Session Confessions
This Session is now in progress.
Note: All biographical information related to client stories are significantly altered to ensure anonymity.
It was Winter’s night in Melbourne, dark, rainy, and ice-cold wind. I was doing a late shift. That evening, I had three clients and my last client for the evening was a young man in his mid-twenties. He had suffered from Depressive episodes throughout his late teens and up into his twenties. He presented with very common depressive symptoms such as persistent low mood, motivation and energy, little desire to engage in many activities he’d previously found pleasurable, sleep issues, lacking hope about his future, social withdrawal, and some interpersonal issues with his parents.
One of his drivers into therapy was to be able to finish a creative writing course he’d enrolled in. The depression sabotaged his creative energy to write and as an emerging writer his punitive critic wounded him daily with self-doubt. The pervasive idea that he wasn’t going anywhere in his life was a primary source of his unhappiness. He knew deep down he was creative but found it hard to consistently engage in his writing. His variable capacity to submit writing tasks by their deadlines pendulated between procrastination and anxiety. He rarely had bursts of energy that lasted the duration it would take him to complete a task and as much as he loved writing, attending to these tasks were a great source of unease.
After a few decades of being a psychologist, with over 20,000 counselling hours under my belt, very little surprises me anymore, neither in a client’s story, symptoms or how a client behaves during a therapy session. The ‘new’ is often only found when I work with a different cohort of clients, such as working with children and then predominantly working with adults or working with culturally and linguistically diverse or marginalised clients and then working with predominantly white clients. Culture matters and when the group I work with changes, the lived experiences changes, the world view changes, the cultural scripts that govern people’s daily decisions changes.
Whilst human stories vary, people’s interpretations of their stories are strangely similar. At similar ages, humans are very similar in their psychology.
The way we attribute meaning to what we think, why we are feeling the way we do and what’s influencing us to behave in the way we do are actually very similar.
Our fundamental human needs are the almost identical, safety, security, love and connection, autonomy, and freedom, meaning and purpose. Culture has a powerful influence in terms of how we get these needs met, and we humans work towards getting them met both independently and collectively.
When struggles arise that prevent us from getting those needs met, we are met with the experience of a universal set of emotions such as sadness, surprise, anxiety, anger, and disgust. When we meet the above needs, we experience happiness, joy, and delight. It is this level of predictability in the human response to life that allows us therapists to work with clients. To my knowledge, no one has broken out in blue spots as a telltale sign of their anxiety.
However, every so often I do experience something new in the counselling room and on this particularly dark and rainy evening in Melbourne I was about to have a most unforgettable session.
It was cold and I mean a classic ice-cold windy night in Melbourne. My client entered my therapy room wearing a bulky navy puffer jacket. That made sense given how cold it was. The session proceeded as normal with me asking a few prompt questions.
“Hi how are you? How’s your week been? How have you been feeling? How did you go with those writing tasks? Did you get that assignment done? What’s gone well this week? What do you want to talk about tonight?”
By this point I’d had at least eight sessions with this client. I could safely say rapport had been established and he was making some progress in reducing his symptoms of depression. We’d started to delve in to some family of origin issues. He still lived with parents and helped in the family business. His parents had migrated from China, and he experienced some stress resulting from differing cultural and generational expectations about what he ‘should’ be doing with his life. He avoided discussing his depression with his parents over the years and therefore he didn’t receive much understanding for his current ‘stuckness’. He believed if he did tell them, he wouldn’t receive the support he needed anyway, so he kept his feelings to himself.
As he started updating me about what had been going on for him in the weeks since our last session, I could not help but notice some slight movements coming from under his puffer jacket, in the vicinity of his crutch.
My eyes dart back up to his face to make eye contact, to suggest I’m listening to his every word. Our chairs face each other and from where I am sitting, I barely need to tilt my head up or down to have his entire body in my view, head to feet.
I spot more movement down there. His words blur into white noise. I’m now totally distracted. I can’t help but tune into the unspoken. Is his body communicating something else? I don’t know. I’m trying quickly to work it out. My analytical brain is going a million miles and hour. What exactly am I witnessing here? What the hell is going on here?
Looking for the most innocent of explanations first, I scan to see if his hands are in his pockets, that’s a plausible explanation, I think to myself. But no, his hands are not in his pockets, they both rest comfortably on the arms of the chair. Ok, so the movement isn’t coming from his hands.
So then what the hell is moving under his jacket? Wait it can’t be. I really hope it’s not what I think it is? Seriously what else am I to think? If what I think is actually happening, how am I going to address this with him? So many questions are going through my head, and he just keeps talking. I’m mean I’m curious, but I really want to ignore it at the same time.
“Focus!” I instruct myself to pay attention to what he is saying, as in his words. I hold a ‘I see nothing’ poker face for the next minute.
OMG there it is again, movement coming from his crutch, so no, I’m definitely not imagining things. There is certainly something moving down there. I give some meagre half-hearted micro-acknowledgement, a head nod and an “Ah-ha” in response to some challenge that has presented itself for my client this week. My mind is fixated on containing the evolving behavioural presentation. In reality, this is all happening in a matter of a few minutes.
This situation evolves rapidly when the abnormal movements coming from the inner layer of his puffer jacket move up his arm and a big bulge presents near his shoulder. Without breaking verbal flow, he readjusts his body and I immediately readjust my hypothesis.
What small creature has he brought into our session and is concealed in his jacket?
I really hope it’s not a rat. I’m not a fan of rats or mice. Maybe it’s a snake! I could cope with a snake, but not a rat. I can’t hear any meowing, so I rule out a kitten. My brain is buzzing and with that thought, out of his jacket’s neckline, pops up the fluffy white head of his pet ferret.
Oh it’s just a bloody ferret!
By this point I cannot contain a huge sigh of relief and let out a little chuckle. My client replies with a smirk. He knows I know.
Of course it’s a ferret. He had mentioned his pet ferret to me in an earlier session. I just did not expect to meet him. After 10 minutes of sitting there not saying a word about his secret therapeutic companion, he apologised and explained he did not want to leave him at home alone. He pushed the swivelling head of the ferret, back down into his jacket and without skipping a beat kept talking. Keep calm (ignore my ferret) and carry on counselling would have been the appropriate sticker at the time.
Nothing to see here. He carried on speaking, and I carried on listening. Albeit, I had a giggle to myself in my head at my initial far from accurate conclusion.
It was a super weird experience. I continued to work with the client for several more sessions, and the little fluff-head did not make any further sessional appearances.
Five important takeaways emerged for me from this therapy session.
1) Expect the unexpected in therapy
2) Maintain one’s composure
3) Attend to the facts rather than jumping to conclusions.
4) Acknowledge the therapeutic benefit of all creatures great and small
5) Know what constitutes as a therapy session deal-breaker.
Number 5 is a particularly good question for therapists to answer early on in their career. What constitutes as a therapy session deal-breaker? The answer for me lies in anything that distracts me so much that I can no longer focus on what my client is saying and / or I have concerns about my own safety. Whilst abuse of any kind and active psychotic episodes (I’m not a crisis service) were already on my therapy session deal-breaker list, it now includes things we weren’t taught about at Uni.
My Session Deal-breaker List
1) Rats or Mice
2) Pet spiders of any kind
3) In session Erections
4) Abuse
5) Active psychotic episodes
6) Drug induced altered states of mind
7) Deranged and creepy Ex’s wanting me to convince their ex-partners to get back with them
8) Adult client’s urinating on my counselling chair.
Items 5, 6, 7, and 8 on the list have all happened and are now also filed in the ‘Unforgettable sessions’ folder in my mind, making the ferret’s appearance subdued by comparison.