What is Therapy?

Many of us have cringe-worthy thoughts when someone mentions therapy. THE COUCH still looms deep in people's psyche. We get images of disconnected professionals peering over their glasses at tear-soaked clients. Freud has been gone for awhile, but the concept of the therapist who holds themselves apart from their clients, "analyzing" them, remains. I think that's what scares people about therapy.

When we can't feel someone, it gets creepy.

Think about all the horror movies where the evil-doer wears a blank mask. We put all of our own fears on that thing, and that's why it scares the hell out of us.

That's what makes people uncomfortable with the idea of telling their secrets. They don't know how it will land. When the therapist remains "a detached professional", the client is left uncertain about the relationship.

For me, the essence of good therapy is about listening, feeling into what I'm hearing, and then giving feedback around that experience.

Therapy is about telling our sacred stories, our secrets, the things that we often hide even from ourselves. That's scary, and it doesn't happen all at once. Our clients test us. They toss out a little firecracker to see how we handle it before they start lobbing grenades.

Our clients need to know a couple of things before they really start to trust us. They need to know we can handle it, that it's safe for us. They also need to know that we aren't going to shame them, that it's safe for them. Once we travel together past those two gates, we can start in with the real work.

If the therapist is not congruent, that is, if what they are saying does not match up with what the client is feeling from them, then that relationship is flawed. If a client comes into the office looking disheveled and out of sorts and states "God, I just couldn't get myself together today", the therapist could say "Oh Mary, you look great, come have a seat". Mary is going to know that therapist is lying to her. even though it's done to try to be polite, Mary now might be wondering what else that therapist has been saying that is not true. It becomes similar to most other relationships.

On the other hand, if her comment about her appearance is met with "yes, you do look like you are having quite a day, come tell me about it", the therapist has just modeled something very important. They were genuine. They didn't try to make it all nice. being polite is not what we do in therapy. That's not to say we are not kind or gentle, but often polite is not honest, and it damages the connection that is so crucial to the therapeutic relationship. 

So, what is therapy?

The reality is, it looks different for everyone, but it often begins by talking about things that can make the rest of the people in your life uncomfortable. The effective therapist will lean in and ask for more when most others would start desperately grasping for a new subject.

The other part of good therapy is accurate feedback. It's a container that's safe enough to hold a real conversation. If Mary comes in looking like hell, we're not going to tell her she looks fine, we are going to say, "you look like hell, get on in here and tell me why".

Why is that important? (stay with me, this is the good stuff)

Chances are Mary, like most of us, hasn't had many people give her honest feedback about how she's coming across. If the therapeutic relationship is strong enough, if the container can hold it, and if the therapist has gauged all of that accurately, then she will be able to hear this feedback as coming from a place of genuine affection and caring.

When the therapist can lean in, look Mary in the eye, and tell her what they really like about her, what they appreciate, what they carry around with them in the time between their sessions, she's going to be able to receive it in a very different way. Specifically because of the care and attention given to building this authentic relationship, one true compliment can change the way Mary sees herself, which may have a profound impact on her need to boast about her accomplishments. 

Without the relationship, none of that happens. 

Silence is (not always) Golden

I had a client tell me the other day that she sat in silence with a therapist for four sessions before she finally called it quits. Silence is a tool that many therapists use to draw a client out. It’s a powerful method, and needs to be used carefully and with close attention and compassion. Giving someone space to arrange their thoughts is necessary and useful. Pushing that silence a little further will cause discomfort. The discomfort can sometimes be the catalyst the client needs to disclose things that might otherwise go unsaid.

But there’s a limit

We don’t generally do silence very well in our culture. We like to fill it in any way we can. In a therapy session, giving a little space allows the client to make the first move, or elaborate on a topic.

Leaving a client sitting in silence for too long becomes a power play, and that has no place in the therapeutic relationship.

It’s unnatural and scary for our clients. By remaining too quiet, we prevent the client from feeling into who we are as fellow humans. As I’ve written about before, if they can’t feel us, why would they want to share their sacred stuff with us?

I don’t hide behind silence in my sessions, because I don’t feel that it’s an ethical approach to therapy. I also belive that good therapy is a conversation, not an interrogation. If we’re paying attention, we can feel the moment that the silence turns from a gift being offered into a weapon being yielded. Being able to feel when that moment is approaching, and heading it off before it arrives, can make all the difference.

Guilt VS Shame

Brene Brown said it best, “guilt is I did something bad, shame is I am bad”.

