Wednesday, August 31, 2011

One minute of forgiveness

In my line of work, I hear a lot of awful stories of transgressions that people have had visited upon them. Neglectful parents. Relationships ended by acts of betrayal. Friendships rendered apart by a moment of thoughtlessness.

As a therapist, I invest a lot of time "joining" my clients, walking in their world as much as I can. Just like them, when I hear about these terrible things my first response is a defensive, protective one. How dare those people do that! (Please bear in mind, this happens on the INSIDE. I don't tend to blurt these things out. That's another post for another time.)

When this happens, I usually realize that I need to take a step back and gain some balance. And when I gain that balance, and a little more clarity, it often becomes apparent that my client could benefit from an act of forgiveness.

Forgiveness is not something I foist easily upon someone. The act of forgiveness can be complicated endlessly by emotion, by habit, and by a lack of understanding the process. Before I lay that on someone's head, we make sure that forgiving isn't just a way of avoiding the emotions underpinning the situation.

No matter the complications, though, true forgiveness can be an amazingly powerful act. And, just like the one-minute reboot and the one minute of gratitude I posted about before, it can be a simple and energizing thing to do in your day. Here's how.

Find that spot you found for your one minute reboot. Get comfortable. Breathe. As before, observe what comes up for you, and then let the thought go. Worried you're doing it wrong? Observe that worry with kindness, and put it back into the stream. Soon, something will come up that you resent, or feel wounded about. Trust me on this one. If you can't find one, stop reading this blog. You're actualized! You made it!

Still reading? I thought so. Now, take that little grudge and let's hold on to it for a minute. If it's a huge one, a life-altering transgression, let it know that you'll be back after some practice, and let it go down the stream. We'll start small. Take the little grudge (that person who cut you off in traffic is a great start) and observe it. Observe the emotion that comes with it. And stop for a minute to consider that the act is OVER. It's in the past. You're in the now. That's a good place to be, sitting there in your comfortable spot. You're in the perfect place right now to just let it go. Just focus your compassion, not on the universe, not on your year or your month or your day - focus your loving compassion on that tiny act you hold in your mind. Say it - "I forgive." Say it again. Flood that act, that crappy driver, with all of your compassion. Don't worry, you'll make more.

And, just forgive. It's a radical act of acceptance, and when you practice it, it gets easier. Just like all the one-minute things in the world, they take some repetition. If your only act of forgiveness today is forgiving yourself for being crappy at forgiveness, so be it. You forgave something after all!

If you have to read this a couple of times to get it right, that's okay. I forgive you.

Monday, August 29, 2011

One minute of gratitude

I got so many nice responses to my one-minute reboot that I thought I might try to make a semi-regular thing out of one-minute ideas. Today: One-minute gratitude.

As you may have guessed, it's a pretty simple process. I'm of the opinion the simplest processes are the ones that have the most profound impact. Rather than complicate them with all that messy cognitive interference (aka "thinking!"), they touch something basic within us.

Here are the steps. There will not be a test at the end.

1. Find a quiet spot.
2. Breathe deeply.
3. Give thanks for something.
4. Breathe some more.
5. Reluctantly leave your quiet spot, but promise it that you will return!

See, I even gave you some exit instructions.

Gratitude is a process that we tend to muck up with our emotional reactions, our learned prejudices and assumptions, and all kinds of other stuff. Like the one-minute reboot, the trick is to let go of the judgment and just be simply thankful, without a reason or an explanation. If your shoes feel good, flood them with your loving gratitude. Good hair day? That works fine. Someone did something nice for you? Direct your uncomplicated flow of love and gratitude their way.

As the complications come in, be grateful for your mind's ability to produce such complicated loveliness and then let them GO. Return to that powerful stream of pure thankfulness. Let it wash over you. Pick a color. Is gratitude green and vibrant? Is it muted and smoky? Plaid? Your choice. Envision it touching the object of thanks, if you want. Let your pulsing blue river of gratitude flood over that guy who held the door open on the bus. See it however you'd like.

The point isn't to do it right. There is no point, really, other than being in that moment of thanks, touching it, letting it become a part of you.

One minute! That's all. No goal. No way to do it right. Just an opportunity to do it.

Let me know what you think!

