managing client expectations while keeping them positive

[The Burning Answer]

Hi everyone,

I had an elderly lady contact me just over a week ago as she had seen an article in the Telegraph re. a journalist who had had her sleeping troubles sorted after one reflexology session.

The woman who had contacted me had many contributing factors to her lack of sleep and her doctor had diagnosed her as depressed following the death of her husband and friend within the space of one month. She had been referred to a psychologist but she only went to one session and does not believe she is depressed.

She was full of hope that one session of reflexology would cure her insomnia. I tried to manage her expectations and informed her it depends on the individual and what is at the root of the insomnia and she perhaps she could make contact with the psychologist to make the most of all options available to her. She had two treatments and today when I saw her for her third she reiterated that she is pinning alot of hope on this and has not seen any change yet. I had a discussion about things again but really felt at a loss as to how to manage her expectations - and that it may take four sessions at least before she even begins to see some change, etc, but even then there is no guarantee.

(oh, by the ways she does not lie in bed tossing and turning trying to sleep she just doesn't sleep - she says. but then tells me she gets 4 hours and yet it isn't enough as her mind is not what it used to be ... BUT it isn't due to her age, etc).

I really struggle in situations like this. Is it only me that does? I want to be honest with my clients, not give them false hope but at the same time give them hope.

 

[Gerald J]

Has she seen any change at all over the last few sessions with her sleeping?
If she says none then ask how does she feel following her treatment ,is she calmer/more relaxed but it does not last as long as she would like maybe??
You may need to talk to her about other things she can do to relax last thing at night,
Also check she is not having a cup of tea/coffee before bed?!!

 

[WallyWombat]

Like you, diamond, if there has been no change I tell clients that there may be a root cause that reflexology simply cannot reach. I recommend a few sessions, to try and help with general relaxation, but if there is no discernable change by session 6, then it is obviously not the therapy for them. For this particular lady, she may need more mind therapy - I would opt for hypnotherapy - I've seen it work brilliantly in early bereavement - even 20 years after the event. (I am not a hypnotherapist!)

 

[babygirlbrunnett52]

she says it isn't a case of not being able to relax. She is not lying awake trying to sleep she just can't sleep. She says she doesn't feel any different at all and repeats she is relaxed already. Good idea about the hynotherapy. I'll suggest that to her (she seems to want an instant fix and was not impressed with the pschologist/psychiatrist). I am of the personal opinion that a mind therapy is what would help her best but just wanted to hear how others would deal with this.

thanks

and I've done the check re. meal times, coffee/caffeine, exercise, alcohol, etc etc. ... no contributing factors there

 

[Bruce Legend]

If she is grieving then that takes time, no matter what support you are given. It takes as long as it takes and the impact it has will depend. You have indicated that there are a number of reasons why she might not be sleeping, so these cannot be ignored.

Mind therapies may help her but she also needs to be receptive and responsive to this, I have found that things like EFT suit younger clients as the very nature of it can put some more mature clients off - not all, but some, so it is something to be aware of. Perhaps a shorter reflex session and a couple of rounds of tapping would be good. I wonder if some emotrance might suit her as it is less demanding.

She is also putting a lot of pressure on you as her therapist to sort things out, which will be adding to her anxiety about this, you're there to facilitate healing, not to cure and not to heal at a pace faster than the body can allow.

The woman who was fine after just one visit was lucky, lifestyle changes, such as long standing insufficient sleep take time to turn around and it does depend on what else is going on.

 

[M.P. Hall]

Hiya

You call her "an elderly lady" and then say her insomnia isn't age-related. There has been research (sorry I can't remember where or when) which says that people's need for sleep declines after the mid-20s, and by the time you get to 60s you may only physically need 4 hours sleep a night, especially if you are at home all day and take afternoon naps!

So some sleep hygiene counselling: remove the TV from the bedroom. Only go to bed when you are tired, even if this is 3 am. No caffeine-containing drinks after 6 pm: this includes cocoa and chocolate, although hot milk has been proved to have a sleep-inducing effect (because of the tryptophan it contains). Also bananas contain tryptophan so have a banana for supper. She should also do an hour's good exercise: if she can physically wear herself out she should find the body naturally sleeps. Gardening, perhaps?

And further counselling: perhaps she might need only to accept that her need for sleep has reduced over the years. If that is the case, how does she fill her time productively? Is she bored and spending lots of time doing nothing - in which case the body won't need as much sleep?

Is she finding, perhaps, that the bed's too big without her husband? Could she get a body-sized bolster to cuddle up to (my catalogue sells them)? Should she get a single bed if the double bed has too many old memories?

Maybe meditation or relaxation techniques could help? If I were working with her on autogenic training, for example, I'd be considering a thought pattern that goes "I get enough sleep to meet my needs" or something like that.

None of this is "pure" reflexology, but as her therapist, you are better placed to discuss these things with her. Reflexology will induce a healing response in clients, but what is healed may not be what the client thinks needs healing!

 

[Cihle]

No, I didn't say it isn't age related. I guess I worded it poorly. SHE says it isn't related to her age. I have said to her exactly what you quoted but she will have nothing of it.



Yes, I've gone through all this with her

And further counselling: perhaps she might need only to accept that her need for sleep has reduced over the years. If that is the case, how does she fill her time productively? Is she bored and spending lots of time doing nothing - in which case the body won't need as much sleep?

Is she finding, perhaps, that the bed's too big without her husband? Could she get a body-sized bolster to cuddle up to (my catalogue sells them)? Should she get a single bed if the double bed has too many old memories?

Maybe meditation or relaxation techniques could help? If I were working with her on autogenic training, for example, I'd be considering a thought pattern that goes "I get enough sleep to meet my needs" or something like that.

I have discussed all the things you mention with her already but I think there is something going on that she is not willing to consider and I don't feel I'm the person to help her as she is adament that she has "forgotten how to sleep" rather than that she "cannot sleep". Anyway, I have advised her and she will have to decide what she does with that advice

Thanks for people's input.