I’ve had a recent influx of clients recently who are struggling with feelings of shame. It’s a huge emotion, it’s big and bad and can really do a lot of damage to our sense of self. Shame also tends to create it’s own gravity field, pulling in events and thoughts from across our life span to feed into this concept that we are horrible people. Right on the heels of this is the idea that we are unworthy of caring, maybe even unloveable.

All of the sudden, this one event starts feeling like the sum total of who we are. All the good stuff we’ve done; the kindness, the generosity, the selfless acts, all of it gets tossed out because it doesn’t fit with this new and supremely powerful idea that we are now a “bad person”.

What’s the road back from this? How do we find a crack in gloom?

If we’re lucky, we have a kind human or two who refuses to buy into this shame-driven concept of self. Someone who can hold our hand and look us in the eye and tell us that we ARE good, we ARE worthy, and they will carry that truth for us until we can pick it back up again. Those are your true friends, the keepers. The ones who save us from our dark delusions.

What if there is no one like that? Then hopefully you have a good therapist who can help you to poke holes in this theory that you’re fundamentally flawed. Sometimes the harsh light of introspection can lead to a softening of the shameful beast.

Working our way out of shame doesn’t mean that we discount or minimize our actions that may have caused hurt and harm. It’s about letting that shroud of shame fall away so we can accurately assess the damage, both to ourselves and others. We can hold in one hand the deed that caused harm, while we hold in the other the truth that we are not just this one thing, we are all of it, and generally most of what makes us up is good and kind and generous.

We stumble, we fall and sometimes we need to lie in the dirt for a little while. But at some point we need to have enough compassion for ourselves to stop heaping hurt upon hurt. We need to allow the love others have for us to seep in and soothe our cuts and bruises. We need to accept on faith that in this moment they see us more clearly than we are able to see ourselves.

A Little About Me and How I Work

I want to tell you about how and why I do what I do, but it's one of those things that hides from words. I know that whatever I put down here won't measure up. It's my hope that you will be able to bring it to life in a way that my words cannot. Maybe if we work together we can get close to it. Most people find me gentle, and caring and open, probably about what you would, and perhaps should, expect from a therapist. I can also be sarcastic, and even irreverent at times. I'm not everyone's cup of tea, but who is? I do bring all of me into the room when I work, and most people seem to like that. The feedback I get around that is that this is what makes my style of therapy work. This post might give you a little more of a sense of how I can show up for you.

I don't have a "professional persona" that I put on when a client walks into the room. To be clear, I am professional. I have a very high level of personal and professional integrity that protects both me and my clients. I also tend towards colorful language, and I may kick my shoes off and curl up in my chair while we are working. I don't own a tie.

I cannot expect you to be real with me if I am pretending to be someone I am not. So, you get all of me. 

Keeping in mind that every session is different, and every client is coming from a slightly different place, most folks come in because there are things they want to look at that they don't feel comfortable sharing with others in their life. Other times they just need some guidance or some different tools to work with what's showing up. I work with lots of both, but this post focuses more on the former...

It's an honor for me to hear people's stories, to learn about where they've been, how they got to this place, what's working for them, and what's not. What wakes them up at night, and what keeps them up. (not always the same thing). The stories don't tumble out in our first session, it takes time, they need to trust the space that we create together. It's always on your time frame, and it usually doesn't take long.

I get to sit and hear about what's really going on. We don't do small talk, we don't chat about the weather. I say "I get to", not because it's easy, but because it's an honor. Because it humbles me every time. The courage my clients show when they risk enough to speak their truth is a gift. The gift is mostly to themselves, because of the freedom they find hidden in it, but it's also a gift to me, because these are their jewels, their treasure, that they are sharing with me.

Good therapy isn't just about listening to secrets, although I do believe there is a great value in just that simple, yet impossibly brave act of giving voice to the unspeakable. Good therapy is about being able to speak directly to whomever is showing up to tell that story. When we tell those hard secrets, we speak from that moment in time. There's an opportunity in those moments to directly address that person at the moment of the event. Maybe it was last week, maybe it was 40 years ago, it's all equally valuable.

Sometimes they just need to hear that I believe them, that it wasn't their fault. Sometimes they need to see that I can hear about something they did that was hurtful or harmful to another person, or to themselves, and that I'm still here with them. I'm not disgusted, I'm not angry, I'm not scared. I'm just here and holding that and I still see all of them, the good, the bad, and everything in between.

It's not the sharing that we fear, it's the reaction.

It's the fear of rejection, fear that we will see them the way they too often see themselves, fear that the worst of what they think of themselves is true.

Sometimes, in the space between the roaring in their ears when they share something scary, and the silence of the space between us that can hold it, something shifts for them. Just a little wedge of light that whispers to them that

Maybe you are not just this thing that happened.