Sunday, August 28, 2011

7 things to do during your first therapy appointment

I have a friend who is returning to therapy after a long time away. She's understandably a little nervous about the whole thing - one of the things I always try and remember is that even though therapy is a comfortable situation for me, a first visit is often anything BUT for my clients. She asked for some ideas about what to do, and what to expect, on a first visit. Being the accommodating type, here they are!

1. Spend a little time preparing. Sit down with some paper and a pen (whoa! Old-fashioned! Keyboard, tablet or phone works just fine, as well) and do a 5-minute free-write about what is on your mind, and about what your therapy goals are. Or, make a thought map by writing random words with your non-dominant hand. Free-associate. Make a spreadsheet. Bake a cake and pipe your goals onto the icing. The point is, rather than just walking into the therapy room and going "oh, uh, what now?" just invest some time in thinking about what you want out of this therapy thing. It is ABOUT YOU. Let's repeat this - therapy is ABOUT YOU. One of the things that makes people nervous about therapy is wondering how to do it right, or how to please the therapist. This will result in less progress and more frustration. Quiz time: Therapy is about ___. Right!

2. Realize that your therapist has some basics that need to be covered. We all do it a little differently, but we all have some things we have to take care of. You'll go through a process that we call "informed consent." This is an ethical obligation of ours. You'll be told about your rights of confidentiality, and about times that your therapist might need to break confidentiality (short version - life-threatening emergency, imminent suicidal risk, some court-related things that most likely won't happen to you). Your therapist will hopefully explain his or her policies about attendance, cancellation, etc. At some point, they'll do a risk assessment, in case one of the reasons you're in therapy is due to suicidal thoughts or intentions. At this point, if you have questions, ask them. It's always so refreshing when someone asks questions after the informed consent process!

3. Get a feel for the relationship. This one is a little tougher to explain in words. As I've said a few times around here, and will say a lot more, the relationship is critical to getting good therapy work done. If you are uncomfortable, don't feel safe, or just don't feel that connection, you're really going to have to force the work, and that's not what you're paying for. Sometimes it is immediately apparent that your therapist is not the one for you - in that case it's absolutely fine to simply say "I don't think I'm going to return" at the end of the session. "We just don't click" is not a bad thing for us to hear. I'd so much rather hear that than struggle through a few sessions with a client who is obviously not feeling the connection. If you're into humor, tell a joke or see if your therapist tries to. Some people want a concerned mortician to talk to. None of my clients are those people. It might not be a night at the comedy club, or a conversation with your best friend, but you'll know if it feels right. If it doesn't, then one and done is fine.

4. Go ahead and trot out that "one thing." Yeah, easy for me to say! I have this theory that everyone has at least one thing that they're sure nobody can accept, or they've been conditioned to think that it's bad or wrong. At least one. I've gone months with people before they've told me that they spend the majority of their time off going to swing clubs and being bound and gagged, or that they're Republicans, or, you know, whatever. And after they tell me, things shift. They've gotten That One Thing out on the table, I've accepted it, and we've moved on. You don't have to spend the entire session talking about the fact that you've lost your last three jobs due to your obsession with Papa Smurf, but maybe just drop a hint. Your therapist will be okay. If your therapist is not okay, and gasps disapprovingly, GET OUT NOW. Really, don't even wait until the end of the session. Therapy is where That One Thing is something that can be talked about. That One Thing is a part of you. A good therapist values all of your parts.

5, Set some goals, but realize that things change. Sometimes one of my clients will express amazement at my lack of whiteboard, or the fact that I haven't made a goal list and set deadlines. Here's the thing: So many times, a client will tell me what they want to work on, or what their goals are, and when I go back at the end of our work together, those goals have been left far behind, abandoned for whatever has become more important to them. Figuring out how to survive your crazy boss suddenly becomes a non-issue when your boss gets hit by a meteorite (okay, no personal experience with that one). Lives change. Minds change. Superficial goals are replaced by the ones that you find when you start to find yourself. This is one of the most beautiful things about therapy work. Come in with your list, but be prepared to burn it ceremonially, or maybe just chuck it in the shredder.

