SOS Response 1

Dear Yvette

Firstly I'd like to say that I agree with your supervisor in the importance of holding time boundaries.  Boundaries give a client a feeling of security even if they do seem to fight them, in the same way that rebellious teenagers need the very same `house rules' that they fight against.  These boundaries show that the person setting them recognises the other person's importance and cares about them.  

However you don't mention the theoretical orientation of either yourself or your supervisor.  If neither of you happens to be psychodynamic, a look at the problem from that perspective might be helpful to you.  

You client gives what appears to be a believable reason each time he is late,  but the reasons that clients give for their behaviour may not, in fact be what lies behind that behaviour.  There may be something else going on that they themselves are not aware of but that could, gently and carefully, be teased out and looked at.  

In your client's case it is possible that his girlfriend's ending the relationship, it seems against his wishes, may have left him feeling powerless and with an unconscious desire to reclaim the power that her action deprived him of.  It may be that he is trying, again unconsciously,  to assert what he sees as his right to decide when things begin and when they end - hence not only his lateness but also his apparent need to push you to continue working after the session time is over.  I would emphasise here that this is only one of several possibilities.  

If you feel like exploring this with your client, I'd advise against suggesting it directly.  Instead you could perhaps encourage him to talk about his relationship and then introduce the subject of power balances in relationships,what might make these change and how it feels if they do. You might even learn something about how he feels about the power balance/imbalance between the two of you!  

There are several other `reasons' why a client might be consistently late.  Maybe the counsellor was late starting the session on one occasion and the client wants to pay them back;  maybe they are scared to talk about something they know they need to look at;  maybe they are angry with the therapist because they are not progressing as quickly as they had hoped, or because of something the therapist has said to them.   

Or, of course, it could be none of these.

If you fancy doing some reading around this theme, I'd recommend `Psychodynamic Counselling in Action' by Michael Jacobs, published by Sage.  My edition is the 1988 one but it has been updated several times, most recently in 2004.  Another good one is `An Introduction to the Therapeutic Frame' by Anne Gray, Routledge 1994.  Both of these are currently listed by Karnac.  

Anne Gray gives an example of when an interpretation that she made about a client's timekeeping was totally wrong and upset the client to the extent that they subsequently ended their counselling prematurely, so care needs to be taken to progress slowly and make sure that such psychodynamic interpretations resonate with the client, rather than stating dogmatically that they are correct!  

I hope that this has shown you a different way in which you might think about your client and his behaviour.  

With warm wishes,  

Sue Whitlock

SOS Response 2

Hello Yvette

Thank you for writing to ACTO `s supervision one-off service.

You write that you have a male client who arrives late for his counselling sessions with you even though you have challenged him about it and are keeping strict time boundaries yourself. I guess, if we are honest, the problem you are experiencing is one we have all encountered at sometime or other with our clients and it is very frustrating.

I wonder if he treated his girlfriend disrespectfully, by turning up late for dates, and that contributed to her ending the relationship with him.

I guess there is no simple explanation. If he was unemployed I would be thinking that his time keeping may have been to blame for that too but he isn't So unless he is his own boss he must be keeping some time boundaries. Had you been a male counsellor I wonder whether you would be experiencing this problem with him.

You have had several sessions with him. Have you looked into his family history as it occurs to me that there may be a gender issue here? It may be worth exploring with him the roles different members of his family have played. I may be wrong but it feels to me as if he grew up with a mother who pandered to his needs perhaps as a way of compensating for some loss in his life. His continuing lateness does feel like punishing behaviour although he may not be conscious of this. You may find it helpful to explore whether or not there have been any separation issues between him and his mother or if father and mother have split up and a new man has come into his mother's life. I don't know if you work with past histories but it does feel as if he would benefit from exploring his early attitudes and experiences. If you are able to help him to expose past hurts it is possible that it will help him to recognise patterns in his behaviour so that he can see where he needs to make adjustments. He may not appreciate that his behaviour is passive aggressive and that by not respecting your time boundaries he is not respecting you or what you represent.