It does not need to define you.

It is a part of a whole.

It's OK to let it be there, you are not alone with it. 

This is a slice of what might unfold in my office, other days it's a recap of the week and an exploration of what worked (AKA, that was a good move) and what didn't (AKA that was a bad move). I tend to move back and forth from diving deep and holding space for the hard stuff, to "how was your week?". Then we get to see if we can connect the dots.

I've written other posts about therapy and group work, please check them out if you're interested and get in touch if you would like to schedule a session.

The Maze

I was out at an event last weekend and the person in front of me was struggling. They were hunched up, tense, staring straight ahead. Their friend was checking on them off and on, and then two folks who I assume were their parents showed up and sat next to them. They were being supported to the extent that they could be in a large room full of other people.

At one point, they stretched their arms out and I saw a tattoo of a semicolon. Many of you probably know about this symbol. Grammatically, a semicolon is used when you could have ended a sentence, but you chose not to. When it's tattooed, it generally refers to suicide. A life not ended, or the wish that it hadn't been. Sometimes it's about themselves, sometimes it's about a loved one. Those tattoos are fairly common, but they always have an impact on me. This one was different though.

That semicolon on their arm was inside a maze. 

It's a powerful image, and as someone who sits with people multiple times a week who are, quite literally, grappling with whether they should end their lives or not, it struck me hard. From my current perspective, I thought about how hard it can be to reach people when they're in that place. To wander through that maze, searching for a way through. From their perspective, I see that maze as protection. It keeps them safe from those that would seek to harm them. The more elaborate and involved the maze, the safer they may feel. The heartbreaker is that the harder they are to reach, the longer it takes for them to receive help.

I can't say what that tattoo meant for this person. I watched as the people who cared about them tried to comfort them, and from my perspective, it looked like they were barely scratching the surface, bumping around on the outside of that maze, always hitting a dead end and needing to backtrack. It looked they all knew the dance steps, the helpers knowing they weren't getting all the way in, the one needing help knowing they were not allowing them access. But still, in the moment, it seemed like enough.

So, for all of you trying to reach someone who is struggling, don't stop trying. even when it feels like they don't want your help, even when you know you won't get as far in as you want to, make the effort. It's often the effort that makes the difference.

For those of you in need of help, know that we won't stop walking the twisted and narrow paths of your maze. We see the occasional flower blooming in the ivy on the wall, and we know that it hints at the beautiful garden at the center.

You are worth our efforts; you always have been. 

"...But it's Fine."

I can't count the number of times a client has sat across from me, bravely recounting details of a difficult experience, and ending with some version of "it's fine" or "but that was along time ago" or "you know, so many others have had worse experiences".

Here's the deal, you can always find someone with a "worse" story. That doesn't diminish your experience.

When we go through hard stuff, it's hard for us, period. If you fall off a 20 foot cliff, that's gonna leave a mark, if you even survive it. If the next day you read a story about someone who fell of a 30 foot cliff, does that mean you're not hurt anymore? Does it mean your bones are not broken, your wounds are suddenly healed? Of course not, so why would psychological trauma be any different?

So why do we hold to this idea?

I believe this comes back to the root of our Puritanical culture that tells us not to complain. The idea that no one really wants to hear about your struggles, and when bad things happen you should just suck it up and carry on quietly. If you're unable to do that then you're either weak or needy, and probably both.

One of the results of this thinking is that it keeps us from gaining ownership of our experience. How events affected us, and how that shows up now is crucial information for us to pay attention to. If we dismiss this information, it makes it very difficult to "deal with it". Which in my mind means we have fully incorporated the experience, that it no longer causes us unexpected intense emotions, and it does not prevent us from doing the things we want or need to do.

How can we get there if we keep denying to ourselves that the event was a big deal for us? Our stuff is our stuff, if it keeps popping up, causing us discomfort (sadness, anger, anxiety, fear) then it's a big deal (to us!) and needs attention. Acknowledging that, and validating your experience, without comparison to events that happened to other people, can go a long way towards starting to heal from it.

Emotions are Contagious

My friend and mentor Colin Smith wrote a blog the other day that inspired me. You can find it here.

The line that caught me was “emotions are contagious”. It immediately brought to mind several things. The first thing that popped into my head was the birth of my first daughter.

My mother-in-law, Tina, was a midwife, and a well respected one in the town where my daughter was born. Tina had since moved west, but her reputation in the town was still strong. Our midwife was good at her job, but she was intimidated by attending at the birth of Tina’s first grandchild. So, of course, she was the one on call when Anna went into labor.

