TRANSCRIPT

Counseling Antisocial Clients: A Microskills Approach

Norma Gluckstern Packard
with
Ralph Packard
Microtraining Associates, Inc.
www.emicrotraining.com
info@emicrotraining.com
888-505-5576
Introduction
Allen Ivey, Norma Gluckstern Packard, Ralph Packard
A:
Im Allen Ivey of Microtraining and this is Dr. Norma Gluckstern. We have an important
videotape were about to present to you. One of the most difficult things that Ive had as a
counselor and therapist is working with the anti-social patient. Dr. Norma Gluckstern has been
warden of a major prison in Maryland and is really one of our national experts on dealing with the
anti-social our most difficult type of patient. So shes been both a warden and she is a counseling
psychologist. So Norma what do you have in store for us today.
N:
Well Allen one of the things as a result of what my work was I became aware while I was
initially trying to work with some of the patients, whether the clients and the inmates was a lot of
what I had been taught, got somewhat changed or converted or had to be dealt with differently
when I was dealing with these patients and with these inmates. And since microcounseling had
been my focus and I did my thesis in it, I began to look at what were the traditional skills that
really were somewhat different and some of them perhaps not as relevant in dealing with these
patients. In particular my feeling was that all of them suffered from anxiety, they suffered from
depression, they suffered from all the standard things that bring people into therapy. But the big
difference was they were referred. They did not come to therapy because .
A:

They dont have a lot of choice.

N:
They didnt have any. And that is what does impact on the way our skills are used and
how we can facilitate them. And so I hope that this tape will draw that out and thats sort of why
you and I decided it might be a good idea to try to do an anti-social tape, which really focuses on
communication. It does not focus on necessarily any set therapy. It really focuses on how are
the basic skills that weve all been taught, what happens when dealing with these patients.
A:
I want to talk to you a little bit about goals. What do you see the goal of basically the antisocial client/inmate thats referred to you? What are their goals in coming?
N:
Interestingly that you raised the goals because I think that is the first phase. Anti-social
patient comes to you its because theyve been referred. Theyve been referred by the courts,
theyve been referred because they have family problems, or perhaps theyve lost their job. So
they have one goal in mind, and that goal is how do I get something out of this counselor that will
either get back my relationship with my wife, will satisfy the courts. So they immediately are in
conflict with you because you as the counselor are there trying to get them to look at themselves.
And thats the last thing most of them want to do. So the goals become somewhat conflicted.
A:
And my experience has been too that they want to get something out of me rather than
want to be helped.
N:

And another part is how can I manipulate or maneuver this person to get what I need.

And so that usually is the first phase of interviewing with the anti-social client, is getting past that.
A:
So were about to see that first phase of the interview with a demonstration of key issues
and skills. What are kind of your goals in that first phase of the interview?
N:
I think my goal in that first phase is to develop some kind of a relationship. Something
where there is some willingness to interact with me at some level. I have no illusions that they
going not to try to manipulate me. I guess what I dont want them to do is to necessarily see me
as another authority figure and how do I avoid this authority figure. And thats a very mixed kind
of thing because its difficult and it runs contradictory to much of what weve been taught.
A:

So its a very different type of therapeutic alliance then.

N:
Its a very different and it has to be, which is sort of interesting, a therapeutic alliance.
But it is a different kind of alliance. And I think you put your finger right on that, and how we can
accomplish that, well we hopefully we will see this with the client that were going to use. The
other thing that I probably might want to bring out is that in this opening phase the skills Ill
primarily use will be the sort of basic attending and questioning. Because if I cant get through
that first phase Im not going to get into anything else.
A:
One thing as we wind up I think its important, what is the general theme in the case
youre going to have a demonstration or role-play on?
N:
In this case were going to take a 35-year old man whos been divorced. He went to the
local bar and encountered the boy friend of his ex-wife. They exchanged words, it based into a
fight and actually involved a gun and an arrest. And the client has been sent to me by the courts
for a period of 6 to 8 months and to see whether we can have him look at this dysfunctional
behavior and make some changes.
A:
Good. One thing that is important, this is one example that I think that is kind of
representative of a lot of things, whether you work with anti-social teenager, the same structure is
going to happen.
N:

Oh any kind of resistant client.

A:
Any resistant client. So I think one of the real advantages of this videotape is even that
work in a specific situation, a lot of skills, strategies, and methods are able to be generalized to
lots of difficult clients.
N:

Absolutely.

A:

Thanks Norma lets see whats going to happen

First Session
Counselor and client differ in goals
Counselor: establish a sense of trust and initiate therapeutic
alliance
Client: control the interview and ingratiate himself
Throughout this video, note how Norma must
maintain her own position and not allow herself
to be manipulated by Ralph. But, she must
also win his trust.
N:
Hi Im Dr. Gluckstern and I gather the courts have sent you here. If I look at my report for
something like 6 to 8 months for us to see each other. And I hope before we went on Id be
interested to know how come they sent you here, how you see the incident.
R:

Well I was hoping you could tell me.

N:

Thats a possibility, but .

R:
I mean I dont know why Im here. You know I talked to the judge and he says you either
get 2 years in jail or if you dont cooperate with probation Im going to put you in jail for 2 years, so
he referred me here over the probation department to come and talk to somebody and here I am,
and I dont know why Im here.
Non-judgmental question
N:
Well could you tell me what exactly was the incident that made the judge make that .
Classical denial
R:
Ahh that was nothing. It was a normal kind of argument between a husband and wife,
and the neighbor got nervous and called the police.
N:
The neighbor got was there more to it than this husband and wife argument. It seems
to me that was a little bit more elaborate on the case study.
R:
Well thats why the police came. And then you know one thing led to another and I
wound up in court.
N:
Were you I think thats interesting cause I think that was one aspect, but I also thought
that there was a scene in a barroom that .
R:
Oh that was afterwards. That was the second time they called the police, and because I
found out about this guy she had been seeing and I met him in a barroom and I tried to be nice to
him and talk to him, and things got nasty and he made a very bad mistake. And I hit him.
N:

He made a bad mistake?

R:
Yes he made it. It wasnt me. I mean its my wife. And you know he was running around
with my wife. I was just in there having a drink and there he was.
Search for concreteness
N:
Was there some words exchanged, or how did that happen?
R:
Well yeah we started talking, you know and I thought things were going pretty well and
then he got angry and I didnt do anything to make him angry. But he got angry. So I thought he
was reaching for a gun, and it turned out he did have a gun, so I hit him. I hit him fairly hard. And
I wound up in front of the judge again for that, and he said look there is no choice, you either go
for counseling or lets see if we can get to the bottom of this, or youre going to have to go to jail.
So Im here. Now I want to know Im interested if you can help me, and maybe do something to
make the judge kind of lighten up on the 2 years in jail.
N:
So you see my helping you would be to somehow get the judge or make the judge lessen
the sentence or at least accept the fact that youve come to therapy.
Ralph seeks to control
R:
Oh Ill be more than willing to participate and contribute, but Im kind of interested in what
youre going to do for me. If you can help me with the judge Im perfectly willing to cooperate and
help, but I need some kind of reassurance that Im going to get some assistance from you.
Recommendation
Summary of Ralphs goal
N:
Well youre saying what you want from me is that if you continue coming that somehow
by the end of the 6 months or 8 months that youre going to be here, that Im going to recommend
to the judge that youve done your time and to release you any further. Is that what your goal is?
R:

Oh that would be wonderful. Id like that yes.

