Self-As-Therapist

Mindset

Hi guys, I know I have taken a break from posting! We bought a house, moved, and ran a marathon, and I have had zero free time. I’m back! I’ll probably post slightly less frequently, I'm noticing my click rate (the rate in which people open the emails I send out) is only about 50%.  I think you’re telling me that you’re busy, too!

Positive faces! (Isn't Matt a total hottie?)

Positive faces! (Isn't Matt a total hottie?)

Last month I ran my second marathon, and as part of my prep I read Deena Kastor’s new book, “Let Your Mind Run, Thinking My Way to Victory.” She focuses a lot on how a good attitude, positivity, and affirmative visualizations transformed her runs and made her faster and stronger. I ran my first marathon four years ago, and I can tell you that my attitude and mental state really affected that run. I felt negative, scared, and defeated with almost every step. This time around my mental state was a lot better, and I have felt a big difference on my runs. I run with my husband, who is always better, stronger, faster, and less injured than I am. I love running with him, but always feel bad he could be getting a better time in a race than he does.  It can cause a weird negative mental state for me, because instead of focusing on how I’m doing, I am always aware of how I’m holding him back. 

I’m a bit skeptical about positive thinking used as a tool. Sometimes this advice can come from people who are using it as an avoidance to see what is real, and sit with their pain. But I also am aware that I’m often in a negative state of thought because I don’t want to jinx something, don’t want to be too big for my britches, and want to always be aware of how I can improve instead of thinking of how great I am. Reading Deena’s book made me start to question this, though. 

This marathon, I went in with one goal – to maintain a positive mindset throughout the race. For me that means not feeling guilty and bad about myself when I have to go slow and hold my husband back. It’s such a wormy feeling, and it will really affect my running. My mantra when things got really hard physically was, “this is what you came for.” In every marathon, your body is screaming at you to stop towards Mile 20. I knew that would happen. But I wanted to enjoy that, too, even if that sounds weird. I wanted to enjoy how taxing that race is. 

When people ask how the marathon was, I genuinely reply with, “it was great!”. I could focus on how agonizingly slow I ran, I could focus on what hurt, but I would rather focus on how psyched I was to run this thing, and how proud I am of us that we did it. 

Of course, I think of how much this relates to becoming an EFT therapist, which takes so much mental toughness. I do sometimes have the amazing sessions, where I feel on top of the world. But at least for me, I have far more sessions where I am slogging through the process, trying to shift mindsets and beliefs that have been locked in for years, or decades. Or couples where I feel like I can barely track the cycle at all, because their brains are in such a primal panic. 

It’s easy for me to get defeated. And once that defeat sets in, it brings fatigue, and it makes it hard to do great work. The hardest mental challenge for me in being an EFT therapist is that I cannot be better than I am right now. I can’t be trainer-level amazing. I can’t be Kathryn Rheem or Lorrie Brubacher. My clients are getting my best, but they are not getting the best. This is reality. So how do you keep going, knowing that every single day you are working your ass off to only be above average? 

For me, I’m trying to apply the same mental process that I do with running. Every failure, every bad session, every time I confuse and bore clients with psycho-ed instead of staying in the process, every time I put my foot in my mouth or get triggered with a client, I am learning and getting stronger. I am doing this for a reason, to get better, to see what is possible for people’s relationships to heal. It is a privilege to do this work, and to be learning this exceptional model. This is hard, but it will get better. This is what I came for.

 

 

Adam Arkin Told Me Off

Adam Arkin, aka my subconscious

Adam Arkin, aka my subconscious

I had a dream last night that Adam Arkin was my supervisor and told me very clearly, “You are too aggressive in session and I hate the way you ask questions.”

This dream was so vivid, you guys. I woke up with my heart pounding. And it hit on the two areas I’ve been feeling insecure about.

I have really noticed how I can ramp up my own volume and pacing around certain triggering moments in session. This would be the “too aggressive” part.  I’ve noticed that when I have a couple who appears to be in crisis, and have a frantic energy about them, and also start throwing out defeated jabs in session, I will ramp up and try to control what’s happening. On my best, best, best day, I can hold and validate. But sometimes I’ll have 10 sessions with a couple and that’s all I’m doing with the pursuer, and they’re sucking up 90% of the session time. I can get direct or stern in trying to mange the session and inside feeling like, “it’s another one of these sessions, and I just cannot turn down the fire hose or soothe the triggering of this Pursuer, but I also don’t want to spend another session focused almost totally on them.”

