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Enmeshments in Counselling Setting




NO. Is a complete sentence

- Anne Lamott 



Life, at its core, revolves around balance—a harmony of the yin and yang, the interplay of Shiva and Shakti, and the coexistence of life and death. Striking a balance is the key to a better and more bearable existence. Beyond these profound aspects, have you ever considered the crucial role balance plays in other aspects of our lives? 


Our manner of living and communicating necessitates a delicate balance between assertiveness and empathy. Without this balance, life can feel like traversing a desert without a drop of water. Imagine navigating through existence without the right balance between understanding others (empathy) and expressing oneself (assertiveness). It's like you’re being constantly swayed, either pushed or pulled by the demands and dialogues of others.


Striking a balance between assertiveness and empathy is vital for effective communication. It sets clear boundaries in how we express ourselves and understand others. This balance ensures that communication remains respectful and avoids causing unintended harm. However, despite its apparent simplicity, many find it challenging to strike this balance, struggling to express themselves assertively and empathetically. The struggle to say "no" or express our true selves is a common challenge many of us face, whether it's taking on an overwhelming workload or agreeing to social plans that don't align with our interests. The challenge of expressing our desires often originates from underlying fears and irrational beliefs in our subconscious. We might fear upsetting others, hesitate to inconvenience anyone, or dread being seen as demanding. Our irrational belief systems may convince us that we're responsible for others' emotions, leading us to avoid making requests that could cause discomfort. Additionally, deep-seated attitudes may prioritise others' needs over our own, causing us to become passive or non-assertive, ultimately resulting in silence.


The issue with a lack of assertiveness is its close association with low self-esteem. This lack of assertiveness can create a damaging cycle where feelings of unworthiness are reinforced, making it harder for us to address our own needs. Being non-assertive sends a powerful message to ourselves, reinforcing the notion that we are not good enough. This self-belittling can become a destructive habit, projecting an image of weakness or indecisiveness to others, making us susceptible to depreciation or exploitation. “Yes” is typically a positive and reassuring response that brings joy to others (Hinton et al., 2020). It can pose a challenge when someone habitually agrees and becomes burdened with an excess of something they were already working on or in the process of. Moreover, some individuals struggle to decline requests or say "No" when tasked with something (Andrade, S. 2021). At some point in their lives, they have developed a pattern of complying with others' requests, often for various reasons. Some individuals consistently avoid uttering "NO," navigating through life with a deep-seated belief that their purpose is to serve and elevate their connections by assisting others (Pourjali, F., & Zarnaghash, M. 2010).

As social creatures there is often a deep-seated need for social connection and belonging (Rakshit, 2020). Thus we are unable to strike a balance between empathy and assertiveness because it might jeopardise our relationships and the sense of connectedness we value. This fear intensifies as we navigate our inherent desire to fit in and be accepted by our peers. The reluctance to say "no" also stems from a broader aversion to engaging in conflicts or potentially hurting others' feelings. The hesitation often stems from the wish to avoid disappointing or letting down those in our social circle.

Consider a situation where someone close to us occupies dual roles or there is a role disparity — they may be both a friend and romantically involved, perhaps our spouse and the parent of our child, all while being our best friend. This dual relationship can inadvertently lead to the suppression of our needs. It becomes a challenge to openly communicate our desires and express our true selves due to the complexities of these interconnected relationships.

In such dual relationships, there is a tendency to overlook boundaries, either by violating others' boundaries or allowing ours to be compromised. The more the relationship becomes intertwined, the greater the risk of enmeshment. This web of connection can make it difficult to navigate and maintain clear boundaries, often resulting in challenges in asserting our needs and preserving our individuality. Q) Think about the time when you have said YES to something you did not want to and the detrimental effect it had upon you.

Overview of Enmeshment


Salvador Minuchin, in 1974, introduced the concept of "enmeshment" to describe highly involved relationships that arise when boundaries within family systems are unclear and permeable. This lack of clear boundaries extends within the family and between family members and external systems. Enmeshed families or subsystems are identifiable by intense communication and a notable lack of distance and differentiation among their members.