Shoulder dystocia is when the infant’s shoulder gets hung up on the mother’s pubis after the head is out. Generally this requires the midwife or doctor to move the mom, and/or manipulate the baby, so that the shoulder is able to get by.

I know all this now. At the time all this was happening however, I was just a freaked out almost-dad who was very much aware that the energy in the room had shifted dramatically.

Our midwife was in a panic.

She was speaking sternly to the nurses to get the Doc on call in the room STAT, she was talking about other things that I have either forgotten or didn’t understand at the time. Probably both. Her final solution was to have me and another person each grab a knee and wrench it backwards while she pushed hard on Anna’s belly to expel the baby. Not perhaps the best choice, but it got the job done. As soon as Maya arrived, the panic in the room pitched, and everyone was talking at once, the midwife was calling for doctors and equipment and whatever else she felt the situation warranted.

Here’s where my hero arrives…

Suzy was the OB on call, she was a mountain of a woman. She was tall, and she was wide and she had hands like dinner plates. While the midwives and the nurses were running around and yelling orders at each other, Suzy had scooped up my daughter, and sandwiched her between those two massive hands. She locked my eye and said

“Her heartbeat is fine

Her breathing is fine

Your baby is fine”. 

My system settled immediately. Suzy had not gotten caught up in the drama that was swirling the room. She didn’t need a stethoscope. She didn’t need a heart monitor. Her hands were giving her all the information she needed. She was a rock in a turbulent sea.

In retrospect, I don’t think it was the information alone that shifted the panic, it was this woman’s presence that refused to be caught up in the tide. It allowed the other medical professionals in the room to get their wits about them once again. Suzy brought with her into the room an aura of peace that infected the rest of us in an almost magical way.

It’s easy to get caught up in a moment, it’s also possible not to.

Working with clients with anxiety issues, I have come to appreciate the power of staying calm when someone else in the room is not. We have the ability to anchor our fellow humans, sometimes in profound ways. Maybe it’s a pack instinct from long ago.

If other beings that we trust around us are not agitated, then I’m probably safe. 

Sometimes we need to hook our nervous systems onto a buddy to regulate. Sometimes we need to be the anchor in the room. It’s a beautiful and powerful thing, and I find myself grateful for it when I notice it, regardless of which end I’m on.

Self on the Shelf

Sometimes we can't take it in when the people in our lives tell us good things about ourselves. There can be lots of reasons for this. Maybe we've never heard that we're good at this or that particular thing. Maybe we're moving too fast to stop and let it settle in. Maybe we don't think very highly of the person praising us, so their opinions don't carry much weight. Perhaps we don't feel they have the full picture, we think if they knew the whole story, they wouldn't be so complimentary. (See this post for more on that and why I think group work is so amazing) Much of the time, we can't take it in because it bumps up against a core belief that we're not OK in some way.

We're not smart, we're not beautiful, we're not strong, we're not worthy, we're not lovable...we're just not...enough.

So no matter how many times we hear that we really are OK, often we just can't let it in.

I invite you try something. The next time someone gives you positive feedback, and you find yourself ready to toss it away, put it on a shelf. You don't have to take it in right then and there, you don't have to accept it as truth. Maybe you never will. That's OK.

But you don't have to completely disregard it either.

Put in on the shelf, and allow the possibility to exist that it might be true. Maybe you're not all things to all people all the time. (nobody is). But maybe for that person, in that moment, you were just what was needed.

Put it on the shelf, then, when you feel ready, take it down and play with it. What would it be like if this thing were true? If this thing were true, what would that mean for other parts of your life? What would it take for you to accept this?

You may find that the second or third time you take a good look at this, you will be able to take it in. Or maybe, it goes back on the shelf. Your choice.

One more thing, think about a second shelf. One where you put the negative things people say, or even the things we say to ourselves. Sometimes the negative things are far too easy to accept as true. What if we put some of that on a different shelf?

Instead of immediately accepting that we are not good enough, not kind enough, not generous enough, not...enough.

Put it on the shelf. 

Accept the possibility that this thing that hurts, this thing that defeats you, may not actually be true. Again, you don't have to believe it, not all the way. Allow the shelf to just hold the possibility, that maybe, perhaps, this doesn't fit you as well as you have always thought.

Think of these shelves as simply an invitation to another possibility. Just a thought that perhaps you are strong enough, beautiful enough, kind enough, maybe, just maybe...

you are actually enough. 

Group Love

A new session of Dream Group started a couple of weeks ago. On the first day, I asked 6 people who had never met to look around at each other. I asked them to notice what was coming up for them. What kinds of judgements were they making? What were they afraid the others were thinking about them? Then I told them that they would all fall in love with each other. Furthermore, that I guaranteed that this would happen. There were some amused and uncertain looks.