In the next section, note how

Ralph continually seeks to
avoid responsibility.
N:
But what are you going to do to make that happen?
R:
Oh Im going to help, whatever you ask me, Ill be perfectly honest with you. Ill tell you
the truth. Ill be right out front with you, no problem.
N:

So whatever I ask you youre going to be truthful?

R:
Truthful, I wont lie. Im not here to Im here to try to help myself. I admit that. I dont
want to go to jail for 2 years. And Im willing to do you got to tell me what you want me to do.
N:
Oh certainly one of the things youre going to have to do is to come and maybe talk about
yourself. Is that something that youre interested in doing?
R:

Well if its going to help me yes.

Norma seeks behavioral concreteness

N:
So youre willing. All right. So we can explore your behavior and thats okay with you?
Do you feel comfortable with that?
R:

Sure if its going to help me, Im very willing to do that.

N:
Okay then let me ask a question. When did that happen, or how is it happened in the bar
before, because see Im looking at your case, and it looks like theres been some other fights in
which you had in the bars before.
Denial of responsibility
R:
Well you know I guess Im just unlucky. When I go places I dont mean any harm to
people, and I get talking to somebody and the next thing I know they get violent and I cant let
them get over on me, Im going to have to handle it, so I do. And I dont give them anything they
dont ask for.
Non-judgmental attitude essential
N:
Alright, so most of the problems that youve gotten into, which I look are substantial, was
other peoples fault, you sort of got roped into it basically.
R:
Yeah, I think I just happen to be in the wrong place at the right time. And you know I
dont mean any harm by it, I go in there to have a drink and to have a little fun and you run into
these people I guess in there. I dont know. Thats the best I can tell you.
Closed question/confrontation
N:
All right, so have you ever happened to bump into somebody like me before?
R:

No..

N:
So is that going to be different, are you going to sort of be always right and Im going to
be wrong?
R:

Well I dont know, thats hard question to answer.

N:

Thats a hard question?

R:
Yes it is. Its a very difficult question. I dont think that my record is that bad. Ive been a
victim of circumstances on a number of occasions. I dont take a whole lot of grief from people. If
somebody gets in my face, theyre in trouble. I mean I tell them one time, get away from me and
if they dont thats it. Thats it. I think thats fair.
N:

But Im not getting into your face. Because.

R:
Yeah, but youre going to do something to help me. These guys arent going to do
anything.
N:

So youre saying because you might get something .

R:
Well I assume that if after six months that the judge is going to get a report and I hope its
going to be you know in my best interests and thats what I hope we can accomplish here.
Defining relationship
N:
Well I know my role, but what will your role be in accomplishing that, because thats what
I think youre here for. And maybe Im here to be sure that that happens. But I might make some
demands on you, how is that going to work out?
R:

I dont know, Ive never had a lot of demands placed on me for too long.

N:

Okay, so thats going to be difficult.

Ralph sees interview as inquisition

R:
Yes. I dont handle demands well at all.
N:

Are you warning me?

R:

No, just being honest with you.

N:

Okay.

R:

I want to be perfectly honest here. I want to be straightforward with you.

Summary of joint goals

N:
All right Ill accept that, Ill accept what youre saying is straightforward. But I think that at
this point I would need to be sure that we understand and I understand your role. And I
understand your goal is to do your 6 or 8 months so that youll be released from the courts. And
my goal will be to insure the courts that youve done that properly. Now how does that feel for
you? How do you like that?
R:

Well right about now Ill do what I can to work this out.

N:

Good so we can kind of work some kind of arrangement?

R:

I do not want to go to jail for 2 years.

N:

Okay and I dont want you to go to jail for 2 years.

R:

So youre going to help me?

Norma stresses Ralphs responsibility

N:
Youre going to help yourself.
R:

Okay.

N:

That sounds pretty strange to you doesnt it, youre going to help yourself.

R:

Yeah it does. It does.

Now, the interview continues

Note Ralphs continuous challenge
and Normas focus on joint goals
Key clarification of goals
N:
Same time. And Ive got something?? I want you to do. Because if Ive got to eventually
write the courts that I think youre looking at the behavior thats gotten you into trouble through the
years, which it has, I mean you have to acknowledge that. That what I want you to do one thing
for this week, and think about, when you get that urge, when you begin to feel that youre being
imposed upon, when you feel that okay what right has he got to ask that of me, does that make
any sense to you or not. You dont understand what Im saying?
R:

I understand.

N:
Because everything thats happened to you has been somebody youre in a barroom
and something was said and you .
Ralph again denies responsibility
R:
Well somebody shoots their mouth off, they say something thats inappropriate, thats
wrong, and that reflects on me, and Im going to take issue with that everytime.
N:

Okay, so what I think Im going to ask you to do, cause its going to happen during the

week, is once try not to take issue. What would happen if you didnt take issue? Cause isnt
taking issue part of why youre here?
R:

Yes. Could be.

N:

What do you mean by could be.

R:

Well Im here because I was told to be here.

N:

I understand that.

R:

Okay, because I didnt have any choice really. Im here.

N:
Okay, so the difference being here, than when that happens in the barroom, is you have
some choices.
R:

I have choices.

Focus on choice
N:
Okay so one of the things were going to look at is have the choices youve made and
youve made the choices, have they paid off for you over the last few years?
R:

Yeah I think theyve paid off.

N:

Tell me how.

Still denies ability to chose

R:
Well I have a reputation you know, people know that when I go into a place that they
leave me alone. If they dont theyre going to get whacked, cause Im not going to take a lot of
guff from them, thats it. You know, and I dont go looking for trouble. Do not go looking for
trouble. I walk in, I want a drink, Im willing to talk to somebody. But if somebody gets on my
case you know Im not going to put up with it. I dont often tolerate that.
N:
you.

You said something interesting just now. That people know they cant take advantage of

R:

Sure.

Series of closed focused questions

N:
How did that happen?
R:

Well its been that way for a long time.

N:

Okay, how did it happen?

R:

I have no idea how it happened. It just you know, its just the way I am.

N:

Thats another question then. Do you like it?

R:

Well I dont like it right now because Im here.

N:

??

Watch Ralph make some

Self-exploration in the next
few comments.

R:
Im here and Im going to have to be here once a week for 6 months and no Im not happy
about that. I dont think that paid off for me, no.
N:
Alright so this is one time where youd say the kind of behavior didnt have a pay off, not
the kind of pay off you wanted.
R:

Yes. I would say thats fair.

N:
All right. So maybe in the end I think the judge is hoping that in fact there will be a pay
off. That by being forced into this situation and you were forced into this situation, you might think
again in situations that have gotten you into this position might change. Is that ???
R:
Its just I dont know of any more barrooms. I dont know if he didnt say you cant, but
he said maybe you shouldnt go to barrooms.
N:

Well if anything he said maybe you shouldnt go to barrooms.

R:

Well I dont know if he was joking or what it was about, but I remember him saying that.

N:
Well as I look down here I think the reason he said that is somehow when you went to
barrooms is when you got into trouble. Not because going to barrooms may be necessarily
wrong, but maybe what he was saying to you is that somehow in that barroom something
happens to your behavior. Something different happens when youre in that barroom.
R:

Yeah,

N:

Youre smiling again.