The other area is a little sillier; I do feel insecure that I can ask questions in a confusing way at the beginning of getting to know a couple. Sometimes I’m trying to force some attachment lens in, so I get jammed up and phrase the questions in a way that’s too flowery and obscure. I sound like a Victorian shop keeper in these moments, “Lovely! And how is it to hear how important you are to your lady when she’s wanting you to do the dishes, good sir?”

A wonderful part of learning EFT is that we’re constantly refining ourselves, and getting better. I love this pursuit of mastery. But there are the days where it is just so hard to feel like I’m not getting it right. I can get wracked with doubt – would another therapist have saved their marriage? Have I wasted their time and money?

The uncertainty can kill me. Even if I have a breakthrough session, I can think, “Would a better therapist have done this 6 months ago? What have I been doing all this time?”

I know well that anxiety and uncertainty are roommates. Especially if the anxiety branches into the mental OCD territory, the way mine can. Anxiety craves certainty, craves the guarantee. If only I could be certain I tried everything, if only I could know for sure another therapist couldn’t have saved them. Just like with OCD, reassurances (the “checking”) only soothes for a minute, before the anxiety rears up again. Someone could say, “Wesley, you’re a great therapist! I’m sure you’re doing the right thing,” but it won’t really touch this insecurity. The work is to instead sit and accept the uncertainty. I cannot be certain if another therapist would have done this better. I cannot be certain that I haven’t wasted their time and money. That is the reality, and to sit and accept that uncertainty is painful, but the only way through.

So I appreciate the feedback, Adam Arkin, I'm going to try and sit still with it.

Compassion Fatigue

How do you know when compassion fatigue is setting in for you? I think we talk about burn-out in our industry as something final – like when you’ve hit burn-out, you’re a charcoal husk of your former therapeutic self. But I think of compassion fatigue and that burnt-out feeling as something that comes in waves, and is there to ask us to re-adjust and look at taking care of ourselves differently.

Think for a moment about what we see in a day. We see so much distress. We see people's current relationship all tangled up with their family of origin traumas. We see relationships ending. Sometimes we see the moment a relationship ends, and we see at least one person in the full pain of losing their life as they know it. We sometimes have to be the only one in the room staying grounded while people melt around us, crying out for help we are trying to give them while they simultaneously bat it away. There is no way our bodies are meant to hold all that grief and strife, and it is essential for us to practice radical self-care and rest. 

But by the way, the kids need picked up and the daycare is closed tomorrow and the dog just crapped on the carpet and you forgot to get chicken at the store so now you just have rice and broccoli for dinner and everyone is going to hate it. Plus you forgot your mother-in-law's birthday and your partner wants to have sex with you but you can't stop thinking about how a client described walking in on their partner cheating on them.

Hmm, so what does balance even look like?

For me, I have to notice it is happening first. I have a few signals that I’m getting fatigued:

1)   I feel more negative and complaint-oriented in general. I feel more critical of my couples, less understanding.

2)   I feel less grounded in the room. I start to feel like I’m running around after my clients trying to put out the fires instead of staying grounded and clear in my seat.

3)   I lose sight of myself, and what is unique about me in the room. Each one of you has something special and unique about you that is important for your couples, beyond EFT and the techniques you are using. When we lose sight of that, or are working with clients who don’t seem to see that, it’s hard to feel positive about our work.

4)   I start hard-core longing for alcohol at 4pm. I barely drank in college, I don't remember alcohol ever feeling important to me in my 20s, I'm not a social drinker; but 35 and a couples therapist? Yeeaahh, I really want it. 

 

Working with couples is hard work. They are really looking to us to help them understand what to do and how to fix their marriages, and with the energy that we are going to be the ones that solve this. That is a lot of pressure! I have couples who have been disintegrating for 15 years who after two sessions say, “this isn’t working.” And I’m thinking, I’ve known you for 3 hours!! Give me some time! We also are experiencing two people’s distress, stuck places, and family of origin traumas. The work requires us to be much more active and alert than in an individual session.

It doesn’t feel good as a therapist to hit this place, and to feel crispy and less compassionate in general. But just like with our clients, I can also feel resistant to change. I want the bad feeling to change, and I want the tiredness to change, but I don’t always want to change other things in my life that I likely need to. So I’m here giving me and you a little push, because we know that if we don’t change something nothing else changes.

Depending on who you are, different things are going to be the solution for these feelings. I’m an introvert, so this is what works for me:

1)   I need to cut down on socializing. I don’t socialize a ton, but I keep up with friends and stay connected to them. I move a lot so most of my friends I take time to text or have phone calls with fairly consistently. I hate saying no to friends or not making an effort, but it drains me right now when I’m already interacting compassionately and relationally during the week.

2)   Take a night or day off here and there. It’s really hard to block off your schedule when clients need to get in, and it’s hard financially, but do it. DO IT. And then go away from your email and work phone. Maybe even put an out of office on.

