Working with Negative Feelings
BGSP alumni demonstrate the importance of recognizing and learning how to navigate negative feelings when working on the front line in mental health institutions.
Negative feelings, such as anger, envy, hopelessness, fear and disgust, are part of being human, but they often present the biggest challenge when working with patients, colleagues, or institutions. This is especially true for frontline mental health workers who work with complicated and challenging cases. This Fall, a panel of BGSP alumni presented examples of dealing with difficult feelings in a variety of mental health settings, including a hospital diversion program, a group home and a home-based treatment program.
Alumni Juan Faraoni, M.A., Lauren O’Sullivan, M.A., LMHC, and Sarah Smith, M.A., LMHC, all graduates of the BGSP Master of Arts in Mental Health Counseling program, have clinical, supervisory, and administrative experience in a variety of settings, including a rehab center for developmentally delayed adults, psychiatric residential programs, outpatient psychiatric and substance abuse clinics, a therapeutic day school, in-home therapy programs, the Boston Public Schools, and private practice.
The program began with Faraoni presenting a case from a psychiatric skilled nursing home. With this case, he needed to understand the function of powerful feelings of revulsion that were induced in him by the patient, a phenomenon known as countertransference. He stressed how his training helped him to withstand his emotional reactions, to avoid acting on them, and to use them to learn how to work with this particular patient. His ability to tolerate the countertransference feelings enabled him use his energy to “fight” for the patient and obtain an appropriate space in which he could meet with the patient (which was not previously available). In spite of his negative feelings, he was able to care for the patient.
Smith spoke of her experience in a program, primarily as a supervisor, in which the clinic expectations were for very short-term improvement in extremely complicated and chaotic family settings. She highlighted the frustration of this impossible goal, and the hopelessness and helplessness that she and her supervisees felt. Her main intervention was to provide a space for the staff to discuss their negative feelings, in order to recognize and validate the therapists’ experiences. She also helped them write up acceptable treatment plans and streamline paperwork. Understanding that anxieties about paperwork can sometimes mask worries about the clinical work, Smith was able to work with the frustration on multiple levels and help the therapists spend more time with their cases.
O’Sullivan presented a heart-wrenching case of an adolescent girl who was trapped in an institutional setting because of her adoptive mother’s complicated relationship with the mental health system. O’Sullivan was able to sit with the intense negative feelings that the mother induced in her. By studying these feelings, she was able to understand that the mother was involved in a repetition that caused her to make people want to get rid of her – similar to the feelings the adolescent was inducing in her mother. This understanding enabled her to work much more constructively with the family.
Dr. Jane Snyder, President of BGSP, and Dr. Patricia Hugenberger, Director of Continuing Education, moderated the discussion, which involved thoughtful contributions from the large audience of people from a variety of mental health settings. The honest, intelligent, meaningful, and heart-felt presentations about the challenges of working with complex cases, and even more complex mental health settings, seemed to resonate with the audience’s experiences. The discussion focused not only on the complex theoretical concepts of transference and countertransference, but also on the therapist’s use of self – highlighting a cornerstone of BGSP’s training that differentiates BGSP from other counseling programs.