regular, non-encrypted email. They will not protect you completely but may go a little way towards keeping you safe.

  1. Avoid giving away personal information and/or names of individuals in the subject heading. (As a parent, I have been guilty of using my child’s name in the subject heading when sending an email to their teacher!)
  2. Avoid discussing anything personal, especially information that may be damaging, in the content of regular email communication. Once the two of you have developed a rapport (and given the informal tone of many emails), this can easily happen without thought. You need to know you are then making yourself vulnerable.
  3. Look for a counsellor that uses a generic domain name that does not immediately reveal their role. Eg. kirsten@kirstenluise.ca, rather than kirsten at rainstormcounselling dot com.

BEST PRACTICE: Look for a counsellor that provides secure, encrypted email that allows you to talk more privately!

Speaking of Encrypted Email…

My Cybercounselling teacher has said it is a breach of ethics to use regular email for any communication with clients. A conversation about an appointment time can easily slip into sharing information about something upsetting that happened that day. You may want your counsellor to be aware of it. After all, they are supposed to be a safe person for you to talk to, right?

“The rationale for encrypted email requires no more comment than does the rationale for a locked filing cabinet in a face-to-face counselling office” (Ibid, September 2016).

Very simply put, the web may route any email from within Canada through the US on particularly busy traffic days. Once it reaches the US the USA PATRIOT Act (and related legislation) applies. This is still the case even if you are sending elsewhere in Canada, and using a Canadian based email company. If you are using US based company such as Gmail, or Yahoo, the same American legislation automatically applies. It is not going far enough to exchange confidential information through regular email as long as they give informed consent. It is not going far enough to provide a warning in small print at the bottom of your email. The issues are too complex; we cannot be properly informed.

“It is akin to telling a client that you might break confidentiality ‘if bad stuff happens’ and then assuming they understand that disclosure of child neglect will lead to them being reported” (Ibid, September 2016).

Finally …

Online counselling goes by many different names: telemental health, cybercounselling, online counselling, e-counselling, and more. In all types, there are ethical concerns that cross the modes of communication. Whether it is by email, phone or video, you need to consider who else in your world can see and/or hear. Does anyone else know your password? Is there someone in the next room that you don’t want to hear you?

Working online can be notoriously unreliable. What if the application goes down? What if your account locks you out? What if there is an emergency? What if a space of time goes by when I don’t hear from you? Both of you need to have phone numbers you can use for backup, or in the event of an emergency. For crisis counselling, getting services online may or may not be the right choice. All of these things need to be considered carefully.

The new frontier, (especially for counsellors who work with young people) is communicating with each other by text. All of the above ethical concerns still apply. Free encrypted texting and email products are commonly available. (Most systems require both parties to sign up in order for the exchange to be encrypted.)

Are you feeling worried now?

Despite all these concerns, I am still a big believer in this form of therapy. (Check out another blog post I wrote to learn more about that.) When I started Rainstorm Counselling & Consulting I researched the various choices. Currently, I use Proton Mail for email and Signal for texting. (Communicating by video seems to be another matter. Several choices exist but they all cost money. Video counselling is coming soon!) Contact me if you have further questions about what I learned in my consumer research. If you are interested in getting training yourself, check out Therapy Online. This article only covers a small amount of what there is to learn.

A CBC article shows that more Canadians are worried about their privacy online. How about you? Do you communicate with your counsellor online? Have you ever tried out encrypted email?

Counselling by email: Does it really work?

(Spoiler alert … counselling by email does work IF you can build a good relationship with your counsellor. After being challenged by a family member, here’s the journey I took to demonstrate that!)

As any parent of a teenager knows, if you want your blind spots pointed out, ask your kid. Little kids love you and don’t want you to leave; teenagers want to take you down! (Okay, that’s an oversimplification – but it sure feels that way some days!) My teens would never hesitate to tell me if I have a hair growing out of my chin, a new wrinkle on my forehead, or spinach in my teeth. Or even (gasp) that the email counselling techniques I was learning would NEVER work!

Yes, that really happened.

I felt excited about the tools I had learned and so I shared some of them with my 19 year old. Of course, as a young person, they are a “digital native” and very familiar with text based communication. So, while I felt deflated, their opinion held some weight, and I decided to investigate further.

