Queries Concerning Psychotherapy and Privilege

Every time we ask a question, we are generating a possible version of life. (~ David Epston in Cowley and Springen, 1995 , p. 74)

Friends (Quakers) approach queries as a guide to self-examination, using them not as an outward set of rules, but as a framework within which we assess our convictions and examine, clarify and consider the direction of our life and the life of the community. (~ Philadelphia Yearly Meeting Faith and Practice, page 205)

Does psychoanalytic psychotherapy as a profession make sufficient assessments of conscious and unconscious, explicit and implicit racism, sexism, heteronormativity and bias in all its forms in ourselves and others, and the destructive consequences to all parties?

Do we believe that healthy relatedness demands well-developed empathy, mutuality, and parity? Do we recognize bias in all forms, personal and institutional, implicit and explicit, acknowledged and unacknowledged as a failure of empathy, an objectification of others and as an obstacle to healthy relatedness and psychological well-being?

Do we accept that the conscious and unconscious empathic failures surrounding bias and oppression are certainly a more profound loss for the oppressed, but a loss to all parties nonetheless?

Do we consider Lacan’s and Foucault’s idea of the privileged “Gaze” of the therapist? Do we see ourselves as people who gaze out from inside a dominant narrative, a “regular” story requiring categorization or explanation from all who we see as “different”?

Do we understand the differences between individual prejudice, institutional racism, and unexamined privilege?

Do we examine the narratives of success, of health, of family, of connection, of development that are viewed as “normal” regular, ordinary, usual, and taken for granted as universal by the dominant culture?

How do we take this made-up story about who is “regular” for granted, and wittingly or unwittingly put these narratives forth as better, more important, more normal than others?

Do we examine our own participation in how “othering” or “normaling” stories get disseminated or disrupted? Do we critically examine how the institutions in our culture – media, government, schools, religious institutions, and graduate and post-graduate psychotherapeutic training institutions – inform us as to what is “regular”?

Do we advocate for inclusivity in our psychotherapeutic practice and training institutions? Do we feel an institutional environment, or our own caseloads are sufficiently diverse when in actuality very few of people of color, differently abled, or LGBT people are represented?

Do we recognize that we speak through our inaction as well as our action? ~ Philadelphia Yearly Meeting Faith and Practice

Do we participate in panels, conferences and workshops, peer groups led entirely or predominantly by those in the dominant culture?

How have the dominant stories about race, gender, homosexuality, disability, and class determined and shaped our psychotherapeutic practices and training institutions, fee setting, size and composition of our caseloads, choice of colleagues, and our preferred psychotherapeutic models?

Do we, as psychotherapists ever place ourselves in professional, or social circumstances where we are not in the majority? How might such experiences help us to better empathize with those who carry narrative burdens, who are regularly challenged to explain, defend, or advocate for themselves within the dominant culture, and those who are on the receiving end of bias and oppressive circumstances more often than we are ourselves?

Do we cultivate relationships with adults with whom we have racial, ethnic, cultural, or religious differences outside of the psychotherapeutic setting?

Do we cultivate therapeutic relationships with clients who differ from us in identifiable ways?

What life experiences or personal characteristics, if any, have made you feel “gazed at”: forced to explain, alienated, ignored, misunderstood, distorted, or excluded by most people or by institutions? What circumstances, if any, have you found yourself in where you were instantly and visibly identified as an outsider in someway?

How might these experiences be useful in practicing psychotherapy with a concern for social justice? How might these transitory experiences offer only limited insight into what it is like for a client who lives with more chronic or different forms of oppressive, exclusive, or unjust circumstances?

Do we listen deeply without becoming defensive or competitive when clients friends, or colleagues or people online share experiences of oppression, even if we feel implicated, guilty or uncomfortable?

Are avenues for exploring differences kept open? To what extent do we ignore differences in order to avoid possible conflicts?
~ Philadelphia Yearly Meeting Faith and Practice

Do we allow ourselves and our worldview to be changed by hearing stories of other people’s discomfort, anger, grief and pain from experiences of oppression, exclusion, bias, and prejudice?

Do we monitor ourselves for defensiveness, minimizing over-identification, excessive or non-generative forms of guilt, hopelessness and indifference?

How can racial, gender, sexual/gender identity and/or class differences between therapeutic partners affect the way they tell and hear each others story?

Do we proactively and thoughtfully confront, explore and examine biased narratives when we experience them in our office, with friends and colleagues, and in ourselves?

Do I treat conflict as an opportunity for growth, and address it with careful attention? ~ Philadelphia Yearly Meeting Faith and Practice

What do you worry people will assume about you?

What do you hope people will assume about you?

What do we understand about our clients’ hopes and fears about the assumptions of others?

What assumptions have we made about clients that were inaccurate, injurious, or unrecognized (by us)?

How do we respond when confronted with the inaccuracy or injuriousness of our assumptions?