6. Make sure your therapist checks in. A good therapist will check at the end of the session, and throughout your work together, to make sure you are feeling comfortable (or at least aware of why you are uncomfortable) and safe in session. They will assess in an ongoing basis how you are doing on your goals, whether you are making progress, and how you feel about the therapeutic relationship. If you finish your first session, and your therapist doesn't at least ask if the match seems okay, then listen for it at the beginning of your next session. If they skip past this, then ask them why. Some therapists, believe it or not, have a tough time with some of the necessary work of building the therapy relationship. Make sure that your therapist isn't one of those.

7. End with some adjustments. Screw up your courage and make a suggestion or two. "I'd be more comfortable if we could spend more time chatting at the beginning." "I noticed you checking your watch and wonder if that's necessary." "I realized that I don't really want to talk about my mom yet." Whatever you've got. Hopefully your therapist will do number six above, and give you some time to just relax and reflect on that first session. If the two of you can do that together, you're on your way to good work.

There are plenty more suggestions all over the internet, if you'd like to do some more reading. That counts as preparation! The bottom line is this - you should feel respected, listened to, and be in an environment that feels safe and non-judgmental. You are by far the best judge of what works for you. Stay open, breathe a little, and take that first step on your journey.

Saturday, August 27, 2011

Is it really that easy to Just Do It?

Today's email brought news of another study about the impact of exercise on depression. This one was conducted by the University of Texas, seems very well-designed, and the upshot is that exercise works just as effectively as a second medication for folks with long-term depression. The trend among prescribers is to add something like Abilify to a current SSRI (Paxil, Prozac, etc.) for their patients who have depression that's not responding to just one med. This study shows that there is another way for many people to have the same result, without an extra med. Around half of the people who added regular exercise to their SSRI improved significantly.

So, you say, why don't I just tell all my clients to exercise?

The answer, as always, is that it's just not that simple. While I am keenly aware of the benefits of exercise, and try try try to add it into my lifestyle (No, really, I try!), it's not as easy as simply suggesting it to someone as though they've never heard that idea before. Can you imagine that there's someone left in the U.S. who hasn't dealt with a daily barrage of messages about their size, their laziness, their lack of motivation, their inability to look like people on TV? This is where my job gets complicated. Again.

The act of fostering change is one that we spend all our time in graduate school trying to figure out. And then we go into practice, and we learn a little more, and we keep trying. We get a dozen years of experience under our belts. And we are faced with a client who, for all we know, would make rapid improvement with exercise. And our years of experience sit there in our heads, mocking us.

While there are some who benefit from the boot camp approach, I'm guessing that many of them aren't overcoming serious depression, or a life of parental shaming, or a daily battle with body image. Screaming at my clients to "just do it" might benefit a couple of them, and damage my relationship with the rest. Mine is not really to urge, or cajole, but to join with my client in a process of discovery - how do I really feel when I resist exercise? What are some thoughts about my body that I might want to choose not to believe anymore? Is there a gentle experiment I can do, one without a failure component, that will let me try something new in a safe way?

Unlike the trainer at the gym, my job isn't to goad you into getting your workout done, no matter how positive the results may be. My job is to help you realize that no matter where you want to go, you've got to start just exactly where you are today. Judgment doesn't change that. Then I work with you to help you find about yourself, figure out what might be in the way, and to stand by and support you as you try out some new behaviors. If those behaviors don't "take," that's just as successful an experiment because we've learned more about the problem. I'm happy to help hold my clients accountable, if they want, by asking them to exercise, and I'm hoping that they'll have a few experiences that show them there's a better way.

There are therapists who will push, and goad, and you can find them by asking if they'll do that for you. In the long run, I've seen my way work more often than not. And, to me, that's reason enough to stick with it.

Thursday, August 25, 2011

And, in other news...

I actually write about things other than psychology from time to time. Here's a story of mine about commuting, at the most excellent Trimetdiaries.com.

Monday, August 22, 2011

Why won't my therapist give me longer appointments?

One of the things I do when I come into work in the morning is pick up the messages from people who have called during the hours we're closed. This morning, there was just one - a plaintive request from a client of one of my colleagues, asking for longer sessions. The client said that she felt she could do more with more time.

This is not an uncommon request. My clients will ask from time to time if we can meet for two hours instead of one, or go 15 minutes over, or any stretch of extra time, because they feel that we're ending while they still have something to say. I understand that, and I think there's all kinds of merit to the desire to do more work in therapy.