R:
Yeah, well its theres a lot of guys in the barroom that are somewhat like me, you know
and we usually have a lot of fun, but now and then somebody goes too far and something
happens. I dont think anybody means any harm by it, but it happens.
N:
But something harmful could happen. Like that scene where somebody might have been
hurt. Once that gun came out, somebody seriously could have been hurt.
R:

Well once I saw he had a gun that changed everything. Yes.

N:

And that could happen again

R:

Yes.

Normas reinforces his observation

N:
And so that may be an important issue for you to think about. Before we go a little bit
further, cause I think thats an important thing that the judge said to you, and that that is
something that you dont want to lock out going to barrooms. But maybe what you want to do is
how do I control when I go to a barroom.
Here and now relationship
You know our hour is almost up, what is your reaction, are you comfortable coming here working
with me?
R:

Im comfortable now that I know youre going to help me.

N:

Okay, so its based on..

Some progress in session

R:
Write a good report for me and the judge is going to look favorable on me, and Im not
going to have to go to jail. And yes Im much more comfortable that I was when I came here I
admit it.
N:
Well when did you get the impression that I was automatically going to write a good
report for you?
Still seeking control
R:
Well we discussed it, and Im satisfied that youll keep your word, and Im comfortable.
Norma keeps session on track
N:
My sense is that I never gave you the word. I said that providing we accomplished some
things I would write the
R:

Yeah, but I assumed were going to accomplish something.

Clarification of goals again

N:
Oh all right. And also the ground rules to me and so we get clear what the goals are, I
understand that I need that you need from me in 6 to 8 months something that says yes you
attended counseling.
R:

You didnt say 6 to 8 months.

N:

I did say 6 to 8 months. That was what it said in the .

R:

I thought it was 6 months. And maybe I misunderstood the

N:

Well the 6 months probably is up to me.

R:

I didnt have that report in front of me or I wasnt allowed to see it.

Clarification of goals
N:
Okay, the 6 or 8 months are in my report. But thats going to require that one of the
things that youre going to have to do is to look at your behavior and see the relationship between
your behavior and why you have a folder of so many minor ?? but that youve encountered the
law or youve encountered your employer. Something thats brought you some problems. And so
one of the things that I have to be honest with you, is Im going to make you look at that.
R:

Thats fair enough.

N:

You look like youre going to tolerate it right now.

R:

Im going to work very hard, Im going to try. Ill try very hard.

N:
All right, because Im going to have to try very hard. Im going to try very hard not to get
angry at you.
R:

Im pretty easy to get along with actually if the truth of the matter is.

N:

Youre also very good at coming across as a compliant kind of person.

R:

Oh absolutely. Yes. Completely.

N:
Okay I think weve accomplished enough. When you come back next week, if you go to
the barroom again, which you may think twice about doing as a matter of fact, but if you do, and

something happens in that barroom, can you control your behavior at any level? Thats asking a
lot on a first round. At least maybe think about it because you do have this thing hanging over
you.
R:

I understand. Yeah.

N:

Okay, well see you next week.

R:

All right, thank you.

Discussion of Session I

A:
As we do a little debriefing I think its important to say that Ralph Packard whos doing the
role play here so well has a lot of experience with this area. In fact he was a warden on the
Maryland House of Corrections, so thanks Ralph for doing this. You know these people like Ike
and provide a great demonstration. I think I might start thoughwell I think Ill start with you
Ralph. What were your impressions of Normas work?
R:
Well I think what struck me is how difficult it must be as weve had experience with
working with people that are able to manipulate you so well and to give you answers, but at the
same time not give you answers. And it was very hard for me to do that, but I did some of it I
can understand how difficult it must be for a counselor or therapist to have to work with people
who are so good at this kind of behavior. And it really kind of hit me more than I used to accept
the fact that I dealt with people like this on a day to day basis and became used to it. It was kind
of a survival technique, but I guess it kind of hit me what it must be like maybe I never
appreciated that what it must be like for a therapist to have to sit down one-on-one and try to do
therapy/
A:
Deal with those manipulators. Can you give us a specific example of where youre doing
a little manipulation and how you saw her responding which might have been useful?
R:
Well I thought that she stuck to the she kind of like moving toward what she wanted to
accomplish, which.
A:

She kept her agenda rather than .

R:
To get me to say that I was going to try to participate. I was going to be active, I was
going to try and contribute and that I was going to have to be there for so many months and if I
didnt then probably I was going to go back to jail. In other words there was kind of an implied
threat that she would write the report that my well put me back in jail. Thats the way I felt.
A:

So do you feel that she held her power?

R:

I think so.

A:

If she hadnt held her power what would have happened?

R:

Well I think I would have taken advantage of her. Yeah.

A:

Okay Norma what are your thoughts?

N:
Well I was conscious of trying to keep this focus on what he had to do and I recognized to
some extent I was implying that if he didnt he might end up going to jail. And at some level I was

10

worried that I would just become one more authority figure in his world, and how was he going to
manipulate me. And so what I was hoping that for the next era that we got together in the next
session, that I could establish more of a rapport with him where he would not I think he would
always see me as an authority figure, but maybe the authority figure he can trust. And it was
worth listening to some of the things sort of suggestions I might make. Like I asked him to look at
his behavior in a barroom. But I was concerned that I may have overstepped that bar and he was
smart enough not to be turned off because he knew I had this power. But I didnt want to use the
power in a way that would not allow us to establish a relationship.
A:

In terms of the microskills, listening skills and so forth, what are your thoughts on that?

N:
Well perhaps I wasnt thinking too much about them. I think I really was asking questions
and doing attending behavior. I dont think I did any of the other skills at this point. I think that the
initial interview was just trying to stick with those two
A:
Theres a major difference though at the same time the attending behavior you stay on
the clients topic, your attending behavior is youre laying out the topic.
N:

Thats right.

A:

Trying to get the client to attend while youre attending to that and not getting off track.

N:
It really was attending to my need without being obstructed to his needs, and thats the
conflict.
A:
So a different type of attending behavior. Its also a very different type of therapeutic
alliance. How would you describe the therapeutic alliance or is there one? Or is it building?
N:
Well the last route first. I mean I know what I was trying to establish with the alliance is
that maybe were more of on an equal footing as opposed to my being in a power position.
R:
Well I kind of found that sometimes some of the skills that you used on me stopped me
from going where I wanted to go with the conversation. And I had to kind of pull back a little bit I
couldnt get what I wanted out of that.
A:

Can you identify specific points.

R:
Yeah, if you narrow something out where somebody cant move outside that box then
you cant use I kind of like I was trying to create the role that the person I was trying to
create would be one that would use communications to get what they wanted out of the
conversation. And I wasnt getting that. I was getting close, but I was not getting it and it was
frustrating me a little bit and I was trying not to show it, but at the same time I was trying to find a
way to break through that. The theories, I think the theory of counseling would have worked more
in my favor. When she started using real like open ended questions and things of that nature and
then I would answer and she would ask another question, it would be a little different, be a closed
question, I found it harder then to get where I wanted to go. I had to think more about what I
wanted to say. It didnt create a free flow of information that I could give that would make me look
the way I wanted to look.
A:
Its a very different purpose to help you get on track openly. She needs to kind of hold
you on that track, rather than let you off. I was kind of intrigued with some of the discussions
around the bar. And I wonder how you reacted to those.
A:

antisocial client might react to some of those discussions.