Am I careful to speak truth as I know it and am I open to truth spoken to me? ~ Philadelphia Yearly Meeting Faith and Practice

Do we consider that there are parts of our client’s stories that are never given words, are essentially deleted, or never even noticed by themselves, by us, or by others because they just don’t fit in with the dominant story, or with our assumptions as psychotherapists?

How can we learn from clients and colleagues who are different from us without making them feel unduly burdened or pressured into teaching and explaining?

Are we mindful that those with experiences of oppression and narrative burden need to protect themselves from scrutiny and the unempathic Gaze of individuals, institutions and environments that are distorting, enraging or exhausting?

Do we condone or assume that narratives of privilege are healthy for privileged people? Do we remind ourselves that none of us are free unless all of us are free?

Do I examine myself for aspects of prejudice that may be buried including beliefs that seem to justify biases based on race, gender, sexual (and gender) identity, disability, class, and feelings of inferiority or superiority? ~ Philadelphia Yearly Meeting Faith and Practice

What is my psychotherapeutic practice doing to help overcome the contemporary psychologically wounding effects of past and present oppression?

Questions, and more questions, and questions as yet unformulated.

No answers please.

Deeper questions.

Keeping Secrets

Kalli was the secret-keeper of Maldinga. Every day the people of Maldinga straggled through the woods to the clearing where Kalli’s cottage stood. They came one by one, never in two or threes. And one by one, they told Kalli their secrets.
~ Kate Coombs, The Secret Keeper.

Almost two years ago, when I began to talk to friends, colleagues about writing on-line – I could see it made people uncomfortable.

“How are you going to do that?”

“What if your clients read it?”

“I wouldn’t want my therapist to have a blog.”

At the time, the questions and comments struck me as strange: therapists publish their narratives all the time, in books and journals easily purchased or subscribed to on line. They give presentations in public settings, to other psychotherapists, and to the interested public, often filled with extensive case information and histories, whose names, occupations, sometimes genders and personal details are obscured to protect their client’s confidentiality.

Early one morning Sheld the baker came to the cottage. He gave Kalli a basket of fresh rolls and a copper coin. Then he whispered, “I sell loaves weighing less than full measure.” Kalli nodded and caught his words in her hand. After Sheld went away with a sigh, Kalli opened her hand again. The secret was now a small gray rock, like a stale bread crumb. Kalli went inside and tucked it into one of the hundreds of tiny drawers that lined the walls of her cottage. ~ Kate Coombs, The Secret Keeper.

“But aren’t you supposed to stay anonymous?”

“Why don’t you write under a pseudonym?”

Anonymous? With a secret identity?

You mean like Batman?

Clients have seen me in public spaces in hundreds of different ways: putting out my garbage in my sweat-pants and slippers, sweating with my hair in a headband on my morning run, bickering with a sassy kid at school drop-off, dining with my husband on “date night,” in line buying tickets to see a stupid romantic comedy that I am half ashamed see at all, in my bathing suit on the beaches of Cape Cod, in public restrooms in department stores, looking like a foolish middle-aged woman practicing martial arts in the park, picking up my prescriptions at the pharmacy, and at rallies for causes they disagree or agree with.

Such public encounters reveal things about me clients may not like or feel comfortable with. It has never crossed my mind to try to be anonymous, to disguise myself, or cauterize my own needs or interests outside of the office, or in any public setting.

Anonymous
1: of unknown authorship or origin
2: not named or identified
3: lacking individuality, distinction, or recognizability
~ Merriam Webster

I don’t move through the community in drab camouflage, and I made no vow to live an unidentifiable life.

I am not a traditional Freudian, and have never, at any point in my career, aspired to be a “blank slate.” I don’t think it’s even possible.

Although I try not to intrude my own agenda into my clients’ experience, or make them tend to my needs in anyway, the notion that it is possible to “keep myself out of the room” seems to me a mystifying illusion.

Therapists are always “in the room” whether they admit it or not.

I am not required by my profession to live in anonymity – I am mandated to maintain confidentiality.

When confidential information is used for purposes of professional education, research, or publication, the primary responsibility of the clinical social worker is the protection of the client(s) from possible harm, embarrassment, or exploitation. When extensive material is used for any of these purposes the clinical social worker makes every effort to obtain the informed consent of the client(s) for such use, and will not proceed if the client(s) denies this consent. Whether or not a consent is obtained, every effort will be made to protect the true identity of the client. Any such presentation will be limited to the amount necessary for the professional purpose, and will be shared only with other responsible individuals. ~ New York State Society for Clinical Social Work Code of Ethics

I don’t publish identifying information about any client, or any extensive material about any single case history or study. I have tried to fictionalize cases, and blur out identifying specifics entirely. I have created studies of clients in aggregate, noted typical clusters and trends among the clients I have seen over the years, made note of cultural trends, and tried to use my imagination to put me in the midst of cases that I have never met or heard of. I try to speak about the universalizing aspects of the therapeutic experience, my own therapy, my own experience of the work.