3)   I heard this great talk from a therapist on depression last year (no recollection who, sorry citation gods!). He said the brain responds positively to two different states – Mastery and Pleasure. Mastery is making your bed and getting the groceries, and Pleasure is something for pure enjoyment or relaxation. For me, I’ve got the Mastery on lock. I’m a hyper-vigilant do-er, so I’m good at the getting things done. I’ll work out, I’ll get the groceries, I’ll do my notes, I’ll work on a blog post. The thing I’m bad at is giving myself permission for Pleasure, and total down time. My ideal recharge is about 3 hours of uninterrupted Netflix watching by myself, and finding time to laugh and take a walk with my husband. What's yours?

But check in with who you are. If you’re more likely to avoid the Mastery, forcing yourself to cross things off the list may actually help you feel less frantic and burned out.

Mostly I just want to normalize this and make it less scary. We are going to hit compassion fatigue and feeling burnt-out. We do something really difficult. We involve our whole selves in what we do. We also get yelled at sometimes by people we are doing our utmost to be empathic to. It is impossible to imagine we can do this without our bodies checking in with us and letting us know what we need more of or less of. 

Taking in Client Feedback

I like to think that I welcome client feedback. I pride myself on being someone who can take in feedback without getting (too) defensive. In my intakes I always tell clients to please let me know if something I do doesn’t feel good or right to them. But when it actually happens – whew, it can be hard to take in.

When I stop and think about it, I rarely get client feedback that I really need to take all the way in to my inner core and process. If a client gives us feedback like, “I don’t think we need to talk about our feelings, she just needs to stop being so needy,” or “It’s not helpful to go through our cycle, he just needs to stop drinking,” we take that in only somewhat. I want to process that, and validate that, but I don’t take it all the way in because I know we do have to do those things in order to help them heal.

But sometimes there is feedback I need to take in all the way. And it’s difficult. I think the Johari Window, developed by Joseph Luft and Harrington Ingham in 1955, might be helpful in explaining what I mean. Do you guys remember that from grad school? I love the simplicity and visual of the Johari Window.

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Square One: Known to Self, Known to Others

If a client gives me feedback on something like, “you validate a lot,” that’s something I know about myself. I can process that with them, and understand why that’s upsetting to them. But I know why I do that and I’ve chosen to keep that part of me. I can tweak it a little per client, but ultimately I know if that truly doesn’t work for someone they would need to find someone else, because I am ok with that part of myself being there and I find it effective in my work.

Square Two: Known to Others, Not Known to Self - “The Blind Spot”

OOoo, this is the hard one. This is the one where when I get feedback here, it hurts, and I need to spend time processing it. I’ll expand more on this below.

Square Three: Known to Self, Not Known to Others – “Private Space”

This would mean something I would be uncomfortable about if a client knew, but it would be unusual if a client found out parts of myself I want to keep private. I don’t see this as an area for feedback, so much as just information about myself I’d want to keep private.

Square Four:  Not Known to Self, Not Known to Others

This one is the truly hidden part, that hopefully gets smaller the older we get. Sometimes this would get smaller because I realize something about myself, and sometimes it happens from another person commenting on something about me, but I see this as the burgeoning awareness part. Neither me nor someone else is really sure about it, so it is either not seen or tentatively seen.

The toughest feedback for me to receive comes from the second window. When someone else knows something about me, or sees me in a certain way, but I don’t realize that part of myself or my work, and it can be quite painful to get feedback here. This week, a client I adore gave me some feedback. I have been working with her and her partner for about a year, and our work is not re-bonding them. Currently, one is deciding to separate.

The client told me, in such a lovely way, that she felt although learning about their cycle was very helpful, they wished they had been having the really hard conversations about the reality of how they each felt all along. Meaning the real conversations about one partner leaning out of the relationship.

Wow, guys, this hit me like a ton of bricks. Because I knew she was right, exactly in that moment, and I hadn’t seen that before. And because they are separating so now I have the added component of feeling like they spent a lot of time and money on me and I did not help them.

Truthfully, I don’t think anything I did would have altered the leaning out partner’s feelings. I have come to this conclusion after 85 hours of non-stop anxiety processing. But I think my client’s feedback is right on, and I want to take that in and help it change my work.  And it’s hard. It’s hard to come face to face with something I didn’t see before that has negatively impacted someone. And honestly, I get kind of afraid. What would this mean if I accepted this and admitted this? Would my clients see me as a terrible therapist? Could I get sued? (this is always my panic place I go to). How do I apologize for this?

