Sometimes, when interviewing a person with an obvious disability, professionals assume it is more polite to ignore crutches, missing limbs, wheelchairs, or even canes indicating blindness. However, as stated earlier with regard to race and culture, asking directly about the “difference” is usually welcomed. Such questions as “Have you used a wheelchair all your life, or is it a more recent addition?” can open the door to a candid discussion of the disability.
Facing and managing a disability affect all areas of an individual’s life. However, too often, mental health professionals without rehabilitation training do not know how to calibrate the presence of the disability. The disability is either treated as the de?ning feature of the individual, overshadowing all else, or it is ignored; ignoring a disability implies that it really should not have any direct impact on the emotional and interpersonal functioning of the individual.
Men who have accepted their disabilities or chronic conditions often have adopted a new set of values that replace the dominant male values in society. This process may take a good deal of time, depending upon the man’s special circumstances, personality, and social situation.
-A Man’s Guide to Coping with Disability
The Religiously Committed
The challenge of ministry is to help people in very concrete situations-people with illnesses or in grief, people with physical or mental handicaps, people suffering from poverty and oppression, people caught in the complex networks of secular or religious institutions-to see and experience their story as part of God’s ongoing redemptive work in the world.
Transference is characterized by inappropriateness; the client responds to the interviewer by acting, thinking, or feeling in an inappropriate manner. S. Freud stated that transference “exceeds anything that could be justi?ed on sensible or rational grounds” . Sometimes, but not always, intense and obvious transference issues can come to the surface early in an interview or early in the therapeutic process. For example, an angry, confused young man had an especially negative reaction to his female counselor. He became verbally violent during an initial screening interview, stating repeatedly, “Women. You [expletives deleted] women can’t understand where I’m coming from. No way. Women just don’t get me. Like you. You don’t get me.” Because the counselor had not behaved in a manner that warranted such a strong reaction, it is likely this client was displacing “feelings, attitudes, and behaviors” based on previous interactions he had experienced with females .
More commonly, like many relationship variables, transference is abstract, vague, and elusive. To notice it, you have to pay attention to idiosyncratic transactions clients initiate with you; for example, clients respond to you in ways that are more emotional than the situation warrants, they make assumptions about you that have little basis in reality, and they express unfounded and unrealistic expectations regarding you or therapy.
A fairly common old map on new terrain is the client’s unspoken belief that you, too, will evaluate him, ?nd him lacking, and reject him. An example is a client who expressed evaluation anxiety regarding her performance on a psychological test and cognitive behavioral homework assignment. She stated tentatively, “You know, some of those things the test says about me don’t seem accurate. I must have done something wrong when I took the test.” This comment is revealing because when clients are provided with inaccurate psychological test feedback, they often begin questioning the test’s validity, rather than their own performance. Similarly, she stated, “I did the assignment, but I’m not sure I had the right idea.” Again, she made this statement when, in fact, she turned in a very thorough homework assignment. She did exactly as instructed, but her self doubt was triggered because she viewed her therapist as an authority ?gure who might evaluate her negatively. Her expectation of criticism suggests, based on the psychoanalytic perspective, that she had been harshly, and perhaps inap114 Listening and Relationship Developmentpropriately, criticized before. In this sense, her reaction is similar to the child who ?inches when approached by an adult whose arm is extended. The child ?inches because of previous physical abuse; the ?inch may be an automatic and unconscious response. Similarly, clients who have been exposed to excessive criticism have an automatic and unconscious tendency to prepare themselves when exposed to evaluative situations. This is an example of transference.