I strive to meet my ethical requirements, hyper-vigilant in adherence to the spirit and letter of my ethical mandate. I would never publish anything that would put my clients in harm’s way – that could ever put them at risk to be recognized. And I believe I have done that, at least, successfully.

But is that enough?

Strangely, two years into writing I am revisiting these questions anew, after a synchronicitous cluster of internal and external events, among them several enquiries and comments from other therapists that have made me wonder again why I write. I have been repeatedly asked, and am asking myself about the effects this kind of writing has had on my practice itself and on the clients in my care.

The truth is I just don’t know.

There were so many secrets.
A small boy didn’t like his new baby sitter.
The grocer’s wife had hidden ten gold pieces under a tree root.
A plain girl loved a handsome boy and dared not tell him.
The miller’s son had stolen a coat.
The tailor had left his widowed mother alone and come to Maldinga to seek his fortune.
The mayor’s daughter was sneaking about, keeping company with a young rascal.
~ Kate Coombs, The Secret Keeper.

Publishing my words in public requires clients to trust me even more with their wounds and sorrows and shames.

Most clients have made no mention of it, and I assume have never read my writing, or feel no need to discuss it with me. (If you are one of these, reading this now, and have not brought it up, I hope you will consider this an invitation to address together anything, positive or negative, painful or pleasant, that reading this may activate)

I have told a few clients about it directly, so that they do not feel ambushed or frightened or betrayed by finding out about it in some other manner.

The vast majority of those who have found it or been told of it have expressed positive feelings about it, feel that reading serves as a transitional object between sessions, or gives them access to ideas that may not have entered our therapy directly otherwise.

But that doesn’t mean that it will continue to feel that way. There may, one day, be an essay that agitates, annoys, or distresses. Or words read previously that are experienced differently at a later time, in a different self-state.

I let every client who enters my office know that over the course of treatment I expect to make errors. And although I will always try to protect them from any severe clinical harm, or negligent malpractice I will undoubtedly fail and stagger, causing them pain and discomfort at some point. I may mis-respond, misunderstand, or miss my own blind-spots. I may even re-injure pre-existing wound.

I am sometimes disappointing to both clients, and to myself.

And although I’ve accepted that as inevitable to the mechanisms of the therapeutic process and my own fallibility: it still causes me deep sorrow when it happens, no matter how or where: in or out of the office, on the street, or online.

And as I’ve written about elsewhere ( http://wp.me/p1AOzF-k ) I’ve also learned that powerful therapeutic opportunities for repair, for forgiveness, for re-working, and for corrective experience can lay dormant, almost invisible, curled up within these painful failures.

There is no doubt that publishing my experiences as a therapist, in any format, coupled with my capacity for error and mis-attunement can cause discomfort, and could even potentially disrupt valued therapeutic relationships.

Some have discovered it on their own, and yearn to see themselves in my writing, and feel sorrow that they have not found themselves there. Others, have encountered aspects of my identity, that they do not like, and would rather not know.

Some feel overstimulated, overwhelmed, ashamed at having googled me at all, and try to keep it to themselves – sometimes their dreams have let me know. Still others see themselves in the universalized or imagined scenarios I write about, and hope/fear I am speaking of them specifically.

There are times when we are called to meet deeper obligations that require more from us, beyond the professional guidelines.

Obligations to clients, as well as obligations to ourselves:

I have, and will, make errors in this public space, just as I do in the office.
Even as I scrape off every bit of identifying data, avoid any extensive case discussion, and do my best to disguise all the content, writing about my work carries the capacity to hurt, but hopefully never harm, people and relationships I care deeply about.

I can fail to disguise a reference sufficiently to serve a clients comfort level, or “make up” a scenario too close to one that I have consciously forgotten but remain unconsciously preoccupied with. I can overlook a single word that might sting and intended to edit from an earlier draft. I can leave a client out of a discussion they would want to be included in, or include a reference, no matter how disguised, that activates a sense of exposure.

I can misread how I will be read, or mis-read.

And, as always, our best intentions can diverge from their real outcomes.

One day, in Kate Coombs lovely children’s story, the Secret Keeper turns cold and tired from keeping so many secrets, and stops answering the knocks on the door from the burdened villagers. With their encouragement and participation, she discovers a way to transform the heavy, hard secrets, into meadowlarks, butterflies and rose petals. These re-formed, transfigured, secrets are released publicly, before the gathered village, deepening the both Secret Keepers connection to the village at large, the villagers understanding of each other.

I don’t write or publish to market, practice-build, to make money, or for professional reputation: and although I don’t write for my clients, I always write with them in mind. I believe they are absolutely entitled to read anything I have written, if they so choose, and hold me accountable for it.

