The One Up, One Down Pattern: A recipe for burn out and dependency

counselling-handsI am feeling close to burn out in my work. I provide my clients with lots of affirmation, good listening and suggestions from my training on the best ways to improve their situation or reduce their symptoms. After about 6 sessions I often feel stuck and frustrated.
What are the key pitfalls in offering help and counsel to others? Most problems in helping efforts occur in the ‘one up, one down’ relationship pattern. In my last blog I mentioned how I developed the ‘one up’ position in my family of origin and how this fuelled some unhelpful patterns in my early counselling work. I have also written about this pattern in the chapters in my book [Growing Yourself Up] on understanding family of origin, marriage, parenting and workplace. It is such a central relationship dynamic to any group that it deserves a bit more elaboration. Dr Bowen called this the over- under functioning reciprocity. This is where one person responds to the distress in another with increasing support, while the other responds to the support with reduced responsibility. It happens in a circular back and forth pattern that can start on either side of the relationship. People who feel most secure and affirmed being helpful to others find themselves connected to people who are most comfortable when others are paying them attention in a caretaking manner. In many ways the conventional counselling relationship is set up in this way.
So what’s the problem with this? I recall speaking to an experienced counsellor, Fiona, who came to me for supervision saying:
I am feeling close to burn out in my work. I provide my clients with lots of affirmation, good listening and suggestions from my training on the best ways to improve their situation or reduce their symptoms. After about 6 sessions I often feel stuck and frustrated. My clients say they get so much out of coming to talk to me but they don’t seem to be making any progress in between our sessions.
Fiona and I teased out her pattern in her counselling relationships. She could see how much her clients liked coming to see her because of her warmth and attentiveness. On the other hand she could also appreciate that she was helping in a way that was inadvertently fostering dependency. On behalf of her clients she was doing most of the work to sooth their insecurities and think of ways to address their difficulties. Her clients always felt buoyed after a counselling session and they liked the advice they heard, however because they hadn’t come up with their own solutions they couldn’t find the inner resolve to implement or stick with Fiona’s suggestions. As we explored this approach to counselling and the varied ways it took over a client’s own responsibilities Fiona could appreciate how this fed into her exhaustion and confusion. Increasingly she found herself referring her clients on for more intense therapy or for psychiatric assessment. Previously unbeknown to her, she had been playing a significant part in her clients reduced progress.
Fiona began to see that her position in her family had contributed to her tendency to be so helpful. Her younger sister had many symptoms during their school years and she had learned ways to reduce her parent’s stress by taking on some of the caretaking. She would spend many hours with her sister distracting her when she was depressed and would include her in her social activities. Fiona found it helpful to see how her caretaking posture was so well honed in her family. Her counselling training had acted to consolidate this pattern.
Fiona’s effort went into reducing her support for her clients. This seemed so counterintuitive and yet she understood that she did not want to continually promote dependency. She retained her commitment to good listening and conveying a tone of warm respect. Interestingly she did report her effort to reduce her tone of concerned compassion as she could see that it fed into her client’s perception that she was more on their side than any member of their own family. She began to increase the time gap between her sessions to communicate that she wanted to give people adequate time to observe and experiment with ideas in their real world and to use counselling as a place to review instead of a place to be changed. Rather than give advice she asked questions about the clients own problem solving efforts – what had they learned about what was helpful and what wasn’t? She became more careful about sharing information from professional training. We talked a good deal in supervision about when she would ascertain the appropriate timing for sharing information. Her new rule of thumb became to ensure her client had explored their own patterns of coping thoroughly before she would convey relevant professional knowledge. She would select carefully the information to share that matched her client’s own descriptions. For example when a woman she was working with said that she always did better when she slowed things down, Fiona opened up a conversation about ways to reduce the physiological effects of stress and anxiety. She was able to add some ideas for temporary stress reduction in a non-authoritative manner. Her key message in sharing information was: “This may or may not be helpful for you but might add to the ideas you are trialling.” As a professional helper Fiona was learning to collaborate with her clients, jointly investigating their patterns for dealing with their symptoms or challenges in their important relationship contexts. This more equal posture was very different to the previous ‘one up, one down’. It was providing Fiona with a new way to view her helping efforts and provided a platform for a sustainable counselling career.

Next blog: a story of triangling/side taking in a helping relationship

‘The One Up, One Down Pattern‘ – Jenny Brown