The high level of communication might seem positive, indicating openness, but it often comes at the cost of individual autonomy. The term highlights the potential downsides of relationships characterised by blurred lines and a lack of space for individuals to express their uniqueness within the family system. For instance, in an enmeshed family, the mother continues to pamper her son even after marriage, dictating every aspect of his life, from daily meals to weekend plans and even decisions about a daughter-in-law's job. The mother’s desire for this leaves family members feeling threatened (Sheikh, 2021). Thus it can be observed that through enmeshments the family member that is involved is bound to feel a lack of identity or self-awareness. He /she might seek constant validation from others, harbour a profound fear of abandonment, and grapple with generalised anxiety (Berryhill et al., 2018).  Additionally, he may face challenges in establishing and achieving personal goals, bearing an overwhelming sense of responsibility for others' actions. Lastly, the individual would be hesitant to assert one's needs or stand up for oneself, holding unrealistic expectations of others, and finding it challenging to respect the boundaries set by others.

An illustrative example of how a dual relationship can lead to enmeshment be observed in the character of Michael Scott from "The Office." Serving as the Regional Manager at the Scranton branch, Michael becomes romantically involved with his senior manager, Jan Levinson, who oversees the New York branch and is, in fact, Michael's superior. This dual relationship between Michael and Jan eventually leads to enmeshment, resulting in numerous challenges for Michael.

The predicament arises because Jan, in her role as his boss, fails to appreciate Michael or take his work seriously. Despite their romantic involvement, she even delivers a negative performance review to Michael. While the show portrays Michael and Jan attempting to establish a contractual agreement regarding their relationship, the dual nature of their connection becomes problematic. Michael finds it challenging to assert himself against Jan's demands or bring the relationship to an end, creating a complex and entangled situation for him.

Another instance of understanding enmeshment can be done through understanding Disney’s Tangled. In the movie, it's evident that Gothel exhibits selfishness by confining Rapunzel to prevent her from aging. But at the beginning of the movie, she is shown to care for Rapunzel and acts like her well-wisher. One can see how that comes purely because since her birth, Gothel has been Rapunzel’s mother, friend, and only family member, for she has no contact with the outside world. 


However, Gothel's selfish tendencies are apparent through her fixation on her appearance. While she momentarily reveals a softer side during Rapunzel's birthday trip, she primarily embodies traits of an overprotective, jealous, manipulative, and deceitful mother. These characteristics are vividly portrayed in the song Mother Knows Best: 

“Ruffians, thugs, poison ivy, quicksandMother knows best, take it from your mumsy.On your own, you won't survive,"The above lines from the song she sings aim to manipulate Rapunzel by making her think that leaving the tower and Gothel will lead to only negative consequences and dangers. Despite maintaining a calm demeanour, the song reveals Gothel's short temper, especially in response to Rapunzel's desire to leave the tower for the first time. The composed facade breaks when she later re-kidnaps Rapunzel, expressing her rage by chaining her. Throughout the film, Mother Gothel is consistently depicted in dark, gloomy lighting, and her songs are in a minor key, symbolising her malevolent nature.


It's important to emphasise that enmeshment isn't exclusive to family dynamics or fairytales, as previously discussed. When a dual relationship is present there's a higher likelihood of enmeshment occurring. This is evident in the popular TV show, Brooklyn Nine-Nine. In this series, characters Jake Peralta and Charles Boyle not only work together as colleagues in the precinct for a decade but also evolve into each other's best friends, even taking on roles like best man at each other's weddings. 


The relationship between Boyle and Jake Peralta in Brooklyn Nine-Nine illustrates how having a dual connection can result in enmeshment. In their roles as detectives with equal status, there's a noticeable imbalance where Jake tends to exert authority over Boyle, treating him as if he's below him despite their similar positions. This imbalance blurs professional boundaries, fostering an unhealthy and overly personal connection.


Charles Boyle, in particular, faces criticism for his behaviours that contribute to this enmeshment. His lack of boundaries and somewhat unsettling actions, especially his overly admiring attitude towards Jake, increases the problem. Charles elevates Jake to an extreme degree, allowing Jake to take advantage of him in the workplace. Even so, he is okay with Jake leading the majority of cases while him being the subordinate in turn being bullied by Jake. Their friendship ends up being close-knit and tight, and there is never a single instance of a conflict between Jake and Boyle. Even when Boyle was aware that Jake was wrong, he consistently affirmed that Jake was always right.


