Friday, July 25, 2014

How to keep going as a therapist.

Someone recently asked me what keeps me going as a therapist, so I decided to offer my thoughts. Hopefully, these tips can apply to anyone in a field with people: from pastor to social worker. Now there are plenty of good therapists who don't follow this advice, but in my opinion, if a therapist doesn't want to quickly burn out, some of these things may be helpful. These tips are things that I've learned from much more experienced therapists and stuff I've gathered in the few years I've been in this field. 

 As I always say, I'd love your feedback.  

1. A therapist needs to be good at setting up emotional boundaries--being able to separate his/her personal life from the client. When you go home, don't bring your problems or the families/client's issues to your children, spouse, or roommate. They don't need them. It's not fair to you or your family. It's also not fair to the families you're helping because if you can't separate your work from your private life, you'll likely become bitter.


2. Therapists are careful not to see people solely on the basis of their diagnosis. It's important that clinicians use the DSM as a tool to assess a problem, but not as an absolute rule to interpret a family or an individual. Stay curious about each client and don't assume or predict your clients' motivations and dreams. People are complex, and if one thinks they can solve people, they'll likely burn out from too high or too low of the clinician's expectations. I've found that seeing people as merely their diagnosis will prevent one from being curious and joyful with people, which can cause a quick
burn out.   

 
3. Therapists need to stays humorous. They laugh at themselves because genuineness is just as important as professionalism. Your clients can only be helped when someone points out their strengths and flaws and this often doesn't come by putting on a therapy hat. In other words, if a client is annoying, then it's likely they are annoying a lot of people in their social network. Be genuine. Be real. You're not rude to them, but you're not fake. People are coming to you because they don't see their blind spots. Trying to be "the therapist" without being yourself will burn you out fast.


4. Finally, a therapist is gracious to him or herself. This is a good transition from the previous point. Therapists mess up, a lot! I still remember one of my first cases in graduate school where I literally got up immediately after the session, turned out the lights and closed the door--with the clients still in the room! To this day I have no idea what was going on in my brain to do that. My common sense just turned off. But, I eventually built a great relationship with that person and ended up having some powerful sessions. Even after years of experience, if good clinicians have invested in their clients, they can use their own mistakes as a path to build trust and intimacy between themselves and the client. I had a therapist who called me about a scheduling mistake. His tone was a little harsh and he came across as defensive. The next session, he was very apologetic and told me, "Peter, my tone was very rude when I spoke to you. You actually didn't mess up on the schedule. I did. I got defensive and I'm sorry." It was actually a wonderful session after that and my trust in him exponentially grew toward an incredible journey. Your client may appreciate your mistakes more than you do from time to time and hopefully, prevent early burn out because you're gracious not only to him or her, but to yourself. In Christian terms: you're leaning on the cross just as much as the people you're preaching to.

Tuesday, June 24, 2014

Mothers, be the bad guy once in a while. It's good for you, your children, and your husband.

I counsel numerous families per work for in-home therapy. One of the biggest problems that counselors see in triangular families (father, mother, child) is that the mother is often seen as the nurturer and the father is seen as the disciplinarian. I know many of us in New England are uncomfortable with gender roles. After all, we know plenty of men who are more sweet and kind in their tone, whereas their spouses are what we'd say, "wicked blunt." Now, rather than trying to prove this argument, because you and I know there are too many counterarguments to make this a deductive and sound argument, please just go with me for a minute. If you know the frustration, then keep reading. Also, if you're offended at my description of men as disciplinarians, that's fine, feel free to switch the genders.

What happens when the mother is always seen as nurturer and the father is seen as the disciplinarian? In dysfunctional families (which just means families that are not accomplishing their goals), the child will often hide behind mom's nurturing nature/aura/personality and use it as leverage when dad tries to set limits. Over time, the child will even ignore dad's pleadings, and he will then be seen as the bad guy. Eventually, mom can be tempted to play into this role when she really should join forces with dad when the child is being wilfully disobedient or ignoring him. After all, look at mom, she's so calm while dad disciplines the kids. But if this pattern goes on for years, it's much harder to break.