There is a feeling for me too that he is choosing not to take any responsibility for his actions. I wonder if he is attending counselling to please someone else such as his mother; could she have made it a condition for him to remain in her home for example? You don't state the age of your client but he does sound young and quite immature. I guess if I was working with him I would be questioning value; how much he values himself, how much he valued his relationship with his girlfriend, how much he values his work with you etc and I would be inviting him to tell me about his hopes and aspirations because I sense he does not have much motivation to change and I would want to check that out.

I hope my response is helpful to you and good luck with the case.

With best wishes,

Gill Webb

SOS Response 3

Hi Yvette

It seems what you may be hoping for is a different perspective on your current dilemma that you are being challenged with.  I hope that the prompts that I have provided below will offer possible alternative ways of looking at the same situation and therefore at the same time offer different potential solutions.

Using the emotions that he arouses in you through his behaviour could potentially provide a source for understanding what may be going on within the counseling relationship. How may he be unconsciously reacting in his relationship with you that is currently being mediated by this behaviour? Does this pattern of ‘immature' behaviour that is he currently displaying have any bearing upon the issues that brought him to counseling in the first place?  If he is coming across to you as adopting a ‘childlike' mode with his excuses, apologies and making light of his own behaviour in the situation? Could this regressive behaviour be part of his pattern in coping with the recent lost and separation? Is he attempting to solicit the sympathetic ‘strokes' from his female therapist, which may potentially be his projections for a ‘nurturing', matriarchal figure to soothe his current sense of ‘woundedness'? Does this connect with his attempt to go beyond the allocated time in his possible unconscious desire to be ‘special' that is somehow affirmed by 10 mins extra time? Or…. Is he at the same time unconsciously attempting to arouses the negative feelings in you, in confirming his self evaluation and prophecy, that eventually through his untenable behaviour, they, meaning his expectations of females, will eventually abandon him, as did his girlfriend and potentially his female therapist thus confirming his world view?

When you acted upon the suggestion of your supervisor in confronting him about his time keeping and to stick rigidly to your time boundaries, it did not result in any of the improvement that you anticipate it may have. This may confirm that the behaviour could have an unconscious motivating force that he himself may not even be aware of. These forces are usually perceived as irrational, emotionally charged given that it is outside the consciousness of the client. Time keeping and responsibility are issues that as a rational adult in employment would be very familiar territory and which I assume he is capable of exercising in maintaining his continuous employment.

It may also be useful to ask yourself ‘Was there anything that stood out to you on that one occasion that he arrived on time? At which point during the six sessions was that single exception? Would it be useful to reflect and ask yourself if there is any significance that might be implied or being communicated through that exception?

Any of the above hypotheses could provide the initial material for you and your client to explore together and bring into clarity what may be just below the surface and thus developed and move the therapeutic relationship and process forward. It may require of you to use immediacy in your engagement with your client, sharing your tentative observations in your attempt to make sense of what may be happening between the two of you and inviting comments and reflection from him as you both attempt to co-construct meaning and shared understanding in this joint endeavor.  This would avoid the abdication of his responsibility and imposition of the ‘parental' authority by the therapist thus a potential ‘child-parent' mode of relating within the therapeutic relatiomnship.

I hope the above have given you some fruit for thought and new possibilities.

Best wishes

Alex Chew

SOS Response 4

Hello Yvette,

Thank you for choosing the ACTO SOS service. I sense from your email that you are feeling helpless (as well as annoyed) at your client'sapparent inability to keep to the time boundaries you have agreed, even though you have challenged him about this and stuck to the agreed boundaries at your supervisor's suggestion.

I guess this issue is now starting to interfere with your workingrelationship with him - would you agree? The joking and apologetic behaviours you describe, sound as though they may make the situation worse for you rather than better. You may also find that your annoyance with him gets in the way of a session even before he's arrived?

I'm wondering what it is about this client that has triggered thisreaction in you. Perhaps his actions (or rather, inactions!) arereminiscent of some past relationship? Or maybe it's something to dowith 'value for money' that is interfering in your way of being with him? Indeed you may be concerned (though you don't say so) that he is not getting the 'best Yvette' he could get, because of his behaviour. Do you think this rather cavalier attitude towards another person is how he treated his girlfriend, too, (might this besomething you could explore together?). I digress here - it's alwaystempting to speculate about other possibilities. Now, back to the point.