Another aspect of their relationship involves Jake's tendency to comment on Charles' peculiarities, particularly his unique food preferences. While Jake might appear supportive, his remarks often carry an undertone that subtly belittles Charles. This not only reinforces the power imbalance but also contributes to the enmeshment by undermining Charles and fostering an unhealthy work dynamic. Specifically, when addressing Charles' quirks, like his quirky food habits, it becomes evident that Jake's apparent support is accompanied by a subtle form of mockery. This complex interaction adds layers to the enmeshment present in their dual relationship within the office environment. Q) In life, situations involving dual relationships can lead to enmeshment, where boundaries become blurred. Consider a scenario, whether real or hypothetical, where such a dual relationship could arise and potentially impact the therapeutic alliance. 

Enmeshment in Counselling Setting  

Enmeshment is not only a concept that exists within the framework of family and friendship, it could also be found in counselling settings as well. The reason is that there could exist a dual relationship between the counsellor and the client. The reason could range from countertransference to numerous others which shall be discussed. Maybe the client reminds the counsellor of someone they liked in the past, or maybe the client also attends the same tennis class or dance class as the therapist. During times like these, the therapist is bound to find themselves in a dual relationship with a client.


This type of role disparity in therapy could lead to enmeshment. Firstly, theere is a possibility that due to this role disparity, the therapist may excessively "check up" on the client through frequent calls and texts, indicating a lack of clear professional boundaries. Additionally, the counsellor might experience emotions parallel to those expressed by the client between sessions, reaching a similar intensity. This emotional overlap suggests a potential permeability in the therapeutic relationship.


Furthermore, signs of enmeshment include the therapist's preoccupation with the client, often intervening in their life to offer assistance. Justification for between-session contacts may arise from the claim that the client requires extra attention, lacking a supportive case formulation. This lack of clear rationale indicates a potential issue in maintaining professional distance.


The therapist may also display a parental or even romantic-like worry if the client is late or misses a session, revealing an emotional investment that goes beyond the typical professional concern. Moreover, the therapist may experience feelings of sadness or rejection when the client discusses the possibility of reducing session frequency or ending therapy, further highlighting an unhealthy level of attachment. Moreover, when the therapist assumes a dual role or there is a significant role disparity with the client, the likelihood of experiencing countertransference increases within the therapeutic environment. Additionally, the presence of codependency can increase the development of enmeshment. Consequently, this interference negatively impacts the therapeutic alliance, as the therapist becomes more prone to forming attachments or relationships outside the scope of the therapeutic alliance, ultimately undermining the authenticity of the therapeutic connection.


The imbalance in roles further prevents the establishment of a genuine therapeutic alliance, disrupting the equilibrium between assertiveness and empathy in the sessions. This imbalance also hinders the process of setting and achieving therapeutic goals. Therefore, it becomes crucial to explore strategies for building and maintaining a healthy therapeutic alliance, considering the challenges posed by role disparities and the potential for countertransference. Q) Think about an instance wherein you found yourself entering into a dual relation with your client. What strategies or methods did you employ to deal with it?

What a Healthy Therapeutic Alliance Looks Like

A healthy therapeutic alliance is something that aids the development of the client and aids the counsellor or the therapist in working in a union with the client to work on established goals. In counselling the therapist can find the right balance of assertiveness and empathy and along with this, he paves the way to a healthy and genuine therapeutic alliance. 


Rogers (1951) defined what he considered to be the active components of the therapeutic relationship: empathy, congruence, and unconditional positive regard. All of these factors make up important factors that decide the course of the relationship. Additionally, when the therapist acts with assertiveness the therapist acts with empathy and there is a higher chance that the client is likely to view the therapist in a genuine light. An assertive therapist effectively communicates their desires and establishes boundaries without resorting to making demands or reacting aggressively. This skill enables them to express themselves clearly.


In the therapeutic setting, a healthy balance of assertiveness and empathy can work wonders. This is because, through this assertive communication, the therapist can express oneself in a direct, open, and honest manner, clearly articulating what they wish to convey. This is done by also being mindful to not sound aggressive or to not be passive. Thus in this way, they can achieve the goals of the therapy as well as resolve any issues that arise within the therapeutic alliance. Scholars like Sillars, Pike, Jones, Murphy (1984), and Straus (1979) outlined three key features of assertive communication: Directness, Activity, and a focus on the relationship (Cone, 2017).Directness pertains to an individual's capacity to confidently manage social situations by openly expressing feelings without threatening others, actively communicating expectations, and taking proactive steps in interactions. 


