A psychotherapist thinks out loud about Being Human, and stuff…

Archive for February, 2012

Hello, out there. Come on in.

Yesterday I got another of those calls. I’ve been getting them for years, one or two a month, and I suppose other therapists get them, too. I see I have a message, and when I check, what I hear is just background noise; sometimes street noises, sometimes a TV in the background, sometimes what sounds like people talking in the next room. What I don’t hear is the voice of the person calling. I sometimes think I can hear breathing, sometimes not. After a few seconds, or sometimes up to a half minute, the person hangs up. The calls are on my “land line” business phone. I have no record of the caller’s number, so I’m left wondering: what was that about? They’re not “butt calls”, obviously; I can hear the caller hang up, after a varying length of time, and they’re not wrong numbers; the caller stays on the line for too long. So, what was that about?

What I think is, I’m getting calls from people who have worked up the courage to call a therapist, but can’t bring themselves, yet, to actually speak, even to an answering machine. I remember, very well, how frightened I was the first time I called a therapist for help, more than forty years ago, how my hand shook, holding the phone, and my voice broke when I finally talked with him.

I think that’s what’s happening, and what I want to say to the caller, if only I have the chance, is, “I understand how frightened you are. How hard it is to trust in a stranger and to trust in yourself, and, especially, how hard it is to hope, just to hope that someone or something can help relieve your pain.”

I want to tell them, “Don’t give up. Keep calling for help. Maybe, next time, you will blurt out a number, and we can talk”. I want to say, “Come on in. Let’s start.”

And, until then, Keep calling. I know you’re out there.

Aside

Such a Business, continued…..

I come from a solidly blue collar background. My parents and grandparents were all middle class people, not long off their Oklahoma farms, who valued hard work and knew how to make things with their hands. My grandfather was one of those guys who could actually build a house, from the ground up. He taught me, for example, to never walk by a screw or a nut, a washer or even a nail on the ground, without picking it up. To this day, like most people of my generation, I keep containers of screws, bolts and nails, ready to make small repairs or hang pictures without a trip to the hardware store.

I learned that a job isn’t finished until it’s done- that is, when you’ve put your tools away and cleaned up the area. Then, you get to stand back and admire your work. There are few feelings as satisfying as viewing the results of your labor: you have made a change for the better. Whatever it was, it is now repaired or rebuilt and painted and ready for more years of use. Good job.

So, it’s odd that I have come to a profession in which I can’t be sure that the last hour’s work was useful. Every therapist knows the experience of having a client tell them, perhaps months later, that an offhand comment the therapist can’t even remember making was a life changing moment. Conversely, we all know the experience of thinking we’ve moved the very earth in our last session, and then having the client admit she can’t remember a thing we said. It’s a humbling experience, a reality check and a reminder that in my business we can influence, but we cannot control the outcome of a session or of the entire course of therapy.

That’s a good thing. As I’ve said earlier, my job, as I see it, is to create an environment in which my client is able to take chances that lead to discovery. I won’t pretend I have no hand in that, but it’s my client’s work and it’s happening within her. I might think I know what’s happening at any given moment, but mostly I’m making an educated guess. Neither of us may know, at the moment, that something profound has happened. For all that we try, certainties are rare in this work.

So it is that, when the fifty minutes are over, and it’s time for me to put away my tools and clean up, I can’t know what has been accomplished, not really. I always hold the faith that we did the best work we were capable of, but (as the old saw has it) time will tell. It’s a far cry from painting a wall or even replacing a washer, but we’ve done the best we can, and that has to be enough, for now. Progress, not perfection. Good is good enough.

Thank you for reading, and be well, all.

What’s the matter with being human?

One of my all time favorite movies is “The Matrix”- the first one, only, I have to say- but that’s another column.

As you probably remember, at the end Neo puts on a pair of sun glasses that are just like the glasses the “Agent Smiths” have been wearing, and takes to the skies – a Superman in a long, black gown, lacking only a cape. That ending, and the transformation it represents, has been bothering me for years. Neo, remember, is a kind of klutzy geek, when we first meet him, living in a crummy room, working at a meaningless job, doing odd jobs for people who don’t respect him. He’s klutzy, but very human – confused, aimless, sort of stuck in a late adolescent phase that might have stayed with him until he was middle aged,  had he not been tapped by the shadowy, underground organization that Knows The Truth. What bothers me is that, in the process of becoming “The One”, he gradually becomes less human and more like the tightly suited Enforcers of The Matrix. His motivation (and the motivation of the Wachowski Brothers) aside, what Neo actually seems to do is discard his humanity, by which I mean his uncertainty and fallibility. This transformation is signaled by the wearing of the iconic, insectile sun glasses that make it impossible to see his eyes. This hiding of the eyes seems to represent Power; the wearer can see you, but you cannot see the wearer’s eyes, and the eyes, we’re told, are the windows to the soul. When I hide my eyes I hide my humanity; you cannot see me or my thoughts. I’m safe.

