Understand the past, embrace the present, enjoy the future

GEOFF BOUTLE
BACP Senior Accredited Counsellor

My office provides a safe environment in a pleasant relaxed location on the outskirts of Basingstoke, with easy access and ample parking
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Christmas & Counselling – The first Noel

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I held a rather strange counselling session a few days ago.  I do not usually refer to client meetings in this blog but given the time of year, this case may be of some general interest.

It was one of those sessions when I found myself wondering what I was missing with regard to this client.  There was just something I could not put my finger on.

Let me set the scene....

The client was an elderly male dressed rather eccentrically. He was sporting an eye catching red outfit and dramatic flowing beard.  He had a rather strange accent with perhaps a hint of the Scandinavian. He seemed quite jolly and there was certainly a very pronounced twinkle in his eye but he also showed some very real signs of stress and agitation.

That sense of there being something unusual had been apparent the moment he arrived. There is a large car park here at Worting House just outside of Basingstoke.  Noel, and that was the name he gave, had decided however to leave his rather strange contraption right outside the main door. It quickly became the centre of attention.

My office is in a setting which is both urban and rural and I am used to seeing horses.  The horsepower which moved this contraption was certainly of the four legged type. They were the oddest horses I had ever seen with strange pieces of bone seemingly tied to their heads.

Noel was obviously jolly fond of these rather strange looking horses. Once they were reined in he was very solicitous. He referred to them as dear and requested carrots for them. Apparently they were in the process building up energy reserves for some herculean task ahead of them in the coming days. Noel said that people usually gave them mince pies.  He winked at me as he said that as if I would know what he was referring to.  I had no idea what was going on so I just winked back. I think from his ‘ho ho’ response that was the right thing to do.

It took a while to reach my consulting room but Noel told me that he was not used to stairs as he usually took a  ’ ..more direct route up and down….’ That was the first of some oblique comments which left me a little bemused.  Nevertheless I always encourage clients to express themselves in their own distinctive way and Noel certainly did seem to have a very distinctive if not idiosyncratic approach to life. 

He clearly liked my location.  I work from offices in an old country house. Noel was certainly taken with the architecture of the house.  He kept referring to the large number of chimneys and how useful that would be for him although I was not sure what that meant.

Once seated, Noel launched into a description of what we call in therapy, the presenting problem. This focussed almost entirely upon his work situation which was apparently very important to him especially at this time of year.  As he talked I was aware of holding increasing concern for his emotional wellbeing.

His references to fixed working behaviour patterns and an absolute adherence to a timetable suggested some OCD tendencies. There were clearly elements of delusional disorder as he talked for example about having to please and provide for all the children of the world which was jolly hard work. 

I was certainly uncomfortable with his fixation on children. This seemed to range from the benign with a general concern to see children happy, to a slightly more disturbing comment about the untidy state of all the many bedrooms he had visited in previous years.

As is often the case with new clients I wondered about his background but Noel was rather evasive. He appeared to be an immigrant from northern Europe but he gave no indication of whether he held any formal work permit.  He seemed to embrace the notion of the free movement of labour so he may well have been an EU citizen.

Noel clearly had a family of sorts as he made numerous references to being assisted at home by what he referred to as little people. I assumed this must relate to children although given the way he described them he could almost have been talking about fantasy figures such as hobbits or even elves.  Obviously not!

As he spoke, my concern for the welfare of these minors deepened. Noel talked about them not being in education but instead working in some form of production and that the pressures upon them were intense especially at this time of year.

They also seemed to be living in what appeared to be a cold environment.  He made a number of puzzling references to the north pole. My assumption was that this north pole was perhaps a pub or club, maybe some form of tent support or perhaps even some variant on exotic dancing.  He did not clarify.

Noel was avuncular and jovial in his approach to life and yet there was evidence of  strongly held obsessional fixations. I was alerted to his continual references to his key role at this time of year. He saw the happiness of the children of the world as dependent upon his efforts.  The rather narcissistic comment suggested severe ego fragility. That in turn lead me to wonder about his immediate support network.   Apart from these small helpers and his animals he did not seem to have any other close supporters.

I was also very struck by the absence of female actors in his narrative. My apprehension about something inappropriate resurfaced.  I realised that he was quick to talk about what little girls wanted but seemed rather unclear about how he could interact with women.  It was as though he had real challenges in interacting with individuals once adolescence was reached.

There was certainly a marked ambiguity about his general approach towards sexual symbols and he appeared to embrace some well defined fetishes. I have some personal experience of fetishes – clearly I hasten to add in just a professional capacity –  but his linking of stockings with tangerines rather than an elegant shapely female leg was new to me.

My attempts to understand him then foundered completely when he started to link these stockings to chocolates and small often humorous gifts.  Given that he talked of working very late I started to wonder about Noel and the ladies of the night.  When he then moved on to talking about his preference for dressing up and red noses I decided that he may benefit from some signposting to another agency specialising in unusual deviant behaviour.

Nevertheless Noel seemed pleased to have the opportunity just to unload his thoughts in the room.   I wondered out loud if that reflected his unconscious carrying and shouldering of a heavy burden. His very hearty chuckles and ‘ho ho’s’ indicated that he clearly found that comment rather amusing. Again I was not sure why.

As we concluded I wondered about further meetings.  Noel indicated that he would like a regular meeting and mentioned wanting to book another date in December but one that was not too close to Christmas Day…..’   I assume that would be because of holiday commitments on his part at that time and Noel seemed to agree.  He talked again with the jovial ‘ho ho’  that he would be doing a lot of flying at that time.

Despite my misgivings I decided to offer a further appointment although I was not sure about modalities and strategies. A psychodynamic approach could help him to work through some of that early childhood material, CBT could assist with changing those obsessive thoughts around work; and since he had been able to see an ending of his work load, a solution focussed approach could fit with his positive outlook.

These thoughts quickly faded however when I looked at his preferred appointment date.  He certainly was looking for regular appointment but at a yearly interval. The appointment date he was requesting was for a day in early December next year!   Next Year!  What sort of client is it that wants a regular appointment once a year in December!   

And this where we came in.   I am just holding that feeling that there is something here that I am just not seeing.  So if you have any thoughts on what I may have missed perhaps you could let me know?

As I said at the outset, it was a rather unusual therapy session……! 

And a happy Christmas for all and a very good New Year

(For reasons of good ethical practice the identities in this case study have been changed to ensure client confidentiality. I emphasise for the avoidance of doubt that Noel is not Santa’s real name. The lead horse Rudolph has given me formal permission to refer to himself and his colleagues in this note although a small fee was paid of four mince pies, two carrots and a glass of beer.  These really were rather strange looking horses……….)

By
Geoff Boutle

added on 1st December 2013

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