Here's the problem, though, from your therapist's perspective. If I do that for a client, should I do that for all my clients? If one of my clients finds out what another one is doing (and, in my job in a college counseling center, many of my clients know each other) how will they feel? Of course, I can't talk to any of my clients about what any of my other clients are doing - but they'll know. And they'll wonder why someone is getting special treatment when they're not. And this will color our work together, at least for a while, and maybe distract from the other good stuff that we're getting done in session.

Incidentally, one of the hallmarks of therapists that are sliding towards an ethical violation is doing special favors for one client above all others. Keeping later hours when they'd usually be headed home. Coming in on a weekend. Allowing that client privileges that no one else is getting.

I'm very sensitive to this, and I work hard to keep the "therapeutic frame," that container that helps our work together feel safe and consistent. If I find myself favoring someone, or feel like I'm NOT doing something for someone that I'd do for someone else, it's time for me to sit with that and figure out what's going on.

For your therapist, the work continues after the clients are gone. We need to make sure that we're centered, available, and doing everything we can to clear out those hidden prejudices and acts of favoritism. From the outside, it might just look like 15 extra minutes. From my perspective, it feels like a lot more than that.

Not all therapists are with me on this one, and I know of some folks I very much respect who give extra time to some folks. I've done it myself, when the clinical need was strong, once or twice. Those instances have been few and far between, and I've had a good conversation with myself, and then my client, about the reasons behind the shift. As will all things involved in being authentic and human, sometimes the little things mean a lot more than we think.

Sunday, August 21, 2011

Decision fatigue

Here's a great story in the New York Times Sunday Magazine about decision fatigue, stuffed full of fascinating research and anecdotes about the countless decisions we face each day. It's a real eye-opener, and the bottom line is that there are some basic brain functions that we should really pay heed to if we're making an important decision. The final quote says it all - “The best decision makers are the ones who know when not to trust themselves.”

Check it out if you get a minute, and see if it applies to you.

Five tips for finding a therapist, from a therapist

According to Google, this is online article number 1,630,001 about finding a therapist. Rather than be daunted by that challenge, I'm going to choose to ignore the other 1.6 million and give you some tips that I hope will help you wade through the mass of information.

1. Take a deep breath and start NOW. Therapy goals are often long-term goals, and we're not so good with those in terms of self-reward. Looking for a car means you get a new car. Hunting for the best vacation spot means you get to go somewhere soon. Get comfortable with the idea that you're putting effort into a long-term investment, and put at least as much effort into your search as you would into looking for the best price on a new computer. The benefits of good therapy last far longer than anything you can buy.

2. Like shopping for pants, comfort of fit is everything. We've all bought pants a size too small, just knowing that we'll soon be able to fit into them. Therapist-shopping is like that - many people cut the uncomfortable search process short as soon as they find someone they think they can live with. Some "how to find a therapist" articles warn AGAINST comfort of fit, saying that if you're too comfortable, all you'll have with your therapist are chit-chat sessions. My clients will likely tell you that I'm a pretty comfortable guy to hang out with, but when it comes time to do the work, we don't hold back. Without that welcoming safety net underneath, nobody wants to go up on the high wire. Most people will do more work, more quickly with someone they are comfortable being around.

3. Good therapists are good at recommending good therapists. Ask your friends if they know a good therapist, or if they know someone who does. Get the list of therapists from your insurance company. Then ask your friend's therapist if they know someone on the list. Or, if your friend's therapist is so great, go to them! I work in a college counseling center, and many of my clients know other clients of mine. It has no impact at all on our work. Confidentiality rules and general common sense forbid me from even acknowledging that I see your friend, much less say a single word about our work.

4. Don't let location make up your mind about who to see. The college I work for is in the sticks, location-wise. Many of my clients tell me that they value the drive (or bus ride) there, because it gives them time to think about what they'd like to talk about. And the ride home gives them time to process what just happened. A therapist five minutes from you is convenient, but if you land one of those build some time into your schedule to process your session, right after your session. Trust me on this one. You'll consolidate your gains and make more progress that way.