So, it’s not much of a coincidence that The Terminator, as soon as he can, snatches a pair of sun glasses and covers his eyes, and The Terminator represents another example of the idea I’m examining, here: our desire to transcend humanity, to be invulnerable, superhuman, untouchable. We’re fascinated – or men are, at least – with superhuman images. During televised football games, we see computer generated images of robotic players, running menacingly toward the viewer, mirroring the ideal of the players on the field who are trained to ignore pain and fear -to leave those human feelings behind. I am suggesting that we’re fascinated with images of “more-than-human” characters because we wish we could be them, on some level. Some deep part of us wishes we could move in the world, unencumbered by conscience, untouched by pain, unmoved by love and unlimited by consequences – free, in other words, of those characteristics that make us human.

I see that I have written, without thinking about it, “more-than-human”, but if we could achieve our wish, would it make us more, or less human? Personally, I think it’s our vulnerability that makes us human. Of course, we want to avoid pain, and the first of Buddhism’s Four Noble Truths is that “Life means Suffering”, but by detaching ourselves from desire and all human feelings, what have we made ourselves? I think that, deep in our unconscious, what we aspire to is to be as bullet proof as Superman, as cybernetic as The Terminator and as delivered from uncertainty as Neo – no matter what the cost. Only then can we be safe from pain.

Is such a transformation desirable? Would you do it, given the chance, or would you think the price too high? Immortality, anyone?

Such A Business…..

I think a lot about what I do for a living. In fact, that is one of the major reasons I’ve wanted to write a blog. I think there are a lot of misconceptions about what psychotherapists do, and this bothers me, sometimes.

First, I can’t say often enough that I cannot speak for all psychotherapists, nor am I an authority in the field. I can only speak for myself and much of what I have to say is opinion. I’ll try to make it clear when I’m stating an opinion, and feel free to “bother me with facts” when I stray from the factual path – as narrow as it gets, sometimes.

I’m in a crazy business – irony noted, but no pun intended. There is probably no profession more beloved of cartoonists, who invariably picture us as bearded men, scribbling on a pad while another guy (usually) emotes on a sort of chaise lounge. There is the strong suggestion, usually, that the couchee is being scammed in some way- that is, that he is being charged for the privilege of being fleeced by a cynical huckster with too many diplomas on the wall. I collect these cartoons (many of them are very funny) despite the fact that they sometimes make me grimace. Let me tell you a little about what we really are:

Most of us- at least in California- are middle aged women. Men are a pretty small minority in my field. (I speak here of licensed psychotherapists- Counselors, Licensed Social Workers and Marriage and Family Therapists, or MFTs- the license I hold. I have no figures on Psychologists or Psychiatrists, who may or may not do clinical work.) Many of us come to this profession relatively late in life, having already worked in other fields, perhaps until retirement. Most of us struggle to stay in the middle class- but, of course, so are most of the people we see. So, for that matter, are most of our fellow citizens. Don’t get me started on that.

I have never- and for some reason this is important to me- seen a chaise or “fainting couch” in a therapist’s office. Not as a client, in my own therapy, nor as a visitor to colleague’s offices. Papa Freud had one, as did his various disciples, and I suppose those who continue to practice some version of Psychoanalysis still do it, sitting next to a chaise, behind the patient, avoiding eye contact for fear the transference will be compromised. (Slight snarkiness noted.) For most of us, that aloofness is as alien to what we do as the couch. What we do- what I do, in fact- depends on the exact opposite of aloof detachment. Study after study shows that the single best predictor of a successful course of therapy is the relationship between the people involved. If the client feels comfortable with the therapist, if she feels the therapist is honest (in the sense of being authentic), and can be trusted, the therapy is likely to go well, whether it’s long or short term therapy, whether the practitioner is coming from a “cognitive behavioral” orientation or a “deep, psychodynamic” place, like me. Simply put, if the two (or more) people hit it off, the outcome is likely to be useful, whatever tools the therapist has in his or her bag, or even if the therapist/counselor has minimal training. A lot of people have been helped by “Trainees”, or “Peer Counselors”, who have only learned the rudiments of our craft, but who know when to speak and when to listen, and have the ability to care about the person in front of them, just enough, but not too much. That’s a tricky balancing act, and there’s much speculation about whether it can be taught at all, whether you either have it, coming in, or you should be in some other racket. opinions differ.