By the end of the second session, they knew I was right. 

As they opened, and told their secrets, shared their sacred stories, put their fears on the table and let their masks fall away, the container was set and we were already falling.

Most of us work very hard to build an outer shell that is designed to repel judgement. "Hi, how are you?" "I'm fine, and you?" "I'm great, thanks for asking!".

Bullshit.

In group we ask "how are you?", and we get real. "I'm scared that my love doesn't love me, and I don't know who I am without them. I was overwhelmed last night, and I cut myself, like I've done so many times before. It's been a rough week."

We let ourselves sink down to the bottom of the lake, where it's dark and and sometimes scary. We sit down there and listen to what needs to be shared. It's safe, because we're all there together. It's scary, because we're all there together.

There are two important parts of group work, the first is being able to share the unspeakable. The second is being able to hear feedback on that.

"I feel like I'm unlovable"

Out in the "real world" this comment would be met with "oh, don't say that! You're awesome! I love you!".

But deep inside, there's this voice; "if they really knew you, they could not love you. They love the image that you project, but you know that's not real".

So the idea that we are unlovable persists, because we have created an environment for ourselves that doesn't feel genuine.

Jung said, "the psyche does not suffer deception well". We know when we are being lied to, and it's uncomfortable, and it happens all day long.

So part of group work is calling bullshit when we see it. When someone shares some hard stuff, and they end with "but it's fine, I'm ok". We ask, "what is it that makes you want to box that back up right now?. How does it feel in your body to have shared that and know that we saw through your mask?. What are you afraid we're thinking about you now? Now that we know your secret?". Let's just leave that wound open, let's not cover it back up just yet. We don't need to fix it, that's your work to do, but we can just sit here with that. And it's ok for you to let that happen. This is safe, even though it doesn't feel like it. 

Group is not for everyone. You need to be ready. You need to be willing to shed your skin and stand exposed, and let the group blow kisses that can sometimes sting. 

Once we feel like the group really knows us, knows all the parts that we run around all day trying to hide, then, and only then, can we start to believe it when they say;

You are lovable

You are enough

I see you

I see all of you

Until you can hear your own strong voIce telling you you're ok, I want you to use mine, and believe it.

Bittersweet 16

  When my first daughter was less than a month old, I wrote her a letter.

I remember feeling so connected to her, it was unlike anything I had ever experienced, and I knew it wouldn't last. I knew it would change and shift as she grew. When she was a week or so old, I remember lying down on the couch with her as we listened to Joni Mitchell's Blue album, still one of my favorite albums of all time. It's one of those memories that has stayed clear and crisp throughout the years. It was a moment in time when everything seemed to be in the proper place.

It's a bitter / sweet thing, to love a human so much, and know that to do right by them you will need to step back, to let them fall, let them hurt. Sometimes they need you close, sometimes they need your absence, it's a delicate dance.

On the outside of that envelope, I wrote that it should be opened by her on her 16th birthday. When I wrote that, I was probably thinking of myself at 16. Ready to be done with my parents, ready to have more freedom, ready for "real life" to start. I assumed that as Maya and I both aged, it would be harder to connect, that I might not be able to communicate all of the feelings I was having in this moment, with this new baby.

I wanted to make sure she had those words at a time when she might most need to hear them. 

I wanted her to know how loved, how deeply cherished, she was, and that she still is.

This weekend that envelope will get opened, and we both get to see what I wrote. She doesn't know it's coming. I don't remember exactly what's in there. I do know that the relationship I have with her is not what I feared it would be when I wrote that letter. We're closer than a lot of parents and teens that age. Still, there is an awkwardness when I tell her how much I love her, how proud I am of her. I see it in her face, an appreciation and gratitude for that, along with an embarrassment and a desire for this talk to be over.

It's OK for it to be both.

It's been the greatest joy of my life, to parent two amazing humans. I still find an occasion to parent here and there, but for the most part, they are who they are, and my part in shaping that is rapidly fading. I'm proud of both of my girls, more so than any other single thing I have ever had a hand in.

Most parents probably think their kids will grow up to change the world. Those of you who know Maya know that she's a person who could actually pull it off.

I don't know how her life will unfold over the next 16 years, I can't imagine the challenges and gifts those years will bring. I know that I will see a lot less of her in the coming years, and there will be others that will be lucky enough to gain her presence in their lives. I know she will continue to challenge the status quo. She will continue to bring joy and comfort to those around her, and she will keep raising the bar for what an educated, thoughtful and driven woman can accomplish.