Recognizing the ambiguity and the differences in understanding of the concept of normalcy, it is still safer for the nonmedical counselor to think of his client as temporarily beset by a combination of problems which are beyond him, and as in need of objective exploration, guidance, and kindly assistance, than to assume that his behavior is abnormal and proceed to spin fancy theories about the why's and wherefore's of his deviational behavior or that of the people in his orbit. Where the client's actions do not conform to the concept of normal behavior as commonly held, or where the counselor's knowledge and understanding are inadequate to explain or account for the symptoms, difficulties, and problems he faces, the counselor will do much better to seek psychiatric help than to determine that his client is neurotic or psychotic or to be even more specific in his diagnosis. Seeking medical or psychiatric help will be better for the counselee, too, because if his behavior should be due to some physical, mental, or nervous disorder, he will be put in touch with medical aid without losing what may prove to be precious time.
Psychoanalysts prefer to see only the patient they are working with and, with few exceptions, will not see the other party or parties to the conflict. This pattern has held also for many psychiatrists, although in the last decade there have been more flexibility and experimentation by certain groups who interview the spouse or family members when they deem it constructive. The former procedure is due mainly to two reasons: first, these specialists are primarily concerned with the patient's personal adjustment and they aim to aid him in obtaining his maximum self-realization; second, they believe that the patient will feel threatened and that if he knows his spouse or other family members will be seen, he will fear lest his confidence will thus be violated. The marriage counselor, however, aims at treating the situation as a whole, and the interpersonal relationships of the persons involved. He must, therefore, know the picture as it appears not only to the client who comes to see him, but to the spouse who is intimately involved in the situation. Hence he should endeavor to see the spouse whenever possible. Occasionally it may be necessary to see parents or other family members.
The counselor must be careful, however, to make it absolutely clear that confidences will be respected and under no circumstances should he reveal to one spouse, directly or indirectly, what he has learned from the other unless, as sometimes happens, one spouse requests the counselor to open up a difficult subject which he has found it impossible to do for himself, or unless both spouses give the counselor blanket permission to use any of their material with the spouse as it might seem helpful. The preservation of the client's confidence is at times extremely difficult and requires the utmost caution and self-discipline on the part of the counselor.