5. Know the difference in degrees and licenses, but don't let that make up your mind for you. In Oregon, psychiatrists and psychiatric mental health nurse practitioners prescribe meds and do some therapy. Psychologists do testing and therapy. Licensed professional counselors, marriage and family therapists, and other master's-level counselors do therapy. And there are a raft of other practitioners. If you have questions about someone's credentials, ask. I know people with a year of therapy experience that I'd recommend over others with a dozen years (if I could). Some have it and some don't. Experience helps, but it is definitely not the only thing to look for.

5a. See number 2. Relationship is everything. Look until you find someone with whom you can be comfortable and open.

Okay, add that one to the pile of 1.6 million other resources out there. Keep up the search - the rewards are great. And if you think you've found someone and you find you just don't fit, see my post on firing your therapist. It happens all the time!

Saturday, August 20, 2011

The one-minute reboot

Like just about everyone else, I own a smartphone. My phone, a Droid X, is pretty darned smart, and I've grown accustomed to it. Every once in a while, though, it acts kind of stupid. It will shut down while I'm trying to play a song. Its smart little screen will get stuck while I'm flipping through photos.

When this happens, I've got the solution. Like so many other pieces of technology I own, I just shut my phone off for a minute, let it rest, and turn it back on again. It emerges from its nap all refreshed and ready to do more smart things for me.

In some ways, our brains are like smartphones. The visible stuff like producing speech and guiding your fingers to the right phone keys is just part of what's going on. You know how that feels - you're typing up a letter at work, and your brain is feeding you anxious little tidbits about your checking account or chiding you for eating too much at lunch. It never seems to stop.

I have clients who tell me that they're always running, always working, always tired. I ask them what they've done for themselves lately, and the answer is always the same - and usually comes after a slightly embarrassed pause. "Nothing."

At this point, we do a little experiment. I have them close their eyes, if they're comfortable with that, and I lead them on a one-minute guided breathing exercise. No point to it, no destination, just one minute of slow breathing. I tell them that if those anxious thoughts try to crowd into their breathing space, just notice them and then let them go. Observe and describe. "Oh, there's a thought about money. Goodbye, thought about money." "Hey, I'm judging myself for not being able to do a freaking breathing exercise correctly. Hi, judgment, I'm noticing you. Goodbye, judgment."

And so on.

After a minute, I bring them back into the room. They're often very reluctant to come back from that nice, centered, non-judgmental breathing space. I ask them when the last time they took even one minute to do nothing at all but breathe, and practice kindness to themselves. Again, the answer comes - never.

Next time you're at work in a frenzied day, close your office door if you can, or just find a place to go (bathroom? Hopefully the boss won't chase you there, although I had one in my past work life who would!) and take one minute for yourself. Breathe. Observe and describe your thoughts, and let them go. If it helps, visualize yourself next to a stream, and let your thoughts be leaves on the water. Pick up the leaf, feel your love and compassion for that leaf, release it into the stream. Repeat.

If you're lucky, this will become a habit. Everyone has one minute per day to spare. The more you visit your brain, the better you'll get at quickly finding an uncrowded corner in which to relax.

One minute, one day. Try it.

Tuesday, August 16, 2011

Ask the Doc: How do I fire my therapist?

I've been with my therapist for several months now, and it doesn't feel like it's going anywhere. How do I know when it's time to move on? And, how do I do it? Also, I can't help but wonder if I just want out of therapy because my sessions have been really tough lately.

Some relationships are easier to quit than others. And for many people, the therapy relationship is one of the hardest to leave for a number of reasons. Feelings of guilt and responsibility get in the way. You're reluctant to start over again and tell your difficult and personal story to someone else. Or you're just not sure if it's time to go. Could it be, you ask yourself, that you just want out because therapy is hard work?

Several months is definitely enough time for you to get a feel for your therapy, and a good idea of how things are working with your therapist. No matter what kind of treatment you're receiving, no matter what your therapist's theoretical stance, it is well-established that the therapeutic relationship is key to your success. Often, when we feel like "firing" our therapist, it's because that relationship just doesn't feel right. This knowledge can be helpful when you're wondering if you're just getting out because the going is tough. Put aside your recent, difficult sessions and ask yourself about your relationship with your therapist. Do you trust them? Are you holding back more than you feel you should? (note: just about everybody holds back in therapy as a way to keep themselves feeling safe. But, are you holding back even more, because you just don't feel comfortable?)

