Live and Help Live
by Lee Etscovitz, Ed.D.
Everything I have been writing in this column since it began over two years ago has stemmed primarily from my experience as a transgendered person. Every article has been an example of my ongoing effort to make sense of my gender journey. I have also drawn on my experience as one who sought counseling along the way as well as on my more recent experience as a transgender specialist who in turn counsels other persons trying to make sense of it all. My prior doctoral and post-doctoral training and my professional experience as a professor of education involved a great deal of work in the area of human behavior and human relations. So now I am applying my knowledge and skills to the transgender area. It is thus, out of both my personal and professional experience, I have begun to develop some ideas as to the nature of the counseling process.
There are at least three ways in which a counselor can view the helping process and at least three ways in which a client can experience the receiving of help. One way is the "live and let live" approach, a laissez-faire attitude on the part of the counselor which involves a great deal of listening without offering much, if any, commentary. It is true that simply listening can help to bring about some measure of catharsis on the part of the client, a kind of confession and cleansing of one's soul, if you will. Such an approach is also non-judgmental, for the "live and let live" counselor rarely, if ever, expresses an opinion or judgment.
But what about a client's frequent need for feedback, opinion, and guidance? And what about the need for some kind of real, felt relationship, if only as an aid in the exploration of oneself as a transgendered person? Self-recognition and self-acceptance can grow out of the opportunity to talk to, and to be heard by, a receptive counselor. But a counselor who operates in the "live and let live" mode is usually minimally involved with the client. There is little damage done to the client, but there is also little help received by the client beyond, of course, the fundamental self-recognition and self-acceptance just mentioned. Given this "live and let live" approach, can the client also integrate his or her life? Can he or she begin to deal effectively with his or her body, with feelings, with the web of human relationships, and with the need for hope and courage as a transgendered person in a not always friendly society?
A second way in which a counselor can view the helping process involves a "live and make live" approach. It is this approach which I see as being most prevalent and at the same time as being potentially most damaging to the client. This approach tends to be judgmental, both implicitly and explicitly. Explicit judgments, both positive and negative, tell the client what he or she is, at least in the eyes of the counselor. For example, a client may hear that he or she is definitely a transvestite but not a transsexual, that is, a part-time crossdresser and not a candidate for full-time transition. Whether the counselor is right or wrong, the fact remains that the exploration of inner feelings has been closed somewhat, and now the client faces the task of trying to deal with the counselor's judgment instead of his or her own feelings. It is true that the counseling process does, and should, involve professional opinion, especially when the possibility of body-altering hormones and surgery are involved. But should the client pay to be fighting the counselor instead of being helped to explore these possibilities? Whether the client fights or passively agrees with the counselor, the resulting relationship is just as one-sided as that in the "live and let live" counseling process. In both modes there is not much two-way communication, at least not at any deep or significant level.
Judgments on the part of a counselor can be implicit as well as explicit, or indirect as well as direct, and still have the effect of putting the client on the defensive. For example, a counselor may say to a client: "You should learn to like your assigned gender, the gender assigned to you at birth." That is an implicit judgment for it implies, but does not openly state, that the client is, or should be, a part-timer, a transvestite, and not a full-time transsexual. Again, whether or not the counselor is right, the client is not being encouraged to make sense of his or her own gender experience but rather is being forced to deal with the counselor's point of view. It is as if the counselor is trying to make the client "be" a certain way, with or without the client's genuine, deeply felt, consent. Sooner or later the client finds that he or she is led away from encountering a true sense of self and is led, instead, into coping with the counselor's opinion.
The "live and make live" approach reflects at least two aspects of our western culture. First, though we live in a democratic society, the fact remains that we are used to listening to the voice of authority and the voice of the expert. Sometimes that voice is overbearing, other times it is gentle, but in both cases it is still the voice of authority. And since it is usually the counselor who is the one to sign a letter allowing a client to proceed to hormones and surgery, the sense of counselor authority is reinforced.
Second, the "live and make live" counselor can keep his or her personality at a safe distance from the client by engaging in a somewhat one-sided relationship. In other words, the client shares and the counselor judges. The counselor thus does not have to risk his or her expression of feelings in the context of a counselor-client relationship. Instead, procedures and categories, not human interaction and human involvement, become the basis for the whole counseling process. And yet it is this form of counseling which prevails.
What, then, am I suggesting as an alternative to the "live and let live" and the "live and make live" approaches to counseling? I would suggest what I call the "live and help live" approach. In this mode, the client experiences herself or himself in the context of a real relationship with the counselor. The client is helped to experience his or her own feelings and concerns, not from being told by an expert what they are, whether explicitly or implicitly, but rather by being helped to discover and understand them while on a gender journey with a supportive yet insightful helper. The counselor and client in a "live and help live" process are real persons together, though the counselor does have the added responsibility of guiding the client on this gender journey. In a real sense, the counselor joins the client on that journey, but it is a journey which remains the client's, not the counselor's.
Like the "live and let live" counselor, the counselor I favor listens and does not impose judgments upon the client. And like the "live and make live" counselor, this third kind of helper does have opinions about the client. But unlike the first two types, the "live and help live" counselor responds to the client and helps the client explore his or her own experience as a transgendered person, so that the client begins to see his or her own truth, his or her true self.
Many of us who seek counseling in order to cope more effectively with our transgender feelings, and our transgender situation in general, are often disappointed because we somehow feel that counselors tend not to understand our unusual experience. We, as clients, need helpers who understand both our issues and our need for a genuine helping relationship. We have real problems which require helpers who are themselves real persons. For all that the helping profession must do to maintain safeguards against inappropriate decisions by client and counselor, the fact remains that clients do not want a helping process which simply lets us talk to ourselves (of which we have probably done too much as it is) or makes us bow down to another's notions of who and what we are (which is what we are struggling with in the first place).
We need the human involvement of trained professionals who can help each of us to see ourselves more clearly and who can help us to understand and handle our inner feelings, our bodies and our relationship to them, our various human relationships, especially family and fellow workers, and most important of all, what it takes to be courageous in the face of what are often seemingly insurmountable odds.
Want to comment? Send email to Dr. Etscovitz at hmdm@voicenet.com.
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