The first thing I need to make clear is that counselling (probably) isn’t going to help you heal or create change in your life UNLESS you can form a “therapeutic alliance” with your counsellor. No matter how good that person is or how much training they have had. Sometimes we call it “fit”. You can find that fit with some counsellors, and you might not with others.

Yes,  counselling by email really works, if you and your counsellor can build a good fit.

What is required in order to find that fit? I like Carl Rogers’ (humanistic) approach. He found that three components are essential for therapeutic change to take place: unconditional positive regard, empathy and congruence. I have ordered these in what I consider to be the easiest to the most difficult to achieve via email counselling.

Unconditional Positive Regard

(Defined by Wikipedia as “basic acceptance and support of a person regardless of what the person says or does”.)

This may almost be easier to transmit through email than in person. In person, I sometimes work with “difficult” clients. By this, I mean that they are not very likeable. Working face to face I may have micro expressions or tiny mannerisms that betray my impatience. I may feel triggered by something that they say or do. This can lead to an inability to be truly present within the session.

Via email, I can pick and choose my responses. If I feel triggered, it might stem from a personal experience that has nothing to do with that person. Over email, I can take the time to reflect on the source of my feelings. This can help me reframe my response into something helpful. Communicating warmth towards the other is one element of unconditional positive regard; it is something I find fairly easy to do in both in person and in writing.

Empathy

Empathy involves understanding, feeling, and sharing in another person’s thoughts and emotions. I have two thoughts about conveying empathy in an email.

First, as a counsellor, my ability to understand and share in another’s emotions is highly dependent on that person’s ability (whether written or verbal) to communicate those emotions. Some find it easier to explain and articulate thoughts and feelings in person. Others find it easier to write about them. Face to face, I may draw conclusions about the client’s thoughts and feelings based on their non-verbal communication. I am more dependent on non-verbal communication when the client is struggling to talk. Over email, especially when a client is struggling to write what they feel, I can mediate my response by being especially tentative my approach.

“Correct me if I’m wrong, but I get the sense that you might be feeling a bit angry at your mom?”

In some ways, communication that is not face-to-face can help to prevent me from making unspoken assumptions (based on their non-verbal communication). Checking out my impressions over email can lead to deeper understanding and empathy.

Second, I also believe communicating empathy is highly dependent on my own ability to draw on my personal experiences. This ability is not handicapped by using email. When something resonates, it is here where I may use a small amount of self-disclosure, to show the client that I understand. “I get that – I’ve felt that too – I’m right here with you”.

Congruence

I like to think of congruence as “matching” the client. The best example I have of this is a middle aged Indigenous man who came to me for addictions counselling several decades ago. I was a young white woman. Several other social service agencies had banned this fellow because of his outspoken (and apparently rude) nature. Somehow, without even realising it, I was able to match his approach. When he would tease (or insult) me, I would do the same to him. Rather than getting offended, I lucked out. He thought this was hilarious – and ultimately, matching his style of humour helped us to achieve a therapeutic alliance.

In email communication, I rely on what is called “process control techniques” and “presence techniques” in order to communicate congruence. When it’s done right, it works! But it can be easy to mess this up. Even something as simple as using too many exclamation marks can be entirely appropriate for one person, and not at all with another.

Finally

A good “fit” speaks to the relationship you form with your counsellor, and whether that relationship has the potential to help you create change in your life. Counselling by email really CAN help you heal. As I’ve stated elsewhere, I have heard it said: “try telling people a hundred years ago that you couldn’t have an intimate letter writing relationship over a long period of time, sometimes even with people that you’d never met, sharing your deepest thoughts and feelings!”

I just googled it to remind me if my memory served. Yep, Einstein and Freud’s famous correspondence was one example of this sort of relationship.

Okay. I just shared the story of Einstein and Freud with my teen. The answer I got back? “One hundred years ago? Try today!” Then I learned about a friend who is engaged to someone she met on Twitter! I know nothing about this relationship, including how healthy it may or may not be. But I am forced to conclude that somehow, the conditions necessary for communicating empathy, unconditional positive regard, and congruence must have been met in 140 characters. Surely, the same can happen in an email!

Check out other pages on this site to learn more, including 10 Reasons to Choose Email Counselling, and FAQ: Email Counselling.