Therapy Today

Day in the life
Giving people
space
Jacqueline Ullmann
divides her time between
her family life, private
practice and her role as
a cancer counsellor at
the Royal Free Hospital
in London.
Interview by John Daniel.
Photographs by Phil Sayer
28 Therapy Today/www.therapytoday.net/November 2010
The alarm wakes me at 6.30am and I try
to sneak in another five minutes of sleep.
Sometimes five minutes become 20
and I have to rush. When the children
were at home, we always had a family
breakfast. Now my husband and I have
breakfast together.
In addition to my private practice,
I work two and a half days a week as
a cancer counsellor at the Royal Free
Hospital in London. I’m lucky because
it only takes 30 minutes to travel from
my home to the hospital. I arrive just
before 9am and the first things I do are
to switch on the computer and check
the message book. I job share with a
colleague. We work alternate days and
overlap one day a week, when we meet
to discuss various departmental matters
and other issues.
I see inpatients and outpatients and
their relatives, and cover all cancers
except for the lymphomas and
leukaemias. There are a further two
counsellors for blood cancers, as the
work is different because the patients
go through different experiences. For
example, the blood cancer patients spend
a lot more time in hospital as inpatients.
The counselling service is very much
part of the whole team and works closely
with the consultants, the medical teams
and the nurses. A few weeks following
diagnosis, if the medical team feels a
patient or a relative is struggling to cope,
they call us in. We invariably insist that
they obtain the client’s agreement first.
People can also self-refer and we see them
at any time during their cancer journey.
I am person-centred and start from
where the client wishes to start. I use
some psychodynamic and systemic theory
and a little CBT. I explain this to clients in
the first session. On an average day I will
see five clients for a 50-minute session
and possibly another one or two just
to say hello and introduce the service.
Some clients come for only one session
– it might not be what they want or they
just need to know that they’re reacting
normally. Other clients access the
service long term.
Obviously, cancer happens to real
people and there may already have been
all sorts of problems in their lives before
diagnosis, and now they just can’t cope.
One week they might want to talk about
the worries they have about their disease,
and the next week they might be angry
that parking was a struggle. I meet them
where they are at, we explore their
feelings and often themes arise.
There are some common themes in
the work. First of all, there’s the fear
of recurrence – how to live with that.
Then there is what I would call ‘other
people’ – the patient has a diagnosis
of cancer and outsiders can’t cope
with it, it freaks them out and they
have ‘crossing the road’ syndrome –
they just want to avoid the patient.
There’s another category of people
who are overwhelmingly helpful and
this is also too much for the patient.
Every day I show my face in the
inpatient ward. There is often a nurse
who needs to tell me about a patient
who is not coping or one who is dying.
I always say I am available to the family
if they want it, but I remind the nurse
that I cannot do magic: the patient is
dying and the family is going to be
upset; that’s normal. Often somebody
says they want to speak to me because
they’ve done so much crying with each
other that they need an outsider. This
is why I am here – to care, support,
listen and give people space.