If you establish that your relationship with your therapist isn't what you need, or what you've hoped for, it's time for the next step. Interestingly, one indicator of a good therapeutic relationship is the feeling that you can talk about things when the relationship feels less than ideal. If you can trust your therapist with that conversation, and feel heard and responded to, you may be in the right place after all. But, if you can't open up like that, it's an indicator that there are probably other things you won't want to share either. It's time to let your therapist know that things aren't working as you'd hoped.

A lot of clients simply vote with their feet - a couple of missed appointments, a follow-up phone call, and that's that. I'd encourage you, though, to schedule at least one final session. If you've had a long relationship with your therapist, you may want more than one to feel like the termination is complete.

Yes, that's what we call it. "Termination." An unfortunate term, at best. I tell my clients that we can call it a "goodbye session," or whatever else they like. Termination sounds a little too much like there's a hitman involved for my comfort. Regardless of the name, though, that last session holds a lot of potential. Rarely in life do we get an opportunity for a mindful, face-to-face goodbye. In the world of therapy, that goodbye is a real one. You're moving on, and in all likelihood you won't see your therapist again. Unlike leaving a job, or moving out of town, there are no promises to keep in touch. No Facebook friend-adds. No "I'll drop in once in a while to see the old place." When was the last time you had a chance to truly say goodbye? Take the opportunity if you can. You'll probably learn a lot.

As for guilt - don't worry about hurting our feelings. One of the difficult parts of the job is that we've learned to say goodbye, over and over. All therapy comes to an end, even the good stuff. Through our training, we move around, we terminate with dozens of people, we learn not to take it personally. A good therapist won't make you feel guilty, or beg you to stay, or figure out a way to stay in touch with you. Part of your therapy work unfolds right there in the last session.

The bottom line is that, unlike many other situations, the goodbye can be the most helpful part of the whole process. Don't deprive yourself of that opportunity. And, when it's time to hire another therapist, ask about the goodbyes up front. Set a timeline to check in on the relationship, and on your progress. And, like all things learned in therapy, use your new knowledge to make progress in your next relationship.

Note: "Ask the Doc" is a regular feature here at DocBlog. If you've got a question for me, drop me an email at drjeff@gmail.com.

Thursday, August 11, 2011

In the moment

Take a deep breath, think about all the amazing things in your life (including the simple ability to take a deep breath, and to think). Then take a moment to tell someone you love them, or to just thank them for being there. The more love you put into the universe, the more there is to go around.

Wednesday, August 10, 2011

Defining "healthy."

I'm working with someone who is going through a pile of difficult stuff right now. She has a complicated trauma history, and has been abandoned more than once. She is convinced by trial and error that nothing will ever turn out well for her - the universe has shown its capricious hand with her over and over again, and she feels as though she has been taught the truth by life.

As is often the case with people who have fallen into a run of terrible luck, she is sure that she has done something wrong, navigated poorly, and that because of this things will never change. She is mired in a relationship right now, or the semblance of a relationship, and she feels as though she is being taken advantage of.

Today she told me that she thinks she should just drop this relationship, just never answer another text or call or email, and move on. She pointed to the example of a friend of hers who did this. It just seemed so healthy. This example "proved" that this is how to handle this situation.

I asked her to imagine her emotional reaction if she just walked away from this guy. If she dropped all communication and no longer had him to talk to. She told me that she'd feel lonely, broken and abandoned. She'd feel lost. She'd take a while to recover.

I asked her how healthy that sounded to her.

After a pause and some reflection she began to understand what I was getting at. I'm not sure I agree with the concept of "mental health" as prescribed by endless movies and tv shows. We see our friends' behavior from the outside, with no idea how it really feels on the inside. My client's concept of "healthy" is an impossible standard for her.

To me, healthy starts when you accept who you are, and what you need, whether or not it's ideal. And, trust me, it's rarely ideal. If you know who you are, and you're okay with what you need, you can start adjusting your environment accordingly. You're going to be a lot happier functioning as your true self in an environment that fits that self, rather than trying to force changes in yourself to fit an environment. I would, of course, never recommend that someone stay in a relationship that is abusive or degrading. At the same time, I would never judge them if they felt the need to pull away slowly. I can't look into them, or into their relationship. No one can. Luckily, my client is not in a damaging relationship like this.