Right now, especially with a lot of the survivors of sexual harassment coming forward, our news feed is absolutely swimming in these awful non-apologies. You know the ones, like, “If I did that, that would be regrettable,” or “I didn’t realize at the time how that would come across,” or “if they took it that way, I apologize.” So these are nothing, and no one feels better hearing them. 

But I also get the fear behind the full acceptance apology. What will happen to me if I accept and apologize for this? So I tried very hard to do something different when my client brought this to me. I said, “that is very important feedback for me, and I think you’re right. I am sorry.”

And it sucks. It sucks to sit with this. I wish I had helped them more, and this is the reality of having to learn with/on clients along the way.

 

Luft, J.; Ingham, H. (1955). "The Johari window, a graphic model of interpersonal awareness". Proceedings of the western training laboratory in group development. Los Angeles: University of California, Los Angeles. Retrieved from https://www.accipio.com/eleadership/mod/wiki/view.php?id=1832

 

When Our Strengths Are Also Our Weaknesses

I had a really tough session last night and I can’t stop thinking about how our strengths and our weaknesses are the opposite sides of the same coin.

Something we are continuously doing as therapists is building our identity. Who are we, as a therapist? Are we going to be tranquil and wise, like Becca Jorgensen? Surgically precise, like Gail Palmer? Or a reflective pixie genius, like Lorrie Brubacher? And we have to work with our own personalities, to find out who we are going to be in the room. If this is not your struggle, and you’re reading this thinking, “I just am who I am!” then that is wonderful, and this post is probably not for you. 

There are two aspects of my self (as a self and as a therapist) I’m struggling with today. I get some great things from these two parts, and man do they bite me in the ass sometimes.

1)   I am a little intense, and I have a fervent cheerleader energy for your relationship. I can’t help myself. Even in the first session, I am immediately invested in wanting your marriage to get better.

2)   I’m a do-er/fixer. If you stayed at my apartment, I’d get you blankets, I’d make you pancakes, I’d wash your clothes. My energy of caring immediately springs into action. With couples, this means it is very hard for me to just leave things at reflection, and I weigh in in micro ways frequently. This might look like small snippets of psychoeducation about trauma, or addiction, or self-care. 

There are some undeniable good things with these traits. With my intense investment, I genuinely care a lot for my couples. And I think they can feel it, that I am in this with them. I think they can feel that I am working as hard as I possibly can in the room for them. The dark side of this intense caring is that I can’t leave well enough alone. I think I’m helping (when I die whatever celestial being I meet first is going to say, “Wesley Little, STOP THINKING THAT YOU ARE HELPING!!”). When I hear one partner in distress I immediately go into fix and repair mode, without pausing to really assess if both partners are in distress about the rupture they are experiencing. This can shift the dynamic in the room and subtly set a norm that I want this to work more than they do, and I have signed up for the role of convincing them to work on their marriage.

When I go too far into this space, I can start to feel pretty yucky. Then I realize I need to pull back and go into simply reflecting that each partner really might be wanting something different from the session. This is hard, because I know the other partner is really suffering to hear and see this. But I know I need to just let them sit with that. I'm still figuring out how to do that when there is one partner who isn't sure yet if they want to be continuing in the relationship.

Parks and Rec,  via pinterest

Parks and Rec, via pinterest

The do-er/fixer part can really get me into trouble even more. When I weigh in with psychoeducation or validation or anything, really, it can happen that the client comes back in the next session with, "YOU SAID …" and whatever didn't happen well. When this happens I get so mad at myself. I say, “Wesley, WHY did you weigh in like that?? It’s so much safer never to weigh in!” I know, I know it is. It really is much safer not to weigh in, and let these choices play out and let everyone just suffer the consequences. At times, it can feel like there is no upside to this part of myself, because it really gets me into trouble the most. 

However, there might be a tiny upside. This part of me is also the part that takes risks. To bring myself, my opinion, my internal thought process into any situation is a risk. To write a public blog is a risk. To see couples is a risk. To be a therapist at all is a risky profession. And it’s a risk to weigh in, even gently, in the therapy room. Sometimes my risks, like any risks, end up in failure. But I think they help me go much further than if I never risked at all.

If a magic genie came down this morning and said, “Wesley, I can make you be Lorrie Brubacher/Becca Jorgensen/Gail Palmer in the room, if that’s your wish,” 95% of me would want to take that deal right now. Then I wouldn’t have to sit here, tortured about what I said, and where I went wrong, and how I’m going to correct these really ingrained parts of me. But, 5% of me kind of likes my intense, cheerleady, risky, weird self. It would be so nice to be bulletproof - SO NICE - and perfection is the ultimate Kevlar, but maybe there are advantages to the transparent and raw caring I bring into the room. It just might not feel like that today.