Don't we all want to be seen as the cool and collected ones, bringing peace when there's a disruption in the system? That's a tempting role to play. The problem is that rather than bringing peace into your role as nurturer, you're actually bringing serious chaos. When mom believes she needs to always play "nurturer," the kids will eventually ignore dad to the point that he becomes angry and isolated. When dad becomes mad, mom needs to be nurturer because dad's anger loses control as he storms out of the house. This doesn't excuse dad. I can write another blog entry on the need for men to be clear in their communication style and to not overreact. But dad is losing patience with his wife and the children. Slowly, he may just back off completely, and unfortunately, this cycle happens too many times. When these families knock on my door, mom is at the point of walking out because dad's not intervening. Dad's at the point of not caring and refuses to intervene because he thinks mom is covering up for child when she needs to be firm. This is what marriage and family therapists call the vicious cycle.

How do we stop this? We must acknowledge that both partners are afraid of stepping out of their comfort zones. These learned roles have been going on for years. It likely went on with their parents. Mom is going to have to be firm; something she may be terrified of doing because she'll have to take the risk of "losing her child," in that her child will not want to go to her for comfort. What gives her this logic?

"Dad's firm with the child and our child is not close to him. If I'm firm, then my child will not want to be close with me either. My husband and I aren't close right now. Where would that leave me?" 
This actually makes sense. What needs to happen is a slow process of dad playing nurturer while mom plays the disciplinarian. Rather than bringing disunity, they have (for the first time in their marriage) something in common, something to laugh about, and something they can work towards. It's important dad doesn't play the "I told you so" game when she tries to perform this new role. If anything, his role most likely needs to be more nurturing and listening. IF he plays that game with her, she can turn it right back on him while he plays that game with his kids. "Yes honey, you're not supposed to tell Cindy to "just get over it." She'll only cheer up if you take her shopping and buy her ice cream afterwards."




Saturday, January 4, 2014

The Tide Rises, The Tide Falls: Gossip

The Tide Rises, The Tide Falls: Gossip: I love to gossip. If you think you don't, either I doubt you're being honest with yourself or you have few friends. I apologize for ...

Friday, January 3, 2014

Gossip

I love to gossip. If you think you don't, either I doubt you're being honest with yourself or you have few friends. I apologize for being so black and white, but I believe it's in the nature of human hearts to see gossip as a wonderful opportunity to step up on an available pedestal. We look for opportunities to establish ourselves, to prove ourselves, and to justify ourselves. Gossip is fun because it's a way to readjust the focus on our faults and for a moment, forget our shame. I wonder if the same people who are addicted to television, electronics, sex, etc., are also addicted to gossip? An addiction is established when the endorphins are released for a moment when we see a threat. Over time, this high becomes sought for, to the point that we seek it at the expense of seeing or dealing with our regrets and any dragons that may lie underneath our bed.

One of my favorite stories is Oscar Wilde's masterpiece, The Picture of Dorian Gray. The book is about a man named Dorian who makes a deal with the devil to stay young forever. Dorian never ages, but a portrait of him does. When Dorian does bad things, the bad things are immediately reflected in the portrait. Dorian does wicked things in the novel: he commits affairs, he murders, cheats; all the while, he's beautiful while the painting of him becomes more distorted.  At the end of the book, he decides to look at the painting, knowing that although he has the face of an angel, the painting will resemble his character. He goes to where the covered painting is and uncovers it, and behold, he's a monster. At that moment, he can't live with himself anymore, so he slays the painting and in turn, kills himself. In the end, the picture becomes beautiful again while his human form transforms into the old and ugly man he really is.

I wonder if  this is why we love gossip? We hide our own shameful pictures in the attic as we continue listening to stories of other people's sins. We flatter ourselves thinking their stories will redirect others and ourselves from the painting upstairs. This cycle keeps us from going to the attic, even locking the door at the top of the stairs. Gossip is an opportunity where we can forget by losing our sense of shame, even at the expense of stepping on another's reputation.

Yet gossip deceives us. Its tasty pleasures make us forget that one day we'll have to uncover that painting, either through broken pride or exposure. With his sword, Dorian sought to slay the monster he saw and in the process destroyed himself. If we continue with gossip, our sword will only get sharper and the desire to slay, much greater.

If you want to destroy gossip, then you'll need courage to unlock the attic door and look at your own painting. You may see a monster. You definitely won't see an angel. But you'll be reminded of who you are, what you've done, and you'll need grace at that moment. It'll be the most difficult thing you've ever done, but it's the only way to slay the painting without harming yourself. Why? Because at that moment, you'll need grace. Grace kills gossip without killing you.