Working with Rehearsed Material in Counselling: Gentle, Ethical Ways to Go Deeper

Ken Kelly: We’re talking about working with rehearsed material. What is rehearsed material?

Rory Lees-Oakes: Yeah, it’s a good question, Ken, and I think the best way of describing rehearsed material is probably in the early engagements with clients when you first start to work with them, and you meet them, and you’ve probably gone through the contract and all of a sudden you say to them, where do we start, or how can it be of help today?

And they just switch themselves off. You are listening to a long narrative of what’s going on for them, what their problems are. It’s sometimes very scattered and I think sometimes it’s quite hard to keep up. It’s like listening to someone talking about their lives, but in a very disjointed way.

Sometimes clients will speak in a linear way, but in my experience it’s, and then this happened, and I said to them, and they said to me, and I don’t know what I’m going to do. And it’s a way of the client just offloading the huge sack of pain and anguish that they’ve been carrying around.

And I think that’s a good way of looking at it. It’s like emptying a sack of narrative and emotions onto the floor at the feet of the counsellor, who then has to take a deep breath and think very carefully about the directionality of where they’re going to go with this.

Because it can be quite overwhelming, can be very tricky. And I think if it’s handled well, it can aid the direction of where the client wants to go in therapy.

Ken Kelly: Yeah. Beautifully said, Rory. I think, you’ve explained that it can catch you a little bit and that it can be quite derailing.

I’ve got this definition for you. Rehearsed material is a well practiced over coherent story that a client can tell fluently about really painful events with little effect in the room. Often functions to keep distance from overwhelming emotions, preserve stability within the client, or gain a social or administrative traction.

So that’s a very cold definition of what it is. But you might recognise it. It’s almost like the person is there, they’re bringing what may sound to the ear, like really painful, deep, troubles that this person has gone through, yet you don’t see the emotion in them. It’s almost a rehearsed story.

It’s almost like they’re telling you about a movie that they saw as opposed to their real life.

And it’s got other names throughout the years, Freud speaks about this in 1914. He says, the patient doesn’t remember anything, but acts it out. He reproduces it, not as a memory, but as an action. And what Freud is alluding to here is that there was a lack of connection with the emotions. It was rehearsed material.

Another name for rehearsed material is pretend mode. That mental state of, if I keep the story far away from me and I just tell that story without linking in, I am safe as the client.

Now, where might we see rehearse material?

We might see rehearsed material in a client, or a service user that has been involved in multiple agencies, has had a journey where they’ve had to tell this story many times over to many different professionals, and they develop almost a rehearsed way of putting this information over to get all the facts out. Keeping themselves at a distance from the actual emotion or the pain. What are the clues we can look for Rory, for rehearsed material?

Rory Lees-Oakes: I think one of the clues is that sometimes rehearsed material lacks deep emotion. It’s as you said, it’s almost like the client’s watching a movie of their life and they’re just repeating back what’s happened.

It’s usually in the early engagements in my experience of practice where somebody is trying to almost convince the therapist of the urgency and the validity of what’s going on for them and what’s has happened. And this is particularly when someone has been through multiple agencies, because if someone’s been with multiple agencies, what usually happens is they have to repeat their story time and time again.

And my thoughts on this are that there’s almost like a convincing the therapists that they’re worthy.

And I also think that it does speak to, if you get a referral, read the referral. Because sometimes in the rehearsed material, clients may go through something that’s very traumatic and in the very early session, when they don’t feel grounded or secure, become quite detached or sometimes unwell in the therapy session.

It is about validity in my view, that they want the person listening to feel that what’s going on for them is valid.

Ken Kelly: I like that. Rory. It’s understandable why a client may do this. And what’s really interesting about rehearsed material is when we’re linking to trauma work, if you’re doing any kind of trauma work, you may see a higher instance of rehearsed material.

And it’s no wonder, because it’s painful stuff. In counselling, there’s a technique called reframing where when you’re facing an emotion or a situation that is too overwhelming for you, you can use exercises to reframe yourselves. And imagine you’re sitting in a theatre and watching this on a screen, now let’s discuss it. And you’re able to distance from the actual feelings and emotions. In certain instances that is useful.

However, when we’re talking about therapy, where we want to be touching on the emotions, where it is relevant, we are looking for the client to go there.

Because there’s the surface, we’re not gonna find the work. It lies in the feelings, it lies in the emotions. That’s what we work with within the sessions. It’s important that our clients go there where it is relevant, and there are times where it is not relevant to take the person to those high emotions.

But we’re looking at this rehearsed material, why clients do this.

There’s some safety there.

Another place where we might see this and why clients might do this is for service shaped storytelling. You would see if you worked in an agency where you have multiple referrals from multiple places, and sometimes clients are coming in and they’ve got an agenda of what they are there for.

Sometimes it’s not therapy, sometimes it’s just part of their journey and they’ve been sent for this therapy that they have to interact with and it’s service shaped storytelling so that they can get to the next goal. And this is an interesting one, it could actually show itself in a counter transference loop. There’s a new word for me, Rory. When I was doing the research on this, a countertransference loop therapists may feel bored, drowsy, or pressured to do something which can collude with the script of that rehearsed material if it is missed or if it is unexamined.