By the way- continuing my obsession with the iconic Couch (which has now acquired its own capital letter)- most of us do have one, but it’s just your basic living room number- a two or three seater- often passed along from therapist to therapist as we retire or move up to better furniture. I’ve had my couch for nearly twenty years and (in the way that I often overbond with inanimate objects) I’m terribly fond of it. It’s more of a love seat, I suppose, too short to take a proper nap on, although I do my best. It sags a bit, and could use a good cleaning, but it’s become sort of my lucky charm. Hundreds (feels like thousands, some days) of people have settled into that couch with a sigh, commenting on how comfy it feels, and I’m not sure I’d be as good a therapist with some snappy new number from Ikea. The pillows need to be put out to pasture, though. But I digress…

Continuing to use the cartoon therapist as a foil, the implication is that the person on the couch has come to be told what to do, in order to be happy, or just “sane” instead of “crazy”. The scam is often that the person in the chair is just as hapless and nutty as the patient on the couch, but, because of the pieces of paper on the wall, the patient doesn’t get that, and is paying for nothing.

Where to start? First of all, yes, sometimes I do have to take charge, as much as possible, and tell my client what to do. If she’s in crisis or some kind of life threatening situation (hers or someone else’s), or she’s so disabled she’s unable to care for herself, I have to act in what I believe to be her best interest. I’m mandated to do so – to act responsibly in the interest of those unable to do so themselves, and in the interest of Society. Thankfully, that’s a rare occurrence. A grayer area might be my work with an addict who has come to a place of desperation and hopelessness. My training and my life has given me a pretty good idea of what will probably help, if I can get the client on board. In such a case, I’m going to be pretty directive: here’s what others have done. How about trying it?

For most of my clients, though, however much I might think I know what they need, my job is to nudge them into the experience of figuring it out for themselves. Most of the people who plop themselves on my couch have lost a lot of whatever faith they may have had in themselves. Maybe they want me to tell them what to do, like the therapists in the cartoons. Often I’m itching to do just that – but what good will that do them? I’ll be just another authority figure, telling them (however indirectly) how inadequate they are. Infantalizing them. That’s not my job. In most situations, it’s actually more important for the client to blunder his way to his own answer than for someone like me to tell them what to do. In most cases – and I’d put this in all caps if it wasn’t so hokey – I Don’t Know What The Client Needs. I might think I do, but I believe it is the height of presumptuousness – even arrogance for me to put myself in the ever-so-tempting role of Wise Man Who Knows What You Need. You are on your path, as I am on mine. We share humanity, but we are separate humans. You are paying me to help you discover your path, not to tell you what it is. Unless the situation is dire, the journey is more important than the destination and (ready for it?), “All who wander are not lost”. (My geek credentials are now established.)

I think that’s it for this installment. Clearly, this subject is going to take more than one entry. I’ll get back to it soon. Feel free to comment on anything I’ve said. Love to hear from you.

Until we meet again, happy trails to you….

Shrinkery

Hello. Hello. Is this thing on? Okay, here goes.

I’ve been thinking for the last year or two of writing a blog about what I do for a living; about psychotherapy and the way I practice it. I am not an authority in the field. I am, however, an authority on what I do, and that’s what I intend to write about.

That said, I’m realizing that I have no intention of limiting myself to so narrow a subject. I intend to speculate, to wonder out loud, to deliver myself of opinions. I will try very hard to make them considered opinions, and to label them as such. I’ll be passing along ideas that I’ve encountered in my reading, asking you what you think about them. I’ll probably fulminate, from time to time, about things that have angered me, though I’ll try to keep that to a minimum; there’s enough anger on the net, and in the world in general, without my adding to it. Above all, I expect I’ll be circling constantly around what I consider the Core Question of our human condition: given the fact that we know how to create Heaven on Earth, why don’t we?

Begs the question, doesn’t it? Maybe more than one.

I’ll try to keep these postings short and snappy. You have a lot of things to do, and so do I, but, like that Greek guy said, the unexamined life is not worth living. I intend to examine my little corner of it, and I invite you to come along.

Be well and see you later.