10 Questions

Here are ten questions I got sent via email. I LOVE getting questions in the mail, or on the comments section so keep 'em coming!

1. So, as a newbie psychotherapist early in your career, what did you do immediately after seeing your first ever client?
I sat at my desk and cried for half an hour. I was help? I talked about this with my supervisor who told me that nearly all therapists feel like this early in their careers. When you start to see people's lives shift and change and see them getting mastery over their circumstances, you feel better about messing around in their lives.

2. What do psychotherapists not like to admit to?
We don't like to admit that we spent a whole session with a client and had no idea what was going on. It doesn't happen often, but it does happen. We also don't like to admit that we make mistakes, screw up or otherwise create messes for our clients. We do it. We just don't like to admit to it. I try to be as honest as possible in sessions, even going so far as to say, "I'm really, really confused right now. Help me out and repeat everything you just said, would you?" Unfortunately, sometimes even the repeat doesn't help.

3. What is the most challenging aspect of working as a psychotherapist?
The amount of background work you could do thinking about a client is endless. I frequently read information on their religion, the part of the world they come from, (even if it's "just" the US), their social class background, etc. I find myself thinking about my clients frequently, and if I'm worried about them for some reason, I've had dreams about them too. I get concerned that I won't be able to get creative enough, fast enough, to help them through a really tough patch in their life. ("Lighten up, Jassy!")

4. Do you ever dread going into your office in the morning and have you ever cancelled an appointment because you were dreading going into work?
I've had days when getting up and going into work has been hard. This is usually more to do with what's been going on in my own life, and rarely to do with my clients. On the whole I don't tend to cancel appointments, and on the rare occasions when I've been forced to cancel sessions, it has been something really unavoidable that precipitated the closure, i.e. my car broke down, our basement flooded or I had something disgusting and gastrointestinal. I figure if I can't stand the thought of going into the office, I should not be working with a particular client.

5. Is there one especially unique challenge with just about any client?
I would have to say that the hardest thing to communicate to just about any client is the concept of differentiation. I could write a whole blogsite which just focused on issues of differentiation, so it's going to be hard to address briefly here. But, as simply as I can put it, differentiation is about the ability of an individual to tolerate feelings of stress, tension and anxiety in a relationship with another, without losing sight of one's core self, without blaming the other person for your feelings: to learn how to self-soothe strong feelings that arise in the relationship; to learn how to hang onto a sense of autonomy in relationships without feeling flooded with feelings or getting overwhelmed by the other person's needs, wants and desires. The ability to differentiate in a relationship has to do with an individual's ability to manage the complicated dance between closeness and intimacy on the one hand, and separateness and autonomy on the other. Few of us learn how to do this as children, and most of us will spend our lives trying to figure out how to do this passably well. More in a future blog!

6. What do you think is one of the biggest misunderstandings about therapy?
I think that people misconstrue the idea of therapy as advice-giving and are surprised when their therapist holds back from doing that. And leading on from this, I think that a "comorbid" misunderstanding is the idea that the therapist is able to fix or cure their clients, rather than the therapist acting as a mirror in which the client begins to be able to truly see themselves, understand themselves and select their future path.

7. Is it important that the therapist be perfect?
No, not at all. How awful would that be to try and struggle with one's personal challenges in the face of an all-perfect, all-knowing, super-persona who can do no wrong? Yucky. What is important is that the therapist be honest, be real, be truthful and be willing to take responsibility for places where they aren't perfect.

8. Do some clients become jealous of your other clients?
I think the fact that the relationship between client and therapist is more or less doomed to end at some point is a really difficult and painful idea for people to think about as they become more invested in their therapy. After all.....doesn't everybody want to feel special? One thing that I have noticed is that when people have a regular appointment, they frequently become inquisitive about the people who come in before and after their particular appointment. Some folks want to ask lots of questions, or create stories about the other clients. I'm quite sure that it's frustrating to be told, "I'm afraid I can't answer that question." But also reassuring. If I won't give out any information about somebody else, then it's likely that I won't pass on confidential information about them either.

9. Have you ever been scared of a client?
I conduct an intake over the telephone, during which time I ask a fair number of questions about the client and their presenting problem, so I have a pretty good sense of who a person is. It's not impossible to fake being a psycho, but I trust the ripple of hairs on the back of my neck as a predictor of craziness. I must admit that I'm more likely to be anxious about men coming for their first appointment (they don't call it "The Dangerous Profession" for nothing) so I tend to sandwich new male clients in between other clients, and schedule the appointments for the earlier part of the day when there are more people in my building and also when the folks next door at Watertown Community Housing are still in their office space. The only time I was really scared before a visit was when an angry ex-husband of a client insisted on meeting with me. It turned out fine and I think the visit really helped stabilize things in the family, but it was scary contemplating his arrival, given that he was an unknown quantity.

10. Do you feel relaxed when you're with a client?
Most of the time, I'm just grooving on hanging out with my "peeps." I want passionately for my clients to have the lives, loves and relationships that they truly want and I get a kick out of watching them work their way towards that. Even when a couple is having a really tough time in a session, I nearly always can reach for a place of relaxed bonhomie. I try to maintain my sense of humor, which helps when couples are trapped in difficult and painful places with each other. As I have been known to point out, I don't have to live with them and so can afford to be relaxed! As I've written elsewhere on this blog, self-care is very important for therapists. Everybody has stress in their life and therapists particularly carry a full load, mostly other people's, but it's still considerable. A therapist who lacks the ability to set down that load regularly isn't going to be a great deal of help to their clients in the long-term.