I publish what I write because I believe in what I do, and believe that being transparent is necessary to empower clients as full and equal participants in a process that is too often cloaked in disempowering mystification.

I write because I am full to bursting. I have spent so many years hearing stories that have whitened my hair, broken my heart, vicariously and directly traumatized me, inspired and consoled me. Stories such as these can fill your drawers, accumulating until they turn cold and heavy.

I write to ethically make use of what I have experienced and absorbed, and learned vicariously from others – and if I did not, I suspect I could sink into a vast ocean, a sea of other peoples’ pain and trauma, triumph and intimacy, joy and loss.

I write to let other practitioners and younger clinicians know what life in this field feels like, to share some of what I have learned, and to transform some of what I have held as single secrets, as individual stories, into something that can be released to the larger community to help us all understand each other better, and the culture and era we are embedded in.

I write to wrest meaning from it all.

I will stumble and I will mis-step, and I will do all that I can to make reparation.

But writing itself has become an integral, essential part of my practice.

I write to continue working, so that I can keep on keeping secrets.

copyright © 2013
All rights reserved Martha Crawford

The Myth of the Good Client

So you want to be the best, most gratifying client ever? You want to insure that your therapist adores you, always looks forward to your sessions, gets as much out of working with you as you get from them? Thinks of you as polite, funny, intelligent, astute, self-reflective?

All that probably makes you totally anxious, ties you in knots, and blocks your ability to teach your therapist what it is you actually need from them. And what you don’t.

But it won’t make you a good or a bad client.

There are in fact clients that I’ve thought of as “bad clients” – and I’m certain that if you are concerned at all about “being good” that you are probably not one of them.

“Bad” therapy clients are those have presented in therapy with completely ulterior manipulative non-therapeutic motives (See Deliver Us: Thoughts on Evil in Psychotherapy http://wp.me/p1AOzF-74) who want nothing to do with engaging in a therapeutic relationship. They come because they think it will help them win a legal case, to create false “pain and suffering” for a spurious lawsuit, to establish trumped up psychological disability to subsidize leave from work while they look for a better paying job, to inflate their insurance claims following an accident, to do some seat time to placate the demands of some other person who has “forced” them into treatment – to prove to their employer or their partner that they don’t have a substance abuse problem (when they do), to try to coerce me into helping them rationalize abusive or destructive behavior toward others, to prove to themselves that therapy and therapists are all full of shit and therefore they won’t have to take responsibility for the pain they inflict on others or on themselves.

Those cases usually come to an impasse in a few sessions and they leave quickly as it becomes obvious that I will not provide whatever it is they are seeking from me.

But, not every “good” client shows up because they want to.

When I was in agency based practice, I worked with many legally mandated clients – clients whose probation or alternative to incarceration requirements (or parents or school principals – practically all kids and teens are “informally mandated” clients) required that they remain in some form of treatment. The first step was to assess the client’s capacity to engage in the process on their own, for their own purposes and to “undermine the mandate”:

“I know that to avoid trouble that you are required to be in treatment, but you are not required to be in individual psychotherapy with me – and there are many kinds of appropriate treatment I could suggest to your P.O. or to the courts (or your parents). I have a good communication with them and it won’t put you in harm’s way at all if I say that you would benefit more from an anger management group, or a recovery support group or some other kind of help. You’ve shown up at this appointment to meet your requirements, and part of my job today is to see if this is the right kind of support for you or figure out what might work better. Also, I am not mandated by anyone to provide services to you or anyone that I think will be ineffective, destructive, or waste my time or yours. So can you think of anything that you would like to talk about in therapy with me, or work on for yourself, to make your own life feel better? In other words: Is there is any part of you that might actually want to be here?”

Many stayed because they wanted to and to fulfill their mandate simultaneously, and we went on to do constructive, deep pride-inducing work together -and some were referred to other kinds of services.

Perhaps the rest of us are just mandated to seek therapy by Life Itself.

Ultimately what is a “good” case and what is a “bad” case has nothing to do with you, and everything to do with the hope and fears, world view, strengths and limitations, and unconscious processes and projections of the therapist.

A “bad” case is lazy language for a case that activates the therapist’s sense of inadequacy.

I have no specialized training in eating disorders for example, and although I did a brief tour of duty in drug rehab and recovery for a few years – and have a working knowledge of the most basic treatment methods for both issues, I know that I do not have the skills necessary to support anyone but those in the very earliest stages of either of these conditions, those with the very best prognosis, or already well along in their recovery.

Sometimes clients don’t view themselves as having an eating disorder, or substance abuse problem – and present to therapy trying to address their depression and anxiety without treating the addictive or compulsive disease. Answers to assessment questions are minimized, or denied along with the painful core issue. No matter how much I may like someone, no matter how much I may wish to attach, support or help them, I will experience these as ill-fitting cases for me, cases where I will not be of use, where my hands are tied, my skill set the wrong one, or the modalities I offer are inappropriate to apply to the issues at hand. I will end up – in service of best practice and the clients well-being – referring the case on, (sometimes sadly and unfortunately experienced by such client as “sending them away” no matter how I try to articulate my limitations)

But these are not in any way bad clients, they are merely clients for whom I would be an expressly bad, or at best a not-good-enough therapist.