11

R:
Well I think the bar question was one that the bar is kind of a place where anything goes.
I mean you can go in a bar and theres no real Queensbury roles in there of decency or anything.
You can be as wild as you want, you can say what you want. You can essentially do what you
want within limits. I mean not when it gets outside those limits, but she took some of that away
from me, or kind of restricted my ability to have that freedom and suggesting that maybe you
dont go to a bar, which essentially is what the judge was saying.
N:
But I think that in terms of what I was saying, if you do go to the bar, because I know I
cant really tell you not to go to a bar, then these are the constraints I want to put on you when
you go to that bar. And well in my mind not to say you cant go to the bar, but go to that bar,
thats part of you life, learn how to put some constraints on it.
A:
Now as you get ready for the second session, what type of set up do you need to set us
up for that? Whats going to happen, where are we going to be?
N:
Well I think what were going to be is really now going on were exploring a problem.
Maybe in a more personal what are his problems in terms of his behavior that he could perhaps
look at those, his behavior and how thats created all sorts of problems for him. And I would see
that as a second phase and that would be using some of the paraphrasing, we could look at the
issue of reflection, feelings, and maybe even somewhat confrontation and so forth. But not in the
problem solving, but more what is the problem, or beyond the fact that if you dont come and see
me youre going to go to jail.
A:

So this next brief segment will be about how it would be next week or two weeks later.

N:
Oh this would probably be maybe three four weeks later. Wed probably I would say it
would take a little while before we got to that point where he would be willing to say okay there
are some behavioral problems that Ive got to address.
A:
So basically those first three weeks are going to be some continuation of whats going on
here in this very short session. Thats still kind of a struggle for power and keeping him on track.
N:

Sure.

A:

And the therapeutic alliance is begun but kind of a long way to go yet.

N:

Long way to go.

A:
Okay, cant show it all in 20 minutes, so lets stop now and you can go on with the three
weeks later. Well see what happens.
TAPE 2
Second Session
A Delicate balance between confrontation and clarification: Exploring the clients problem
N:
Hi Ralph, let me just reflects, in our last session you said one of the things we were going
to talk about was that you somehow allow that you acknowledge that some of your behavior is
your fault. And you seem to be willing to confront that, am I right or .
R:

Of course Im willing to confront it.

Exploration of anger
N:
So that youre willing, so that you think that your anger may have been part of the reason
that some of these incidents took place?

12

R:
No I dont think so at all. Not at all. If people dont have respect me and treated me
decently I wouldnt react violently, theres no way I would do that. Im not that kind of person. I
dont want that to happen.
N:

All right, you dont want it to happen, but youve allowed it to happen.

R:
Well people make mistakes and they say the wrong thing and then I dont let it go by, I
dont let it go by.
N:
Were just going back over and over the fact that you wont look at your role in that fate,
that somehow I can allow you, I can create your anger. But it has nothing to do with you.
R:

I dont know what youre talking about. What do you mean by that?

Anger in the here and now

N:
What I mean is that if you get annoyed with me .
R:

Im annoyed right now.

N:
I know I can sense that, but youre blaming that onto me. Youre saying it has nothing to
do with the way you look at the way things are happening.
R:
Look Im here trying to cooperate with you, Im trying to help, I know whats at stake for
myself, and Im trying very hard. Yet you keep asking me the same questions over and over and
over again every time I come here.
N:

Whats the questions that I say over and over that are bothering you?

Ralph finally moves to self-exploration

R:
Well this question about like you know my behavior. Its like my behavior is so wrong.
Im responsible for myself, I cant be responsible for other people if they provoke my anger, its
not my fault. Its not my fault. I dont go out of my way to look for trouble when I go into a
barroom or when Im anywhere, at the supermarket or anywhere else. But if other people use
bad judgment and make mistakes, you know, Im not responsible for them.
N:
All right, if I agree with you that other people are making mistakes, but youre ending up
perhaps going to jail, whats the payoff for you in your behavior then?
R:
What does that mean? That in order not to go to jail Ive got to take crap all the time from
people. They can say whatever they want to me, they can push me around, you know they can
make a fool out of me, and Im supposed to say, oh Im not going to do this because Ill go to jail?
Thats not fair, does everybody have to do that? Why just me?
N:

Well I dont think just you, but not everybodys in jail. And

_R.

I m not in Jail yet

In the next section, watch

problem solving starts
while Ralph continues to resist
N:
Okay but thats the prospect that you have

13

R:

Yes.

N:
So what Im trying to get you to look at is to what extend you allow other people to control
your behavior, because thats what youre saying. Youre saying well okay I cant manage you,
youre going to get mad, youre allowing me to control your behavior. Youre allowing me to have
you loose your temper, do whatever you do in the bar, end up youre the one thats in court. So
youre giving me the power rather than yourself taking the power. Have you ever thought of it in
that way?
R:

No.

N:

All right.

R:

No I never thought of it in that way.

N:
Well lets hope that sort of quieted you down. I see you thinking or at least reflecting on
what I just said.
R:
So what have I got to do? I mean have I got to walk around like Im some kind of a wimp
or something and not say anything and stand up for myself and what I believe in? I cant do that
anymore, Ive got to give all that up because the judge thinks that Ive got to do it, or you think Ive
got to do it? I mean .
Here and now relationship
N:
Youre not hearing what Im saying that if I can make you get angry.
R:

Im angry right now.

N:
That Im controlling your behavior rather than youre saying like how come you cant just
say, well you know so thats what she thinks. Im going to go on to something else. What Im
saying is Im trying to make you think a different way because youre giving me the power. Im
not going to go to jail, youre going to go to jail if you loose your temper. So youre allowing me to
provoke you and Im just saying that thats another way to look at it. Youre thinking that because
I demonstrate my power, well Im just going to tell her off. Rather than saying well Im not going
to fall into that trap with her.
R:
Well I think Ive been very respectful of you, I come in here, Ive been making a very
strong effort to try to cooperate, how much have I got to do, how much more have I got to give up.
N:
Youre misunderstanding when Im using me, forget it, were not in a barroom. Im in a
barroom Im going to set a fight with you. Im going to call you names, youre going to slug me.
And so Ive controlled your behavior. Im just using me as an example.
R:

I dont think if I slug you that that means that youve controlled my behavior.

Reframing of doing nothing as strength

N:
I have. Because youre the one thats going to go to jail. But if I provoke you and you
just turn away and say what do I care, I mean Im not even going to get to his level, wouldnt that
be a different way of dealing and protecting yourself? Not that you necessarily arent irritated with
him, but number one is how I protect myself from doing something that Im going to get in trouble.
Ralph reflects on a new definition of manhood
R:
You know youre right, maybe I could do that. Maybe I could do that. Maybe I could just
kind of laugh and walk away. But what do I do if this person persists and follows up and
continues? What do I do then? Do I do it the second time, or do I hit him?

14

N:
I guess what youre asking, what I would do, Id say well what are my options. And how
do I come out of this better, cause Im not going to let this guy get me in trouble. And so if that
requires my just say leaving the bar, .
R:
Well word is going to get around real quick, you know, hey you can say anything you
want to this guy hes not going to go anything to you. Hes going to let it go.
N:

Well what if .

R:

Thats not bright.