There’s a lot to take on board there. And I guess when we look to what might we be looking out for, how might we recognise that rehearsed material is coming within a session and we look for high fluency, but low vulnerability. When the story is told in great detail, but the person does not seem, or appear to be emotionally moved by that.

Low effect congruence. So, horrific content told with a flat tone, dry eyes, no emotion shown at all. That can be an indicator of rehearsed material.

And relational distance, very little curiosity about how this lands with you, minimal checking in. It just seems like a little bit of a distance between you and the client.

Us is the counsellor, we may feel this counter transference and find ourself bored, maybe irritated, maybe not knowing what to do, maybe feeling that we have to jump in and do something with this material. So there’s an element, of self reflection as we speak about this topic, Rory.

Rory Lees-Oakes: Absolutely Ken and I think rehearse material speaks to storytelling and what the client is doing is telling you a story.

I remember saying to my supervisor many years ago, this client give me a litany of abuse she had as a child. And it was just like she was reading a shopping list. Going to the supermarket. And my supervisor said, yeah, that’s probably what it was because it was probably like going shopping because it was probably an event that happened on a regular basis and she’s had to protect herself.

And I think the thing with stories is not to get sucked in. There’s always a bit of a danger of getting sucked in too much to the lyrics, if you like, and not to the melody. We just need to take time with rehearsed material. is it has to come out, and then once it’s dropped, we can start looking carefully at what is the priority for the client, what does the client want to look at, as opposed to going in, and trying to talk about everything or reflect on everything.

It is a process that takes a bit of time.

It’s really early presentation in the arc of therapy that we have to be thoughtful of.

Ken Kelly: Yeah, very much so, Rory, that is absolutely beautifully said. And what is really important here is to put in that ethical view on this, avoid forcing the retelling.

If the person is bringing rehearsed material, putting a distance between themselves and the material, there’s a reason for that. We don’t want to be going in heavy handed and forcing a retelling.

It can re-traumatise and that can really be damaging to a client. There’s usually a reason why the rehearse material is at distance. Our job, is to know that rehearse material exists, what it is, how to spot it. And now we’re gonna just speak a little bit about some interventions that we can use to very gently bring that client closer to the emotions of the material.

And as you’ve said, Rory, we need to do this with kid gloves. We need to tread carefully, we need to have patience with the client. Sometimes they just need to get that story out in the beginning, so we leave the space for that.

These are little micro interventions that you might use if you are feeling that maybe the material that you’re seeing is rehearsed material and one of them, it’s a simple skill that I guess we all use all the time. It’s, as you say that, I wonder what might be happening in your body right now, as you say that.

And it’s just very gently saying to the client, I see your words, but I wonder what is happening inside as you’re saying that. And then another one, this is like more going into the getting consent from the client, we might say, I notice your voice gets very steady here.

I wonder if it’d be okay to pause with that steadiness just for a moment. And what we’re doing there is, it’s a very gentle form of immediacy in a way. I notice you’re really steady as you’re saying that presentation. I wonder what might be going on for you underneath that.

Another thing that you can do is you can use sensory anchors. So you might say to the person, what did you hear? What was going on around you? Invite details in because in details you can’t be in the narrative. You need to go back and actually look at what really happened. We can ask a question that might just get them to have tore-look on that.

And name the function without shaming, my hunch is this story helps keep a lid on a lot that might be going on for you.

I think that’s a powerful one. I think it should be used with with care and caution. But it is a way of inviting into the deeper material.

I wonder if you had any other thoughts on ways and little interventions we might use, Rory.

Rory Lees-Oakes: I think if someone is sharing something that is very personal to them, in service of building a relationship, you can thank them for sharing it. I think that just by saying, thank you for sharing that, I can see from what you’ve said that you’ve gone through a really difficult time and, acknowledging how you honour the material that’s been brought.

The other thing that crosses my mind, Ken, is that rehearsed material has another function, and that is a test of the therapist. Because how many times have we as practitioners heard clients say I don’t wanna tell you anymore, in case it upsets you.

And I think sometimes, rehearse material can be a way of just testing out the metal, if you like, of the therapist. Because I’m sure that when other people are told that people either discount it, disregard it, or avoid it or change the subject. This happens a lot in families, where someone’s talking about abuse or loss or real powerful, deep stuff, family members either can’t handle it or they discount it.

And I think that when a client comes to you, especially if they’re new to therapy, they may think, are they gonna be like everybody else? Are they going to do the same things that all the other people I’ve told my story to are going to do?

So by thanking them for the story, and being really present makes a huge difference. And in some cases you can see the relief, it’s like literally putting down a heavy sack.

There’s a lot more to rehearse material than we might first think.

Ken Kelly: There is, there’s great depths in rehearse material.

I can’t tell you how many times I heard the words, I’ve told that story so many times, I’m just so grateful that you took the time to listen.

When you just stop and really listen and just be kind and patient, just that active listening is incredibly powerful. Because you’re seeing the person, not the material, and it allows the person to also see themselves and not just the material.