I have also been the wrong therapist for clients who may think that they want analytically informed therapy, but who in actuality want a great deal of concrete advice, or for me to dictate the number of sessions, focus exclusively on symptom reduction (rather than also searching for deeper understanding, more meaning in life, and greater acceptance of themselves) assign homework sheets, want me to provide concrete answers and prescriptions to “so what should I do now?” or expect that I will be the one to somehow “fix the problem.”

There are plenty of respectable therapists and coaches who work in a variety of cognitive, behavioral, and solution focused models, many of whom I admire, as well as groups and programs which will also offer more highly structured services. I begrudge no client (or therapist) their path or their process – it simply isn’t mine.

I’m going to ask you about your night-time dreams and try to engage you in exploring the symbolic content within and around you. I’ll ask about your past, your future, your relationships other people animals, the Earth as a whole, and to me. I’ll try to understand if your work and sexual life are satisfying and meaningful to you.

And if that isn’t what you want from therapy, I am sure to annoy the hell out of you. And you will blanketly reject what I do have to offer, which won’t be that much fun for me either.

(Although I do love being honestly and authentically disagreed with when my course need to be corrected. If you really want to be a “good” client, you’ll find some way, however polite and subtle to let me know when I’ve missed the mark, and hold out for being understood as precisely as possible)

There is another kind of client, that senior clinicians often call a “good training case” which is short hand for a client that would be a bad fit for their practice, but would benefit from a therapist who is building their practice, perhaps with a smaller case-load, where the client will have to share the therapist’s attentions and energies with fewer “therapeutic siblings”. There may be more space in the schedule for extra sessions, and more room to go the extra-mile for clients who may need more support, email or phone contacts than a therapist with a full and established practice can offer.

Therapists sometimes also need to balance their caseloads for their own well-being as their needs shift and change. Too many clients of one type, or with similar needs, or with one kind of presenting problem can leave a therapist burned out, overwhelmed, or as disconnected as a flight attendant offering instructions on how to buckle a seat belt. Too many challenging cases can fatigue a therapist, rather than keep them on their toes: too many easy-going clients can let a therapist phone it in as they lay back in their recliner.

Winnicott used to only allow one or two clients at a time to move through regression to stages of intense dependency as he would become too overwhelmed otherwise – and would either need to hold their dependency at bay until he was emotionally available, or refer the case to another analyst.

Therapists also balance their caseloads out by modality – (couples, individuals, groups, supervision etc) by diagnosis, by areas of speciality, and by fee. Early in my practice, I was firmly instructed by supervisors who cared about me, that I was not allowed to take on any more sliding scale clients – no matter how connected I felt or interesting the case until I had cared for my own basic financial needs. I now pass the same instructions on to overextended supervisees.

And by the way: A “good client” can look an awful lot like a “bad client” before trust, and an alliance is earned:

I remember presenting a case at my first clinical conference about a client I cared deeply about. During the question and answer someone asked if I had felt connected to him right from the start: In fact, when the case was assigned to me at the clinic where I was working at the time, I’d had an immediate and intense aversion to his written case history, for no obvious reason. After our first meeting I’d entertained the fantasy of handing his folder to my supervisor and refusing the case outright because I was confident I could not connect to him.

Yet, quickly, I developed warm affection for him, the work had been rich and rewarding and my understanding of symbolic content archetypal forces cracked wide open. The very client I’d imagined ducking out on became a profound honor to serve.

I realized then, that quite often my first response to a client that I was about to connect to deeply, who was going to require a new level of intimacy from me, who was going to change me, move me, press me into new terrain, was likely to be a semi-conscious sense of dread.

(In total honesty – I felt a similar fear, trembling and sickness unto death the week before I moved to NYC, on my first date with my now husband, and of course again in the hours before we married. I was filled with terror on a Biblical scale the evening before becoming an adoptive mother to both of my children, and immediately preceding every single good, disorienting, transformative blessing that has ever befallen me)

Even now, still, with many years of this awareness, the unconscious resistance to being changed asserts its self, as many cherished therapeutic partnerships tease me about how I didn’t return their initial calls right away, or lost their initial emails, or sent them back to the preceding therapist for further closure, or how I just sounded “weird” on the phone, or somehow unwittingly made them run some minor obstacle course to get to the first appointment.

When my son was in kindergarten he once said (after several readings of Pickles the Fire Cat – which I highly recommend for the under 6-year-old set) in words that might make my favorite non-dualistic theoretical and spiritual mentors proud:

“You are not a Good Mommy.
And you are not a Bad Mommy.
You are a Mixed-Up Mommy and that’s the Very Best kind.”