N:
Then thats really important because what youre saying is if you do that youre giving up
your reputation. Youre giving up a piece of yourself.
Significant self-disclosure
R:
I may be giving up my manhood by doing that.
Paraphase of key word manhood
N:
Okay thats the so in other words if you change this behavior you have a vision of your
manhood that requires that you fight back, or an eye for an eye. And if you change that that
somehow its going to give up a piece of yourself. Is that what Im hearing?
R:
Yes. Thats correct, thats right. Absolutely. I wont be able to walk down the street. I
wont get any peace at all.
N:

But it goes back to will you get any peace if you get yourself into serious trouble.

R:

I didnt get in fights that often. Ive been in maybe 8 or 10 fights in three or four years.

N:
I know but those 10 fights youve had have been costly for you. Theyve been costly. I
think youre on to something. That is you give up this piece so maybe the issue is how much of
a piece are you going to give up. Is there something that you can do so that you still can maintain
your manhood, still feel good about yourself, and not have to get into a barroom brawl or
whatever it is? That maybe there are other things that you want in life that would make you feel
that youre a man.
R:

Give me an example if you can.

N:

You think about it.

R:
I have, I cant think of you have to stand up for yourself, youve got to
.
Search for Ralphs strengths
N:
But you see it only as physical, are there any ways I mean there are other things that
would make you feel good about yourself, besides the fact that youre a very physically strong
man, is there other stuff that would make you feel good about yourself?
R:

Well I dont know what.

Reframing, connects to concrete reality

N:
All right Ill get an idea because I heard you talk about how you admired somebody that
you had met when you were in the service who had gotten involved in karate. Or is it judo. I
dont remember, but you said here was somebody that was always in fights and what he did, in
fact you even said he was a big drinker, was find another way that would be not as destructive to
himself but still allow him to feel good about his manhood. Is there something that you might

15

enjoy doing that you would associate with manhood?

Note Norma now uses Ralphs word
manhood to facilitate change
R:

Yes thats possible.

N:

What sort of thing? I mean lets explore this.

R:
Well I thought of taking up boxing before just to maybe vent some of my energy a little bit,
or to let it out. Its a good form of exercise and its a release, yeah I thought of that.
N:
All right, and Im sort of listening cause I think what weve arrived at a little bit is that for
you to give up sort of these barroom brawls, that youd be giving up a piece of your manhood and
that manhood is very important for you. And what I have been suggesting is maybe theres
another way of still having your manhood but one that would give you satisfaction and keep you
out of any serious problems. And youre saying one of the things you thought about is going to a
boxing?? Is there a gymnasium where you can sort of have the boxing and sort of enjoy that?
R:
Well youre around different kind of people when youre in a boxing gymnasium youre
around people that are aware of what its all about. And they dont give anybody any grief and
they dont give you any grief, you dont give them any. Thats kind of like everybody is the same,
they kind of respect each other.
N:
So theyre also playing at something else, that I had thought wed gotten into was the
environment. Does the environment when youre in that boxing, when youre at that gym, its a
bunch of guys that are
R:
They work hard, theyre doing what they like, and theyre struggling to get to be better
boxers. They havent got time for any nonsense. So its a pretty easy place to be in, and not get
in any trouble. Most people wouldnt believe that I know, but its very true.
Emphasis on environment
N:
So youre saying that maybe one thing that would be helpful to you is to look at the
environment youre in, and is that creating some of the ??
R:

Maybe just in lieu of barrooms kind of like go in that direction a little bit. It might work.

N:
Because I think its important that you keep your manhood. I think thats a piece of who
you are. And the only thing Im saying is that theres a variety of ways of doing that, and in one
way because you are physical
R:
Im a pretty good boxer right now. I havent had a lot of professional training, but Im a
pretty good boxer in my own right right now.
N:

All right.

R:

So Id gain something, I wouldnt be giving anything up. Do I understand what youre .

Summary of key manhood issue

N:
No I think youre understanding and I think what Im trying to listen is that Ive understood
something about you that I need to understand how important it is for you to keep your manhood.
And if I can share something with you, its sort of like for women, I have a certain amount of
vanity. So I go and I have to get my nails and I have to take care, and thats part of being a

16

woman, and youre saying being part of manhood

R:
For a man you know if people are afraid of you, that means youve got some status, and
maybe being in a barroom and getting in trouble there, isnt the way of getting that kind of
respect. Maybe I could do it through boxing. People are going to know Im a boxer and the word
will get out.
N:

Theyll want to stay away from you.

R:
Theyll leave me alone maybe. Its very possible. Im willing to think about that. Maybe
give it a try. I could try that out and see how it works.
Exploration of anger
N:
Okay well is there anything else that you might like to talk about today, cause it seems
weve come to sort of . Because one of the things that were said was in this phase were going
to talk about figuring out what your problem was, and to some extent weve looked at that.
R:
I just kind of feel that in the short period of time that Ive been seeing you once a week
that something maybe changing as far as my anger is concerned. It doesnt seem to be oh so
deep when I get angry and I can kind of let go of it a little bit.
N:
Would you like to talk a little bit more about your anger and how you can I mean Ive
given you kind of a behavioral thing to do, but youre talking about maybe understanding your
anger or whats causing that anger.
R:

I dont understand my anger.

N:
Okay. Cause one of the things you told me about your anger is that it sometimes almost
gets to the point of rage and you could in fact fortunately youve never really harmed anybody
seriously, but theres a potential.
R:

No Ive never hurt anybody seriously.

N:
But theres a potential there. All right then lets explore the anger and rage and maybe
the way it would help me and maybe help you is identify when that happens is there something
specifically going on that suddenly generates that kind of anger that you can reach out and hurt
somebody or hurt yourself.
R:

Yeah.

Search for concreteness

N:
Think about it, give me a specific incident maybe if you can think of.
R:
Well I think I can give you one incident that happened to me not too long ago. I thought
this guy was trying to take advantage of me and I guess I kind of got angry with him a little bit and
kind of told him you know what I thought of him and he made a mistake and he got angry at me.
So he came out on the short end of it. But I guess people try to take advantage of you
N:

Be more specific about taking advantage.

R:
Well somebody that wont take no for an answer. You know like somebody wants to try
to sell you something and you tell them no Im not interested and then you know they keep
persisting. And if you tell them that what theyre trying to sell you wouldnt be caught dead with
anyways, theyd cop and attitude then. And then they get angry. Well thats you know, if youre
going to go out of your way to provoke somebody and they get angry at them you got to expect
that youre going to come out on the short end of it.

17

N:

Im trying to think. Ive provoked you, Ive forced you.

N:
You know Ralph what I want to know is Ive provoked anger in you, whats gotten in the
way of that? Because Ive done the same thing that guy in the barroom might be doing.
R:
Well but you know youre on my side. And youre helping me, so I dont really view you in
that way. I mean Im kind of very tolerant of whatever you say and what
N:
If I tell you cant manipulate me and I understood what you were doing, were going to get
back to this, because its very important that we understand your rage and your anger.
R:

I was not trying to manipulate you.

Relationship strong enough for humor

N:
Take that grin off your face.
R:

I was not trying to manipulate you. I was being honest.

Norma keeps her position

N:
Ralph weve been together a long time, and I can tell when Im being manipulated. But
lets leave this one, lets go back to this one when you see me next week, because it really is
getting to the heart of where youre at and whats happening to you.
R:

All right, Ive had enough for a while anyways.