I wonder if you could tackle the problem in a slightly different way by removing yourself from the centre of it. Sometimes, when our point has not been accepted or 'heard' by the client, we lose confidence in our ability and in some ways it does feel as though this client has de-skilled you.

So let's suppose this client were not a client but a friend. You can see his poor time-keeping behaviour is irritating those around him and you want to help him see how he is affecting other people. So what might you say to him about this? How might you put it so that he understands it's his behaviour that is causing the problem, not the person himself. Can you help him to look more generally at how his time-keeping behaviours might affect other people? Would that be easier to deal with this in a more general context rather than dealing with it as though it were just your problem?

I imagine (speculating again here) that if you can help him to see how his behaviour affects others, you will be helping him to become more aware of himself in future relationships and that will probably be extremely beneficial.

I hope this answer is useful to you,

Warm wishes,

Gill Jones

SOS Response 5

Dear Yvette,

Thank you for contacting the ACTO SOS support. Your message has been forwarded to me to form a response.

I sense that you are seeking an additional perspective on the client's presenting issues than you have received from your regular supervisor to form a way of moving forward with the current issues within your client work. I hope that my reply provides this for you and helps you to find a positive resolution to the current difficulties. Please feel free to come back to me if there is anything within my reply that you require clarification on.

I can hear your frustration with the way this client is continuously trying to blur the boundaries regarding his appointment times, and appears dismissive of the relevance this holds within your work routine and counselling practice. The excuses he provides are indicating that these circumstances are beyond his control, i.e. a bus being late, or stopping at a cash machine for money to pay for his session or bus fare etc. You mention that you have acquired experience of working with clients, but are finding it difficult to know what the underlying reasons are relating to his boundary and time issues. I'm sensing that this might be the first occasion where such circumstances have arisen within your clinical work and you feel quite puzzled or affronted by his behaviour. I can hear that his lateness has been discussed in the sessions and the implications of this, where you have indicated he explicitly states that he will try to be on time for his next appointment. It sounds as though you are becoming increasingly annoyed by the fact that he hasn't ‘heard' this in some way and encourages the sessions to overrun and shows no real willingness arrive on time.

I've used the word ‘boundaries' a couple of times already within my reply and I wondered if the client presents material in sessions which indicates that there may be other areas of his personal or working life where he ‘pushes boundaries'. I mention this as there seems to be a very strong sense of this occurring within the counselling context, and therefore may be evident elsewhere. Do you feel it might be possible to discuss this with him, perhaps asking how he finds time keeping and adhering to the structure imposed within his work routine or social contexts etc? You might also want to ask how others react to his lateness etc, if this does occur elsewhere. This might help him to understand how his behaviour impacts upon others, including within his counselling.

Looking at the presenting difficulties from a further perspective, you have mentioned that he initially came to counselling after his girlfriend had ended their relationship and this had initiated a low mood within the client. I'm interpreting this as the client not accepting the ending of the relationship as being a joint decision, and perhaps feeling resentful to his ex girlfriend as a result. It occurred to me that perhaps the client might be ‘acting out' in some way with you as his counsellor, by trying to assert a sense of control over what occurred with his girlfriend. Does the client mention how he currently feels towards females? Perhaps he mentions other women he knows on a social level, or within his work context. Does it feel as though there might be a similar thread occurring elsewhere which might indicate that his behaviour could be a transference response to you as a female?

You've mentioned that your current supervisor has suggested being very explicit with the client regarding these boundary issues, but the client isn't ‘hearing' or responding as a result of discussing the matter with him. I can understand how you might feel talking with him again about this could only result in you feeling more frustrated or annoyed with him and not resolve the matter. I wondered if spending some time with the client re-iterating the contract for the work and holding a mini review of how that has proved to be successful/unsuccessful so far? Perhaps giving him a hard copy of the contract, which includes details regarding late arrival for appointments etc, might help to open a more honest discussion with him regarding the reasons he is unwilling to comply. Depending on your orientation, you might feel that it would be relevant to let the client know how his lateness impacts upon you, so that he can relate to how this may also impact upon relationships outside of the counselling context, if this does apply elsewhere.

I'll have to close my reply there Yvette. Thank you again for contacting the ACTO SOS service. I do hope that my suggestions help in resolving the current dynamics within this piece of your client work.

My Best Wishes,

Jane Evans