Why Client Autonomy is Sacred, and Needs to be Upheld, Supported & Honored at All Times, Every Time
- Brainz Magazine
- Jul 28
- 8 min read
For nearly 14 years, I've helped individuals navigate the complex landscape of addiction in order to achieve recovery. Nicknamed "The Casual Counselor", my approach is unconventional but undeniably effective.
For the sake of privacy and anonymity, we’re going to call her “Kat”. I chose “Kat” because there was a ferociousness to her energy. Kat was from the streets, and you could just feel it. She was tough. Hardened. A survivor. A warrior. A fierce adversary/ And, generally, just a bad mo-fo. Truth be told, I was a little bit scared of Kat. Well, maybe not scared, but intimidated. And when my Clinical Supervisor told me that I was going to be Kat’s primary counselor at the clinic, I was a little shaken and wary.
No, wait. Let’s be honest. I was absolutely scared of Kat.
She might have been half my size, but if it ever came to blows, I had absolutely no doubt in my mind that Kat could take me to the proverbial woodshed, and with little effort leave me laying in a bloodied heap. Kat also had zero interest in being in the clinic to begin with, but after a series of not-so-healthy decisions she had made, the district court judge had mandated her to get some help with her problematic substance use, and that’s how she wound up under my care at the clinic.
Now, despite her badassery, there was also a very guarded, nearly hidden softness to Kat. It’s all in the eyes. With the right kind of gaze, in very infrequent moments, you could see the glimmer of something that I might describe as gentle or tender, or even a little bit warm in those dark eyes, but it wasn’t what she led with. Her hardness was her go-to, her suit of armor, and it had served her well out on the streets. It had kept her alive, literally, as Kat had been in some truly dangerous situations with some truly dangerous characters along the way.
She was 22 years old.
She wasn’t one to share in group therapy as a matter of course, but when she did, it was always relegated to the point that she didn’t want to be there to begin with, and when she did share, it was all, “fuck the courts”, “fuck the system”, “fuck the world”, “fuck ” all of it. Fuck it all.
She was a loner. She smoked alone. She ate her lunch alone. She sat in between groups alone, outside, scrolling on her phone or chatting with her people who were still out there, running the streets, and hustling whatever enterprises with which they were involved, and in which she could no longer participate, at least for a while.
She had a beautiful laugh, one that was spontaneous, loud, and genuine, that occasionally burst out. No, chuckling with Kat, when she received a message from a friend on her iPhone, she would occasionally let out an unbridled laugh that was drenched in joy and enthusiasm.
When she wasn’t laughing, however, she remained hard and intimidating, ever guarded, and she kept her distance from anyone and everyone, no matter how much effort the other clients tried to make to invite and embrace her into the fold.
As a treater, it was obvious to me: Kat had been hurt, and likely many times, in very serious ways, over the course of many years. That’s why you couldn’t get near her. That’s why she wouldn’t “let you in”. If you couldn’t get close to her, you couldn’t hurt her. She was going to take preemptive and effective measures to protect herself from that possibility. But as a treater, what’s also true is this: I’m never in the business of intentionally trying to hurt anyone. I’m a helper, a healer. My motive is always to do my best to try to help and not to hurt the clients under my care, no matter how scary or intimidating they might be.
But how was I going to help Kat, specifically? I was stymied.
Our first session? Oh, man. I went in scared, and Kat went in angry. Those two energies flying around my tiny office were a visceral, energetic mess of a thing. She stared at me with that oppositional, dead-eyed look. I looked back at her with as much gentleness and compassion as I could muster, but my look betrayed whatever vibes I was putting out there, and Kat could feel that better than most, because she had street smarts. She knew I was scared, and she liked it that way. A scared therapist is easy to work with, as they’re never going to have the courage to try to crack through that tough exterior to try to find out what feelings are lurking beneath.
Despite my intimidated energy, I had also been doing this work for a few years by this time, so I was able to “break through” my palpable waryness, and attempt to start a dialogue with Kat. It didn’t amount to much, but we had to start somewhere. It sounded something like,
“Listen, I get the impression that you don’t want to be here. I’ve heard you say as much in groups. You probably don’t want to be sitting with me in this session right now. I’m guessing you want no part of therapy to begin with. But we have about an hour to kill, so tell me, Kat, what do you want to talk about?”
Rage.
She exploded.
“Motherfucker, you don’t know anything about what I want or what I don’t want, don’t be coming at me with your assumptions! You don’t know where I’m from or what I’m about! How dare you come at me acting like you're familiar with me! You don’t fucking know me! Who the hell do you think you are?!? Some kind of expert on who I am or what I want?!? You know absolutely nothing about who I am, what I want, what I don’t want, so don’t be talking that mess to me! You have no idea about the things I’ve been through to end up here or what I’m trying to do with my life!”