Discussion
A:
I think as you know I was fascinated with right there at the very end of that segment
where I saw Ralph sort of taking you off target and what Id use would be snookering you a little
bit, and I was wondering what was going on with you when he started taking you off the topic and
so forth.
N:
Well I saw I had to get him back on the topic, I dont think I consciously thought of him,
interestingly snookering me, but sort of like loosing control of it was going to start to wander. And
I had to get it back, more focused and think I made the attempt to say well weve really got to get
back to that. Give me some specifics.
A:

Youre smiling when you said that.

R:
Well I knew exactly where I was going with that, and then I realized that after I tried that
move that she was not going to fall for it and was going to bring me back to the center again,
which she did.
A:
So in a way were back to the whole central thing and the first thing is the therapist really
has to control the topic in the broad sense.
N:
In the broad sense, because there is I think it presents a problem dealing with particularly
people that are anti-social or have been referred by the courts. Because you are seen as a
power figure and you dont want to be seen as an authoritative figure, you dont want to be seen
as a disciplinary figure. That somehow you want a positive picture of yourself and thats a narrow
line. Whereas I think when you go to regular counseling you want the therapist to take some
control and help you. And I think that always bothers me when I get very directed is he or is she
going to see me as just one more parole officer, one more judge, one more authoritary figure.

18

Sets a balance.
R:
I think that trying a bonehead move like that on my part was a kind of maybe a test or to
see if our trust level was going to hold up, and I think it did. And so but I think I tried that to see if
you were going to turn on me with that one.
N:
And I also think that what you just said is important that with all this interaction and some
of this confrontation there was a trust level that will keep that relationship together and not
alienate it.
R:

Well I have a stake in it definitely, thats clear.

A:
And over time with an antisocial client you can start really bringing in humor. Hey there
Ralph youre pulling that again! What do you think about that?
N:

And theyll accept that cause theyre ?? an ally. ???

R:

You caught me yep.

A:
That happens. Again I saw one thing I want to ask is some of the stuff youre saying
kind of heads towards issues in anger management. Would you do anger management yourself
or would you refer out for anger management or would that even be a part of the whole treatment
process?
N:
Well I think that if we were in a regular it should be part of the treatment process. It was
here that were really sort of more focusing on the communication and not on setting any kind of
a therapeutic process, but I certainly think anger management would be in there, just to some
extent where Im giving directives and we are sort of applying some cognitive material. But
absolutely anger management would have been very important.
A:
I think one part of anger management is learning helping Ralph for example to get in
touch with his feelings and recognize it before he gets overwhelmed. ?? behind him where you
were hitting.
N:
And that is certainly and I think was when I got the rage and I was trying to get to that
point where he then and in some sense maybe why he maneuvered me off that.
A:
And these are very scary talk for counselors because were nicey nice sometimes and
dont really want to deal with anger. Its a topic where I think counselors and therapists are often
quite uncomfortable.
N:
And Id like to bring up a point that if you read any of the literature one of the things that
theyre saying is that everybody cant counsel these clients because that may put them in a very
uncomfortable position, not really how they see them. So that youve got to be able to almost put
on the boxing gloves with them.
A:
And the thing is, if you talk about the manhood issue, if Im sitting counseling you and I
get a little fluffed, theres a chance for you to prove your manhood over me, and Ive had that
happen to me with anti-social acting outside the concept. They end up in charge of the session.
If theyre in charge of the session then theres no session.
R:
And also if a counselor becomes concerned about losing control of the person in
counseling and then they retreat to trying to be a very academic with the person, that can really
piss somebody off. Yes, I know it could me. It would really irritate me. But the fact that she
talked somewhat on the same level I am willing to talk, is a cushion. Where if there was that
supremacy conversation up here coming down, I dont think I would do well with a person like

19

that.
A:
Special observations you have from the session. Your objectives and how well you felt
you achieved them.
N:
I think it went well. I felt to some extent that I didnt have quite the handle that I would like
to have on my client. And maybe that was good, I dont know. But that was sometimes I get
focused on my objective and somehow he was able to sort of take me off course. And allowing
that to happen was important, but it did create some anxiety in me. How was this going to work
out? And always hanging over, am I going to lose him, am I going to lose the rapport.
A:

Thats always possible in this type of relationship.

N:

In this kind of relationship am I going to lose the rapport.

A:

And Ralph, what about you, what are some of your reflections?

R:
Well I think that the ability to be able to be on that common ground and discuss some of
these issues without reducing them to terms which are unacceptable gives you if there is any
wiggle room in a person that functions the way that Im trying to act, gives you a chance maybe to
say, maybe I can change my behavior. I can at least try and its not threatening in that way. Its
something you maybe after a while begin to think is doable. I think I can do this.
A:
I found when the anti-social client gets a little off track with me, Id better say Im off track
because theyve gotten me off track because going back to what are our joint objectives.
R:

Well she did that one time, which helped.

A:

It helps to keep the focus. You kind of agreed openly ??

R:

Quiets things down a little.

N:

There is a common goal and I share that common goal with you.

A:

So lets return to that base. I think thats really critical.

R:
Yeah, when I said to her Ive got a stake in this and you have too, I guess I kind of meant
that when I said it. That there was something for me and something for her.
A:

She gets to keep her job and feel good about herself.

R:
Job, pay. And I want her to write a good report and that was the other thing I was saying,
write a nice report.
A:
You do have a good joint goal. So what shall we look for in this third session? Where
are we going to led?
N:
I think the third session is were coming to some finality. Im going to try to give some
directives because I think it will help him as he returns to society. I dont think well get into much
interpretation, maybe trying to get him to maybe look somewhat at his behavior and how its
changed. But bringing some closure to whats going on and allowing him to feel comfortable in
coming back. To maybe explore and maybe at another level that he fulfilled .
SESSION THREE

20

Closing Session Five Months Later:

Client and counselor goals both met
Exploration of other issues
Encouraged to maintain therapeutic alliance for future
N:
Okay Ralph were coming down to really the end of almost having fulfilled what the
judges expectations were. Theres a couple of things Id like to talk about. One did you ever end
up two things. One about how you feel about the boxing in the gymnasium and weve never
really talked about whats happened with you and your wife. And so Id like to maybe deal with
those two things before we bring closure to this.
Ralph has new outlets for anger
R:
Well I did go to the gym and I spent a few weeks at the gym and as you know and it was
okay, but I realized that maybe that wasnt the answer either. So I looked for other things. And
one thing I found was while I was at the gym they had a pool near there and I started swimming a
little bit and I got very interested in that. And I swim now two or three times a week. And I like it.
It drains energy from you while youre doing it in a very strange way, but when you rejuvenate you
kind of feel relaxed. Im enjoying it. And so I think Im going to probably keep that up. Boxing I
dont think Im going to follow up on that much anymore.
N:

Okay that sounds excellent.

R:
And Ive also started jogging a little bit more. That came out of boxing, but I started
running and I dont think Im going to give the running up. I think Im going to keep running and
Im going to look for a couple of other things to do from a physical fitness point of view which
might help. And I dont know what they are now, but Ive got a couple swimming and jogging and
Im going to keep those up. And Ill maybe add some other things to it.
Reflection of feelintg
N:
Sounds like that you might be feeling good about yourself.
R:

Well I feel better since Ive been doing those things. Yeah.