As my client works towards independence, and self-worth, the last thing she needs is to pull the floor out from under herself. Less-than-ideal relationships, imperfect jobs, tentative engagement with the world - all can function as transitional objects as one finds out where one really belongs, and goes there.

Sunday, August 7, 2011

Does my therapist think of me between visits?

I was sitting with a client a while ago. We were at the beginning of the session, a time that is sometimes less focused and more "social" than the rest of the session, a time when we're figuring out what is primary and what can be left until next time or left behind entirely. I mentioned that I'd seen a sign along the highway that reminded me of her.

She was stunned.

I couldn't untangle all the different emotions that played across her face, but the one I resonated with was the one that probably mimicked the look I had when I was a 3rd grader and I saw my teacher in the grocery store. In that moment it had dawned on me that my teacher was a human, a real person, not someone who sat in unknowing stasis in the classroom until we came back at 8:15. My teacher shopped! She probably peed, and ate, and knew real people in the world. She didn't sleep at school! Maybe she had kids!

It was a little hard to handle.

I think my client felt the same. In a flash, therapy changed for her. She suddenly realized that there was a human sitting across from her, someone incapable of unfeelingly compartmentalizing all the emotion and life that flows during our times together. She knew then that I wrestled with those questions away from the office. She discovered something that therapists do that clients often don't think about - we think about our clients and their lives and their emotions and their problems and their bright victories and jarring losses away from the confines of that rigid 50-minute office frame.

Studies from across the theoretical board show that if you want to get good therapy work done, it's all about the relationship. Therapists from all corners of the profession are in the business of making strong human bonds so they can do the rest of their work. If that bond didn't transcend the therapy hour, it wouldn't be real, it would be an invention meant to enable therapeutic progress. And it just doesn't work that way.

Your therapist, if she or he is doing the job in a competent way, is bound to you by far more than a pile of therapy notes and insurance bills. And I can virtually guarantee you that at some point, on some insomniac night or relaxed coffee-sipping morning, you've been thought of as much more than a client number.

Ask your therapist next time you see them, and see what sort of answer you get.

Tuesday, August 2, 2011

Teaching

I drove up through the Terwiliger curves this afternoon to pick up my final paycheck. I taught a grad-level class in assessment this summer, three hours a week every Thursday night, and instead of having them mail my check to me I wanted to see campus one more time. I do this every time I teach there, because I'm convinced that it will be the last time. The money is not all that great, and it's a hassle teaching a required night class during summer semester. The campus is beautiful. I don't blame someone if they'd rather be sitting on that cool, green lawn right outside the window.

You've probably seen the video that's making the rounds - Matt Damon gives a testy reply to an interviewer who tries to draw a parallel between "job security" making him a better actor, and the threat of job loss somehow forging better teachers. I can tell you with all my heart that fear of losing my job is not what makes me teach. The money is not what makes me teach, although it may well be what gets me out the door and into the car on Thursday nights. Teachers teach. It's what they do.

I had a conversation with a massage therapist a while back about being a "healer." Some of us are just called into that trade, whether through experiences that healed us, or just a desire to make a difference in someone else's life. I think teachers are the same. Can anyone really imagine that elementary school teachers, embarking upon their education, really survey the career field and choose teaching so they can grow lazy in that plush guaranteed job?

I had the pleasure of taking a class from one of the great teachers of all time, Lawson Inada. Lawson had read his poetry at the White House. There was no Wikipedia at the time, but he's sure on there now. And Lawson taught me how to teach, disguised as lessons in creative writing. He understood that if we were distracted, or bored, or not engaged, that it was his responsibility. He kept us fascinated, every hot summer southern Oregon day, and we were always sad when class ended.

When I started teaching grad students, I was at a school that required all the students to bring laptops to class. When I was being interviewed for the job, the person hiring me started talking about ways to be sure that people weren't checking their email, or surfing porn, or whatever else they wanted to do. And none of those ways had to do with my solution, which was to try and be more interesting and engaging than whatever they could see on their screen. This is what teachers do. They teach. They engage. They become invested in the people they see in class.

As I walked back out to my car, a student crossed my path. She was intent on getting to where she was going. I envisioned her sitting in class, mind open, getting that feeling one gets when one is engaged in something important and worthwhile.

If she was going to go look out the window, that wasn't her fault.