And you, in all likelihood are not a Good client or a Bad client.

But, the Very Best Mixed-Up kind.

And nothing is better for a Good-Enough therapist than that.

copyright © 2012
All rights reserved Martha Crawford

New Tricks


Therapists become ecotherapists when we… look to nature (both our own human nature as well as the natural world) as a teacher and source of healing; when we see that human suffering is intimately connected with the destruction of the web of life, and that healing is about making deep changes in the way we live and relate to the world around us.
~ Why and How Do Therapists Become Ecotherapists, by Mary-Jayne Rust
from Ecotherapy: Healing with Nature in Mind

Its happening again. Its happened before – so I know a little about how this goes but it is never an entirely comfortable process.

My stance is shifting, my professional identity reorganizing, my perspective and world view heading in a new direction.

There are always anxieties: How will I bring these new to me thoughts into the room, how will my clients respond? How will this change things? Will my colleagues think I’ve gone off the rails? Will I lose clients, income, reputation, momentum if I veer unexpectedly off to the left? Will I recognize myself in this new model, am I being true to my skills, my gifts, my values, my training, my clients needs, and my community?

When the therapist changes, the work itself changes. The questions we ask, the metaphors we choose, the subjects we become animated about or feel distance from, the defenses we challenge or suddenly accept, all have intended and unintended affects on the content of the work and the client’s communications.

More than that, when the therapist explores new aspects of their own identity – it impacts the client’s experience of themselves, invites new content into the room, changes prior assumptions of what therapy is for, opens up new challenges, and closes down old expectations.

What psychotherapists direct their attentions toward, what we express authentic, energized interest in, and what we consciously or unconsciously overlook has a powerful shaping influence on what clients feel is legitimate to discuss in session. By nodding, or staring blankly, our clinical mirror legitimizes or undermines a notion about the clients idea of themselves and what might be “good” grist for the mill.

A common clinical synchronicity: the very moment that a therapist is able to face down their own anxious conflict and incorporate the previously split off aspects of the Self that live behind it – clients suddenly and spontaneously speak up, initiating dialogue about the very same conflict within themselves.

A supervisor of mine would say with a twinkle in her eye:
“They must have been eavesdropping on your supervision session again.”

Bion says: “When two people meet an emotional storm is created” as their unnamable, ineffable unconscious bits swirl and entangle, exchanging information without our awareness.

My stance has shifted, mutated and incorporated new bodies of thought many times since my original training and clinical inheritance. Trained through social work school in ego-psychological models, and an analysand in a object-relational/self-psychological treatment my earliest clients were used to a certain kind of response from me: one that avoided conflict, was primarily “supportive” of strengths. I saw aggression as a secondary response to injury, as a regressive obstacle to relatedness, or a developmental phase. I believed that it was my job to accept and “absorb” aggression from the client, withstand it, and if I could survive it without retaliating, it would support the clients’ developmental journey to mature relatedness.

For some cases, it provided what they needed – but I noticed that for certain clients, it wasn’t working at all – and perhaps it wasn’t doing me any good either. I began seeking supervision and studying Modern Analytic models and suddenly I found a new voice.

I was joining resistances!
Confronting treatment destructive behavior!
Allowing my aggression into the room to protect the treatment!

New words came out of my mouth and into the room that I would NEVER have thought to say before.

To a client that continually questioned whether or not I was experienced enough:

“It’s certainly a possibility. Would it be more helpful if I referred you to better therapist?”

To another who complained repeatedly about their previous therapists failures:

“When I disappoint you will I get to hear about it do you think? What are all the ways that I am likely to fail you? “

After great prodding in supervision, I finally confronted a client who constantly sought validation by men and regularly missed therapy appointments:

“Perhaps, therapy would be more of a priority for you if I were a man.”

As new concepts trickled down into practice and tentatively inched out of my head into actions and language, it was both terrifying and exhilarating. I never knew what would fall flat, what would be soundly rejected, what might provoke rage or scorn, what error I might make in this new schema or where the unforeseen dangers might hide.

As shocking as it felt to say such things – each time I did it, far more often than not – I saw the client feel safer with me, an obstacle surmounted, a test passed, a barrier between us, removed – and the work would flow again.

Not all clients needed this, but some did – and learning to form these words with my mouth, figuring out what to say – how to implement a theoretical idea about resistance and aggression and make it come alive in practice, was like learning a new language, while simultaneously trying to teach it to someone else.

When I dove into Jungian thought several years later it happened again: a new vantage point, a new clinical language, new tools, added to the old favorites in the box, a new bee in my bonnet, a new schema to try on, and incorporate. A new model to figure out how to make my own, to sort through what was useful, and practical in the consultation room for me for any particular client, and what was not.