N:
All right. Well Im sure that thats going to be interesting in the report. But then lets go on
a little personal thing, because we really havent discussed very much whats happened to your
own personal relationship.
R:
Well my wife came back and weve been together now for some time and were trying not
to keep a record, were just trying to go day by day. And were getting along a little better than we
have and we decided that when we get near the point where were going to get angry at each
other we stop and kind of cool down and walk away for a while and then come back and pick it up
again where we left it off and try to talk about it in a more congenial manner. It seems to be
working, were getting along much better and I think that Ive realized that I control some of my
anger by doing that.
N:

By walking away.

Ralph gains insight

R:
Walking away a little bit and thinking about what happened and not being always blaming
the other person. I kind of say well maybe you had something to do with it, and accept that. It
seems to work a little.
N:

But it seems to me youve also helped her, because youre saying that shes also learning

21

how to control her anger, cause thats what Im hearing. That its not just been a one-way street
for you.
R:
Yeah, well she hasnt thrown any food at me lately. So I think were getting along much
better and its much more peaceful.
N:

Do you think youve helped her somewhat in that?

R:
I dont know. I just am glad that its happening. It feels good, its much better than being
angry all the time.
Self-control defined as manhood
N:
Interesting because one thing that often happens if one person changes their behavior, if
you sort of see what youre doing, it helps that other person changes their behavior. Unknowingly
and not because youve done anything, but youve influenced her in a way that has helped her
and so in some sense by having learned how to control your behavior, youve helped her. And
that should make you feel good about yourself and your manhood.
R:

Yes. Definitely.

N:

And so its going well with her and kids, is it working or

R:
Oh yeah, the kids are great, and were both getting along better with the kids and doing
more with them. So its worked out very well. And I dont want to say too much about it.
N:

You dont want to talk too much about it.

R:
No because its going so well I dont . Im just happy that I dont know what caused it
or how it happened, but its happening. Happening.
N:

For the relationship or because of whats happened the change in you?

R:
Well I dont know if theres a change in me, like tomorrow I could lose my temper and hit
somebody.
N:

Lets not rock the boat is what youre saying.

R:
Im willing to keep going like this and just see how it works out and Im trying to do that
and Im looking forward to getting back to court.
Here and now confrontation
N:
Im tempted to ask you because I know how good you are, do you think youre
manipulating me right now or you think this is for real?
R:
No this is for real. Im very pleased with I think with what both of us have done. I think
its worked well for me.
N:
Well Im pleased in seeing some of these benefits. I guess what I want to do and I dont
want to put a cold blanket on anything is I want you to remember what it was like even when you
find yourself loosing it, ?? or being able to pull back hold yourself accountable and think
through what ?? has meant to you. I think if we had more time and thats something you want to
think about, because getting rid of anger, how to manage anger is not always that easy. Maybe
its been not that difficult because weve had the opportunity to talk. But maybe at some point you
may think that you need to explore a little bit more how to manage your anger more effectively.
R:

Id be willing to deal with that after I get things straightened out with the court and if it

22

comes out the way I think its going to come out, then I would be probably interested in doing
something in that area.
N:
Well I hope so and I hope that maybe you can come back here and we can do that. But I
feel quite comfortable in writing my report to the judge. I wont go into any detail of what weve
said, but simply that I think you have made every effort and are going to continue.
R:

Maybe you could tell him Im not a threat to society.

N:
Youre obviously not a threat to society. You want that in? I dont know about society,
but youre not the threat to anybody in a barroom anymore.
R:

I hope not.

N:

Are you still going to barrooms?

R:

No.

N:

Oh so you really have eliminated that also.

R:

Well its not a good place for me

N:

All right so thats a very

R:

To control anger I guess, not a good place.

N:
All right but I would say that thats a major accomplishment on your part to recognize that
that environment because we talked about environment before. Was not a healthy one for you
and that there was no point in putting yourself in that potential.
R:

I would like to think of it as just maybe its a place that is not in my best interest.

N:

Thats good.

R:
Where theres not too many people in the swimming pool that are going to argue or start
a fight with you with youre there swimming laps. And theyre pretty preoccupied with what
theyre doing. And the same with the jogging. You meet a jogger, you talk to them if youre not
out of breath, but you know nobody is interested in starting any trouble with you. I think its got
something to do with environment.
Modicum of change for the antisocial client
Rewarding experience for counselor
N:
And I want to encourage you and I want to give you credit for being able on your own to
understand that a barroom may just be an area that you are not going to put yourself into a
position that could possibly get you in trouble. That is a very I think a manly thing to do. Its an
acknowledgment of something about you. And not in some ways that you know Im not going to
be able to change that. And so I guess what Im trying to encourage is feel good about yourself.
Good about what you changed in your own behavior and that only you did. It wasnt anything that
I did or the judge did. Ultimately you had to take responsibility and I want you to feel good about
the fact that youve been able to take responsibility for your behavior and say I dont want that
behavior to get me I want to be able to live my life without having to be threatened by the
courts or by anybody else. And that you did that.
R:

Okay.

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N:

Are we almost through?

R:

Yes.

N:

Finished?

R:

Right.

N:

Goodbye.

R:

Goodbye.

N:

And if you need me again call.

Tape 3
Discussion
A:
And so we have a happy ending. As have I had experience with these types of clients
Im learning is it really that easy.
N:
No, I think we accelerated this and its not that easy, but it can to some degree theres a
certain amount of modicum of change of behavior that can allow the anti-social personality to live
a life which doesnt require his going to prison or jail. And hes still going to have his fights but its
some control over behavior. And the other thing of course is simply age. That as you mature
they just get too tired of doing that sort of thing.
A:
One thing that I really heard was a consistent message of he wants to have his manhood,
he wants to have the strength, and in the progress of this therapy hes still got his manhood, hes
got his strength, hes got new ways to identify that strength. Is that right?
N:
Absolutely. And that he should take credit for that. I felt I wanted him to take credit for
his change in his behavior. And not give it to somebody else, that that was part of his strength.
And that he can change his behavior if he has too.
A:
So were really kind of back to that working alliance, is that hes got his goals. Youve got
your goals, and everybody needed to stay on the same track the whole way through, and if you
got off track you were going to be in trouble.
N:
I think the issue in doing a tape like this is we really couldnt get into any of the
therapeutic aspects. I was sort of thinking that we touched on his manhood. Its a belief that in
manhood you have to be able to fight. And I think had this been more of a cognitive interaction
we might have talked about his beliefs in manhood. What it requires, what it is to be a man. And
its certainly the fact that he moved from going to the boxing ring, which is a violent kind of thing,
to something like swimming, something like jogging, was more change in his belief system. But I
just felt that we were not it was attempting to start going through a therapeutic alliance,
because I think it was important that you shifted from boxing to jogging, to swimming, which really
was not a violent sport anymore. And that your change and your belief of what makes a man
began to change.
A:
And that just physically the whole business of what happens in the body with the
exercise, is similar to whats happening in the body, rather than external drugs and controlling
what happens, hes controlling, producing his own endorphins ?? and all those good things.
N:

And I think that probably in terms of behavioral, like the anger management and so forth,

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that sort of is the goal, where youre going to go once you can break through and establish the
relationship, you can then begin to look at some of what is the best therapy or process to make
you change. And we really didnt get into that with what we were going.
A:
And in that sense if you do the anger management we kind of go through a standard
anger management program, we get into the cognitive change, we start looking at Erin Beck and
Ellis and you would follow those standard programs pretty much the same. But the purpose of
that is not necessarily self-actualization, the purpose of that is stay on that original track of how
were you going to stay out of jail, and it always has to be done ?? or its going to be why am I
bothering to learn this stuff. Always have to stay on that track. One thing that Im just curious
about is the question from your experience of a lot of these types, what role does medication
have with patients such as this?
N:
Well I think that basically medication has not been other than with borderline,
medications not been terribly satisfactory. Well you have schizo and so forth you may put some
medication, but generally thats not been the problem. There was an anti-social they fight off
the anxiety, depression, we dont even get into those feelings, but they really are more concerned
in solving their problem and if they solve their problem then somehow they push the anxiety and
depression away.
A:

You think that theres need for the does depression become a factor sometimes?