Assertive individuals exhibit active behaviours by displaying confidence through verbal and nonverbal cues, such as maintaining eye contact, projecting confidence, providing polite but firm refusals, explaining their feelings, and using effective gestures. Lastly, assertive individuals recognise the significance of the other person's well-being and the overall relationship. They can effectively balance their own needs by employing relationship language to assert their needs while also validating the other person's desires, e.g., acknowledging the client's feelings by saying, “I can see that you are upset about this situation”.


In this similar manner, when a therapist is empathic, they are being aware of and showing sensitivity to, and experiencing, to some extent, the feelings, thoughts, and overall experience of the client. The counsellor does this in such a way that the client feels heard and understood and this in turn strengthens the therapeutic alliance.  In counselling setup, after identifying and, to some degree, sharing in the patient's emotions, the counsellor, as the listener, is tasked with responding in a way that signals acknowledgment and reception of the message. This responsive aspect is a crucial component.


A study conducted by Elliot Bohart, Watson, & Greenberg in 2011 involving 3,599 clients revealed that empathy had a meaningful impact on psychotherapy outcomes (Gerace, 2018). The findings from the research showcased that what significantly predicted therapeutic success is the client's perception of feeling understood by the therapist, rather than the therapist's self-assessment of their empathic behaviour.

Thus the elements of assertiveness and empathy,  play vital roles in successful therapeutic alliance. Assertiveness involves articulating one’s needs, opinions, and feelings clearly, respectfully, and confidently, without resorting to aggression or passivity. On the other hand, empathy entails comprehending and acknowledging the needs, opinions, and feelings of others without passing judgement or dismissing them. By combining assertiveness and empathy, the counsellor can effectively convey their standpoint and interests while demonstrating respect and consideration for their client. This approach fosters trust, builds rapport, encourages mutual understanding, and helps prevent unnecessary enmeshment within the therapeutic alliance. 

Coping through Enmeshment in Counselling Setting

Recognising that enmeshment in a counselling setting can stem from dual relationships or other factors like countertransference and codependency is crucial. However, it's important to emphasise that enmeshment is not an unsolvable issue. With proper attention and intervention, enmeshment can be addressed and worked through effectively, here are some ways in which enmeshment can be addressed in counselling setting.


Contracting 

Contracting establishes the focus and trajectory of the therapy. Both the client and the counsellor must reach a consensus regarding the nature of the issue at hand. This process involves evaluating each person's ideologies and perspectives, as emphasised by Rosen in 1978 (Byrne, A. N. S. 2008). It requires an agreement on the client's objectives for seeking therapy. Berne (1966) elaborates on his approach, wherein he engages clients in discussions about their perceived issues, desired changes, and expectations from therapy (Byrne, A. N. S. 2008). He clarifies his therapeutic methods and collaboratively determines whether and how he can assist them in attaining their goals. The underlying rationale for such contractual discussions is to subtly shift the client's perspective on their issues from one of powerlessness to one of mastery.


The client enters into a treatment contract with both themselves and the counsellor. The counsellor's role in this agreement is to provide skills and expert knowledge to support the client in achieving their desired objectives. According to Rosen (1978), the client's goal should be operationally defined, involving specific behavioural changes, and it should be realistically achievable within a specified timeframe (Byrne, A. N. S. 2008). For instance, rather than stating "I will look for a new job," a goal might be summed up as "I will submit applications to at least five prospective employers within the next month." Finally, the anticipated outcomes and potential limitations of the therapy need to be thoroughly explored.


Intention Formation

Another crucial element that can benefit counsellors is effective Intention Formation. Intention Formation or Goal setting refers to the desired outcome that the client aims to accomplish by the conclusion of a therapy session. It plays a crucial role in establishing the course that both the client and the counsellor desire for the counselling process. Additionally, goal setting determines the pace and quantity of goals the client intends to achieve, distinguishing between those they prioritise and others that may be deemed impractical or too abstract to attain.

