A Counselor Prepares – Jerome Doerger

I was in elementary school when I saw the 8^th-grader’s-production of Annie. Between the classic red curly wig, shaved-bald-head of Daddy Warbucks, and the punchy rendition of ‘Hard Knock Life’ stomped out by angsty middle schoolers, I knew I wanted to be up there. I was able to achieve my goal by playing Tom Sawyer when I was in the 8^th grade. In high school I firmly cemented my identity as a theatre kid by being involved in every production possible while leaving other extracurriculars that used to fill my time behind. When I was 16, I knew I wanted to go to college to study Acting and specifically Musical Theatre.

This may be the point where you are asking yourself, “Jerome, what does this have to do with a Genetic Counseling?” And I totally understand this question. It is the question I have been asking myself since the moment I pictured myself even possibly switching careers and attempting to join the field of Genetic Counselling. However, over this last year of course-work and my first clinical rotation, the answer has been revealed to me.

One of the biggest lessons I learned in my acting training was that no matter what character you are portraying, the most interesting and compelling version is the one that you bring the most of yourself to. Think of your favorite actors and the roles that they inhabit so well. Many actors can be transformative, but the ones that often ring the truest are done by performers who always bring themselves to a character. This parallels with one of the biggest lessons I’ve learned over the last year and that is the value a counselor can bring to a session, especially one that has many psycho-social considerations. Sometimes the most important thing you can do is just be a human and stay present with the human sitting across from you.

Often as counselors we need to interpret complex topics involving genetics and testing methodologies. Combine this with a patient who may have recently received a shocking cancer diagnosis, or a parent who just wants to help their medically complex child. Sometimes reviewing the family history brings up complex emotions surrounding loved ones that have passed and relationships that have changed. It is crucial in these moments to inhabit this space of discomfort, allow the feelings and silence to happen, then offer the tissue and assure the patient everything they are feeling is okay. The best way I know how to be of service to patients in these moments is by bringing my whole self into the room and staying present.

In my undergraduate program we studied Stanislavski’s “An Actor Prepares”. Konstantin Stanislavski was a titan of the Moscow Art Theatre whose methodologies catalyzed theatre and the craft of acting in the 20^th century. He is best known for concepts about identifying a character’s Objective or what the character wants. Often the best scenes occur when two characters’ objectives are in conflict with one another.

In our second semester Genetic Counseling course we learned about the Reciprocal-Engagement Model (REM) as a foundational practice theory. I quickly started to see the parallels between Stanislavski’s Objectives and the REM’s Process Goals, or the desired genetic counseling outcomes. Continuing to fall into place, the REM’s Strategies and Behaviors aligned with acting’s ideas of Tactics or the approaches an actor uses to achieve their objective. The obstacles that characters face in excellent dramas often present can be seen in the uniqueness each patient brings to a session and how a counselor navigates each individual session supporting patient autonomy while ensuring they are making an informed decision.

This is all to say that wherever you find yourself in your Genetic Counseling journey, be sure to bring your whole self. It is easy to compare yourself to others and the traditional paths folks have taken to arrive in Genetic Counseling, often with a pre-med background and a fresh bachelor's degree in science. Take it from a proud recipient of a BFA (Bachelors of Fine Arts) that the niche passions you pursue can still inform and assist in your journey into new dreams and goals.