I’d always included exploration of dream work, metaphor and symbol in my practice, but this was so much more explicit: I began bringing in more metaphors and analogies drawn from myth, folklore and sacred texts, discussing archetypes, ego inflation, shadow, encouraging clients with sufficient ego strength to reach for their underdeveloped aspects.

I explicitly asked newer clients to keep a dream journal and tried to introduce the notion to “older” ones. Some bit, some nibbled and others spit out the hook.

I encouraged appropriate clients to court and consult their psyches about the topics they were consciously focusing on. We began to bring the Unconscious into the office as a full collaborator to assist and guide the treatment, rather than scorn it as a mere symptom-generating, conflict-laden mess-maker.

I felt the same nervous sense of exposure as I tested out new ways of being in the room while playing with constructs that I was just beginning to understand – and would only be able to integrate and comprehend through use, failure, success and practice.

In ecotherapy we venture beyond the traditional questions. The ecotherapist is curious about human-nature relationships as well as human-human relationships radically expanding the range of discussion. ~ Asking Different Questions: Therapy for the Human Animal by Linda Buzzell from Ecotherapy: Healing with Nature in Mind.

I am yet again, finding myself trying to wrap my mouth around new words, trying to engage in unfamiliar dialogue about how the natural world effects us, and how we affect the natural world. Attempting to summon the same confidence and professional aplomb that I would draw on to explore any “legitimate” mutually interdependent relationship.

I’ve had more and more outdoor, walking sessions, through the parks of lower Manhattan and the Brooklyn riverside. We notice the urban wildlife as we walk – plantings, and wildflowers, cormorants, hawks, mockingbirds, nuthatches, and Zelda the wild turkey.

The hurricane forced many outdoor walking sessions, as well as sessions in the community garden – with clients I wouldn’t have considered interested candidates otherwise – while the office was inaccessible with no power or heat. It has opened up a new world of connection and communication for some clients, and it is clearly second choice, too diffuse and distracting for others.

Words flow differently as our bodies move, as we watch the waves along the river and scan the horizon side by side.

In and out of the office a new realm of connection emerges, as I meet and invite and clumsily try to introduce new aspects of myself and my clients to each other.

To a client who focuses regularly on perceived conflicts with neighbors and co-workers:

“Wait! Did you just say that you were feeding the birds when you spied your neighbor? Do you do that every morning?”

The client no longer clenched with fear and agitation – brightens, and tells me about the taming and feeding wild birds by hand, the fruit trees, past and present that have thrived and died behind the house, and shares photos of carefully tended rose bushes in bloom next to the garage.

To another, a parent, chronically fretful, obsessive and sometimes completely panicked about toxins and contaminants in their child’s environment:

“What if there is nothing you can do? What if you are absolutely right and there are chemical hazards all around? What if our culture has filled our environment with so many pollutants that there is nothing that you can do to prevent exposure? What if there is no way, as things stand now, to keep our children ‘safe’ from toxins in our air, food, water and homes?”

The client breathes deeply as if for the first time in many weeks and says softly:

“Then I guess I’d just have to live in the moment and face each day as it comes.”

Following the hurricane, a client who had avoided the worst disruptions of the storm describes it as a “no big deal for me personally.” When I ask if they had any thoughts or concerns about climate change, and how related events might effect them in the future, the client shuts me down:

“I prefer to focus on things I can control”

It seems a uncontestable given, a unilaterally accepted rule of life, an obvious and practical mandate for healthy coping, proof that the through-line I am pursuing is pointless. I surrender, just a matter of days after the city flooded, to talk of families and jobs, and online dating.

On the subway ride home the response I wished I’d had surfaces -my thoughts too slow, and my new learning too unintegrated to parry-repost in real time:

“Why, I wonder? What would happen if we talked about all the things we cannot control and how we might feel about them? What might we be avoiding in ourselves and in the world around us by focusing only on what we might be able to control? What if that makes your life feel unbearably small, and is not actually safer in the long run? What if that is an illusory construct ? Is it frightening to feel out of control? Too vulnerable? Might there be something reliving or even healing in it?

What if feeling whole in this lifetime comes from understanding our real relationship to benevolent, destructive and wild forces far beyond our control?”

You can lead a horse to water, but perhaps before you can teach old dogs…

You have to learn the new tricks yourself.

copyright © 2012
All rights reserved Martha Crawford

Flooded

Sometimes a flood destroys a world already made and the people in it; sometimes creation itself begins with the primeval water.
~ Funk & Wagnalls Standard Dictionary of Folklore, Mythology, and Legend

I am not going to over-write or over-think this one.

This is going to be way too long, and under-edited. I give myself permission to not have to be ruthless with my thoughts this week as they float up. Perhaps something valuable will drift in among the debris.

Maybe something that spills out here will help to prepare other therapists and care takers when climate change driven disasters, in one form or another, emerge in their communities.