N:
I dont think that they get you know if you get into just sort of interesting is that we
did more which is just total rejecting now of the psychoanalytical approach, that there is
sometimes if you get, Im thinking of severe cases where this young man had killed three
children, and when we got him to deal with that, and really become in touch now developing a
sense of guilt, developing a sense of empathy, he hung himself. And one of the things is that
empathy is a horror for anti-social because they dont experience empathy. I mean they are the
focus. But if you do get somebody that committed a very severe crime, then you run the risk of
our joke has always been if we can make them neurotic we can make them healthy.
A:
Its kind of like the great strength, I always like to think what are the strengths in this
various personality types, one of the great strengths of the anti-social is they are energetic. And
in some ways theyre fun and theyre interesting. And what we can do with that is some of the
stuff that came out of this is that we worked with his energy, we worked with stuff that was fun
and he maintained his interest.
N:
And I mean if you think about it some of the very successful business men in this world
have certain characteristics, its not the pervasive one, I mean thats the difference between
maybe what we call an anti-socialist, dealing with the law kind of thing, but they have certain
characteristics. We want certain characteristics ??
A:
Certainly there are some very prominent people in business and politics that engage in a
lot of those very same type of behaviors. They may not be hitting in fights, but they are very
much taking care of their needs and manipulating. And the strategies used here with the
therapeutic alliance are just the same. Youre working with a narcissistic person working on Wall
Street a lot of the same strategies are really important and ?? cause theyre going to try to get
you just off topic just as much as Ralph might.
N:
Right, but as I said this was only a demonstration. Maybe more the focus on the
counselor and what happens to them in an environment, rather than the therapeutic, whether
Ralph will have changed but that would require I think a more focusing on some kind of
therapeutic process, whether it be anger management, cognitive behavior, or even Glasses work.
We were really focusing along the communication.

25

A:
And what I get out of this, what I would take home from this, is kind of what I knew before
from experience but is clarified for me, is the real need for the therapist, counselor, interviewer to
maintain control of the topic. But you kind of broaden that with, I can go and maintain control of
the topic if theres room for the client, for the patient, for the inmate. And thats the way you get
your alliance, is basically on the joint. Theres a different way to go about therapeutic alliance.
Thats a powerful learning for me.
N:
And to some extent I think that cognitive behavioral and so forth in that the therapist is
taking control and saying look there are certain directives, there are certain things youre going to
have to do, if were going to continue. Now I may not have of all the ten directives I give you, you
may only take two, but youd better begin to learn to do that. So if you think about the therapeutic
processes that were being used now with these types of individuals, it is that the therapist is
taking more and more control.
A:
Thats a big message for people that we want the client to take control, but the therapist
really needs to be much more in charge. What are your thoughts on that Ralph?
R:
Well I found myself getting caught up in the role a little bit, and it was kind of a relief to be
able to say Id done some other things besides going around barrooms punching somebody,
getting into difficulty. But it was almost like a great sense of relief to be able to do that. And I just
wonder if maybe people really enjoy that when it happens. They change their behavior a little bit.
Start thinking a little different, looking for other alternatives to respond to. The kinder and gentler
society out there, that maybe its helpful to them and they learn how to deal with those issues in a
better way than they have before. It was not fun for me to keep talking the way I was talking
about those things. So when I got around to bringing this to closure, from my standpoint, it was
kind of like a exhausting a big breath and saying wow this is great to get out of this and I guess
Ive never dealt with that before.
A:
A new way to reach old objectives. You remind me of a fellow I was working with and he
was an in-patient in a veterans hospital, but he was there because he was manager of a fast food
change and he had one way of dealing with his employees, was to whamp them. Finally hed hit
enough that they sent him off to the hospital. So as I talked with him, I said what do you want to
accomplish? And he said, what I really want to do is control and manipulate people. I said okay
great, Im going to teach you how to control and manipulate. One thing a way you can control
and manipulate is you start listening to them, find out what they want. So I ended up teaching
some of these microskills of listening and attending. And he was happy as a clam. He can still
control, but in the process of that, hes just like you, hes going to get new ways of achieving his
objectives of feeling good about himself.
R:
Well that reminds me of a story that my grandfather told me years and years ago when I
was very young. This is a true story. I came home one afternoon and I had been in a fight in
school and Id not fractured one of my knuckles, but I had severely bruised it, took the skin off two
or three others. And he asked me why I was looking like I was a little down at the tooth and so I
told him, I said I got in a fight in school. And he said really, he said do you usually get in fights in
school. And I said well once in a while. He said give me your hands. He took my hands and he
said wow, that one dont look too good there. He says the skins gone off this one, he said do you
realize that if you hit somebody at least once a week what your knuckles are going to look like in
ten years. And I kind of ?? Yeah youre right you cant punch your way through life. That was a
very . Ill always remember that. Ill always remember that story.
N:
The one other issue I think Id like to raise is that for the counselor, can we tolerate these
clients as persons. Is it so in conflict with what our values are? Because theres also an
interesting thing that I think counselors have, is that a vicarious thrill. That here sits somebody
who can defy the social of life and do the things that maybe they fantasize doing, having no
constraints. Now the counselor also ultimately knows what that gets them into, but there is a
certain amount of voyeurism in people working with the anti-social, the person that ignores the

26

social standards.
A:

We would all like to toss ??

N:
Its sort of almost like huh, that sounds like fun. And fortunately for us we also
understand that thats the other end is I had a case study somebody could go to jail. But there
is that kind of almost enjoying their behavior because youve never been able to behave like that.
A:

Final words from either of you?

N:
Well I hope for any of the counselors that have been watching this that its been helpful.
Im sure weve left a great deal unsaid and clearly this was not your typical client. But I think you
played the role very well. But I think we did identify the kinds of issues that you as a counselor
will face as you go in, because theres more and more studies being done on at risk youths, more
and more what they call re-entry programs, that youre going to face. And more and more family
violence. And so these clients are going to be sent to you. And I hope that in some ways weve
helped out for you to look at this in a slightly different perspective.
R:
Well all I can say is that its very difficult playing a role like that. And like I said it was a
tremendous relief to bring it to an end and say you know Ive made some changes in my
behavior. But it must not be pleasant to be really in that kind of circumstances and believe it. So
its a good thing if someone can .
A:
Its interesting and a paradox the desire for freedom and do whatever they want, boom,
theyre trapped and encapsulated almost more than anybody else.
N:
They cant deal with their anxiety, they cant deal with their frustration, they are
encapsulated. Its really interesting.
A:

So we can liberate them by an effective therapeutic alliance.

R:
yeah.

Well they can see it would take some time. But its something thats probably doable

27