That’s just a taste of the scolding I got. Kat’s diatribe went on for probably a good five minutes before she started winding down. She got so loud that a few colleagues knocked on the door to check and see if I was okay, and if all was safe. I assured them it was and hurried them away because I knew, within that explosion, I had found the key to how Kat and I were going to move forward with one another. She was going to be my assigned client for at least 3 months, maybe more, and her tantrum revealed the answer to the question that had been haunting me before that initial session:
How is a 30-something-year-old white boy from the suburbs going to get through to a woman, ten years his junior, who grew up in the world of real-deal gang-bangers? That question had been on my mind since her arrival at the clinic, and after observing her behavior in groups, and her non-engagement with the other clients enrolled in the program. How was I going to access the real woman hiding behind that suit of armor? Her walls were strong and fortified impressively, but there’s never a wall that can’t be broken through, if you have the blueprint to how it’s been constructed, and Kat had just revealed the secret to its construction.
Her ranting, however dramatic, ended, and I purposefully sat there with her for about 10 minutes in complete and utter silence. The silence was so loud, it was deafening, and it left her very confused. Instead of looking at me with that intimidating gaze, she was now looking away from me at different points within my office. I hadn't fled from her vicious, verbal attack on me. I had sent my colleagues packing when they came to make sure all was well, and I was now just gazing at her with soft eyes, a tinge of soft amusement, and a whole lot of compassion that I’m sure she could feel.
“You know what, Kat?” I replied, “You’re absolutely right.” I kept my voice firm, but very level and with an energy of empathy and curiosity attached to it. “I don’t know anything about you. I don’t know where you’re from, what it was like out there for you before you landed here with us. I don’t know what you’ve been through in this life, but I’m willing to bet there’s been some hard shit that you’ve had to navigate. And, no, I’m no expert. Shit, I’m not even an expert on myself! I’m still trying to figure out how I got here!”
She laughed that beautiful laugh. I leaned in.
“Hey Kat,” I went on, “You are the expert in this room, not me, and what I can tell you is this: you’re 100% right. I don’t know shit about you except for one thing: you didn’t get here by accident. You’re not just some victim of circumstance. But I also want you to know this: if you want and are willing to tell me about the things that I don’t know about you, so that you and I can get to know each other, and find some real shit to talk about, I’m here for it.”
She went dead silent for a few ticks, and then the tears came. And for the next 30 minutes, I sat in silence as Kat cried for what had probably been the first time in a very long time, and the cleansing of pain started to begin. When she started to collect herself, I leaned in again, and I asked her,
“So, what do you think, Kat? Do you want to give it a shot with me? Will you let me get to know you? And you can get to know me, too?”
No words, just a really sad smile, and she nodded emphatically, a signal that told me, “yes”. What a beautiful moment that was.
It was one of those breakthrough moments that we therapists dream about, you say just the right thing, at just the right time, in just the right way, and under just the right circumstances, and it hits the client right in their heart. It breaks through the wall, and it touches their wounded soul, the hurting inner child. Moments like that don’t happen often, but when they do, they are transformative beyond description.
Kat and I went on to work with one another for the next 5 years. She ended up maintaining a healthy recovery, though it was a bumpy excursion finding the road to get there. But we found it. She found gainful employment. She ended up marrying her longtime partner, another woman in recovery, and she called me up one day a couple of years ago to report to me that through the miracle of IVF treatments, her wife would soon be having twins, and that they were saving up for a condo, saving & getting closer to securing that down payment, getting their credit scores up to pre-qualify for the loan.
Talk about a new beginning.
No longer the gangster, Kat was soon going to be a Mama. Autonomy.
It’s sacred, and it’s really the only best practice there is when we are truly trying to help someone get better, always upholding their autonomy and independence, so that they can discover that all this time, they had all the answers inside of them about how they were going to heal from the wounds of their hurt. What they needed was someone who was just going to let them be themselves, to allow them to be heard, and without any judgement, condemnation, or a modicum of power over their ability to design their own lives, and their own recovery, in a way that feels right for them.
Upheld by autonomy, it’s really just a simple formula. Helping people to help themselves is accomplished by giving them their power and by being a good listener. A good ally. And never pretending that we, the credentialed clinician, are the expert in the room.
Read more from Joshua Bennett-Johnson
Joshua Bennett-Johnson, Licensed Addictions Therapist
After working for 7 years in an amazing clinic, I launched into private practice in 2018. I love my job. I can say that without reservation. Watching people rebuild their lives is something that is worth more than any dollar amount.