For example, a study by Hart in 1978, using a randomised controlled trial, showed that clients who engaged in weekly goal setting and evaluation with their therapist experienced significantly greater improvement compared to those without a specific focus on goal setting (Geurtzen et al., 2020). Recent research has further explored this area, suggesting that goal setting enhances the treatment process by facilitating the initial phase, guiding the treatment plan, maintaining focus throughout, and aiding in treatment evaluation. Additionally, goal setting helps establish goal consensus, ensuring that the client and counsellor share the same objectives. 

Supervision

Supervision is a formal arrangement where counsellors engage in discussions about their work with an experienced individual in counselling. The primary aim is to collaboratively ensure and enhance the effectiveness of the counsellor-client relationship. During supervision, several key aspects are addressed to enhance the effectiveness of the counsellor-client relationship. Supervisees engage in expressing both their concerns and pleasures related to their work. They openly share worries and difficulties with the supervisor, while also expressing joy in witnessing a client's progress and signs of healing.

Another critical dimension involves the thorough review of counselling sessions. Supervisees discuss the specifics of these sessions, exploring any areas that stand out as important or significant in the therapeutic process. Exploration of therapeutic relationships is an integral part of supervision. This entails a comprehensive examination of the dynamics within the supervisee's therapeutic connections, including considerations of gender, race, class, or disability, and assessing the level of openness and the sense of connection or distance between the counsellor and client.

Supervisees and supervisors work collaboratively to address obstacles that may impede the supervisee from being fully present, accepting, empathic, and genuine with clients. These aspects could also include countertransfrence, codependency, etc. This collaborative effort may involve addressing personal issues, managing discomfort with a client, or navigating differences that arise in the therapeutic relationship.

Lastly, one of the major reasons why supervision is essential is regards to focusing on ensuring the supervisee's adherence to ethical standards. This is particularly important as ethical dilemmas may arise, necessitating a careful examination of whether the ethical framework for the counselling profession is being appropriately followed. Maintaining appropriate boundaries is emphasised in supervision, and both the supervisee and supervisor work together to address any boundary issues that may arise in both therapeutic and supervisory relationships.

The principles highlighted in the earlier discussion hold significant relevance in nurturing therapeutic and professional relationships. The establishment of clear boundaries fosters clarity and transparency within the relationships. By delineating expectations and limits, both parties gain a comprehensive understanding of the nature of their connection. This clarity contributes to a sense of mutual understanding and acknowledgement, promoting an environment where both the client and counsellor feel genuinely heard and recognised. As a result, the therapeutic or professional relationship is fortified, and built on a foundation of openness and shared expectations. 

An instance of understanding a healthy relationship could be through the holiday-themed movie 'Catering Christmas' on Netflix, a reflection on the intricacies of life and the impact of dual relationships. The storyline involves Robert a long-serving estate manager to the philanthropic Jean Harrison. As the narrative unfolds, Harrison contemplates expressing her feelings and transitioning into a more personal relationship with Robert. In the finale scene of her expressing her feelings, the viewer can see her deliberate choice to release Robert from his original role as estate manager before delving into this newfound personal connection. 

This scenario serves as a reminder of the complexities of dual relationships and enmeshment in life. It highlights the challenges and considerations involved when navigating the boundaries between professional and personal spheres. The intentional act of disentangling from the professional aspect signifies an awareness of the potential impact of dual relationships on personal dynamics. It prompts contemplation on how our roles and connections intertwine, influencing the texture of our interactions and shaping the quality of our lives.

Thus summing up with the example above, one can understand that balance of empathy and assertiveness in a counselling setting is like adding the right amount of salt to food. Thus it's about understanding that your needs are just as important as the others and that you take responsibility for what you do and not what others end up doing, thus you don’t end up being pulled or pushed by their emotions.

Establishing and maintaining this healthy balance plays a crucial role in fostering trust and cultivating healthy relationships. Even when your actions may not align with everyone's preferences, the act of balancing assertiveness and empathy often earns respect for your commitment to your principles. It contributes to a sense of safety within relationships. When your personal space and privacy are honoured, there's a higher likelihood of feeling genuinely heard, validated, and appreciated.

Furthermore, clear boundaries ensure that you are not taken for granted by those around you, be it your loved ones or professional peers and supervisors. By delineating limits and expectations, you create a framework that promotes mutual understanding and consideration. Ultimately, balancing assertiveness and empathy serves as a cornerstone for building a therapeutic relationship founded on respect, trust, and a sense of shared appreciation.








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