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My blog for health care providers using MI about the process of change!

Reflections: What To Do With the Need to "Get it Right"!!!

Some of the most common questions I receive during my Motivational Interviewing workshops are based in the fear of reflection. The fear of “getting it wrong” or even worse, emotionally harming or offending the client.
 
Many clinicians fear that the client will perceive the reflection as a statement of agreement rather than statement of understanding. Some clinicians worry that using a reflection that will "fall flat" with the client. The fear that the client will respond with a short or one-word answer such as “Yep, that’s right” or “Nope”, followed by silence and lots of crickets in the room.
 
Here are 3 blurbs to help you think a different way about reflections, with references to quotes from Carl Rogers’ writing on “Reflection of Feeling”.
 
1.  A reflection is just a reasonable guess.
 
A reflection is just a hypothesis with the goal of trying to understand what the client is thinking or saying. We use SO much data to form a reflection (i.e., client’s posture, affect, physiological signs, language, sighs, grunts…just to name a few) to make just a reasonable guess about what is happening for the client in the moment.
 
Carl Rogers once said:
 
“I am trying to determine whether my understanding of the Client's inner world is correct--whether I am seeing it as he/she is experiencing it at this moment. Each response of mine contains the unspoken question, ‘Is this the way it is in you? Am I catching just the color and texture and flavor of the personal meaning you are experiencing right now? If not, I wish to bring my perception in line with yours’”. 

He goes on to say, “So I suggest that these therapist responses be labeled not ‘Reflections of Feeling’, but ‘Testing Understandings’, or ‘Checking Perceptions’”.
 
If nothing else, clients appreciate our attempts at trying to understand their inner world, which strengths the emotional bond. Even if we under-reach in our reflections, this creates an opportunity for the client to correct us and to clarify what he/she really intended to say.

2.  Reflections help clients to organize their thinking and deepen meaning about what they’re saying.
 
As helpers, we are able to hold up a mirror and use reflections to help clients hear what they’re saying in a different kind of way. We can also use reflections to help clients process what they’re not saying to advance their understanding or development of meaning. Rogers says, “The feelings and personal meanings seem sharper when seen through the eyes of another, when they are reflected.” 
 
Here, Rogers captures the spirit of reflections: a selfless curiosity. The curiosity is based on compassion. We set aside our judgments and pre-conceived notions, enter deeply into someone else’s world in the moment, in order to facilitate mutual understanding of perception and meaning. We can use reflections to align and walk with our clients down the path of self-discovery.
 
3.  Let there be silence! 
 
Throughout my graduate training, we were encouraged to allow silence to surface in session. Welcome it. Go with it. Sit with it and see where it takes you and the client.
 
Silence also teaches the power of mindfulness, as it allows the client to stay in the present moment before rushing to the next thought. Silence gives the client the necessary space to further process what was just said and to hear his/her own voice or feel what surfaces between moments. Silence can be used to organize the next intention or thought.
 
This is also grist for the mill!  Some of my deepest conversations with clients have been tied to the experience of silence. We can use open-questions process to generate more information to reflect and process:
·      What’s happening for you right now as you sit in silence?
·      How are you using this silence?
·      How did you experience silence at home and how does that play out here?
 
For some clients, silence means punishment or emotional abandonment, so it is important for the helper to be transparent his/her intention for using silence as an intervention. Remember to reflect, reflect, reflect!!!
 
I hope these blurbs spark thought or discussion. How do you effectively use reflections and silence with clients?

Citation: Rogers, C. R. Reflection of Feeling. Retrieved from: http://www.institutohumanista.com.br/ReflectionsofFeelings-comentariodeRogers.pdf, 2016

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