And make no mistake: they will.

If the weather can disable this fortress of concrete and steel, no one can be assured they are exempt.

According to Oxfam International “last summer the US declared 1/2 of their counties disaster zones due to storms, floods, fires & severe drought after 12 month of record temperatures.”

Katrina already happened, and we didn’t take it in. Increasingly violent and recurrent tornados have devastated whole towns, and we continued to respond with our standard disaster/trauma responses. Drought has devastated huge swaths of farm country, brush-fires, and mudslides, and deadly heat waves don’t seem to change our tune.

These are not mere disasters.

This is an initiation into a new way of life.

These are the consequences of our consumption, our drive for convenience, our wish to accumulate, the speed that is never fast enough.

We need to face the realities we have created.

As therapists, social workers, crisis interventionists we have to take this in. This is not about helping people process an anomalous disastrous event.

This is about helping everyone, traumatized, or not, prepare for a whole new normal.

This is about practicing for storms to come, for profound challenges to an unsustainable way of life. This is about learning to let go of what does not work. This is about looking at our energy dependence, and learning new ways of living that respond to dwindling oil supplies, our fragile power grid, our hungry batteries, and addictive fuel consumption.

This is about understanding something about how easily it can all be disrupted by the wind, rain, water, and heat produced by a wounded planet trying to re-establish healthy homeostasis.

Has it only been a week? It feels like 40 days.

Monday – a day of preparation and fear:

The wind began picking up in earnest late Monday afternoon and we retreated from the park and playground into the house.

My kids channeled all their fear into fretting about Zelda and whether or not she would be all right. Zelda, a wild turkey I had seen roaming in Battery Park, the week before, had fascinated them. ( http://en.wikipedia.org/wiki/Zelda_(turkey) ) They had proudly told their classmates about Zelda, the turkey who had wandered by herself, from north of the Bronx all the way downtown. She had lived, the only one of her kind, in Battery Park for the past 10 years.

We assured them that wild birds knew special secrets to keep safe, and that we too had prepared in every reasonable way.

We told them the truth: a big storm was coming, yes, bigger than Irene. We might lose power. That the weather centers were saying that water was going to flood areas near the rivers and ocean and in neighborhoods nearby, but that our house was high on a hill and no one thought the water would come this high. We explained that many friends had evacuated, and were all in safe places, waiting. We assured them that if we were told to leave by weather scientists – that we too would leave right away – and would do everything we could to keep them safe always.

Most importantly, we treated this storm as part of unfolding new realities. We said that this storm would be good practice and teach us important things about how to take care of ourselves and others through future storms, and that we should use it learn everything we could.

On high ground – we watched the waters rising, engulfing the neighborhood two hundred yards away and driving out neighbors immediately adjacent to us. Red Hook, a few miles away where clients and friends both live and work, was submerged, flooded out before the sun even set.

As the night wore on, and the wind’s howls became more ferocious – I began to check in with clients who still had power, some trapped and unable to evacuate in flood zone A, some who lived on the Jersey shore. Colleagues friends, and clients were on disaster calls, working continuously through the storm, and beyond, in the city hospitals. Others who were first responders I was able to catch glimpses of in news clips and know they were okay, at least at the time of the report.

For a few people who didn’t have access to TV or radio, I conveyed by text, the wind and weather reports as I heard them.

Our home was safe enough. We never lost power, and were able to follow the reports of cars floating down Wall Street near our office, of the East Village- our previous home and home to many friends -waist high in flood water.

As the night wore on and the wind intensified, and the power outages began we retreated to the safest room in our house, and followed the storm as best we could, through our phones – on twitter, facebook, and the NYC office of emergency management.

Bellevue, where my husband had worked and I had volunteered through 9/11, where we both had many professional and personal connections – had lost power and the hospitals were evacuating. Beyond unthinkable, trying to imagine negotiating those labyrinthine hallways in the pitch black, surrounded by panicking and disoriented patients.

Every harrowing report implicated someone we knew, someone we had treated, someone we cared about, someone we loved.

The wind began to die down around 10:30 pm. The flood waters began to recede around 11:30 and most communities were starting to drain by midnight.

We have lived, and worked in this city a long long time. Between the two of us, we have lived in many neighborhoods, worked in many different communities, and been professionally invested in hundreds and hundreds of people from all over the city and its surrounds.

On my own roster of open cases – I have clients who live in every severely effected area: The Rockaways, Breezy Point, Astoria, Hoboken, Jersey City, the Jersey Shore, Long Island, Red Hook, DUMBO, Coney Island, the East Village, and of course, all of Manhattan below 28th Street.

I, my children my immediate family members were safe and fine, but I had empathic connections to someone in every devastated community. I knew personally, professionally (which are not so separate in times like these) people and their stories of their families, their friends, their neighbors, their associates – I could envision and imagine a woman I never met but had heard tell of with a severely disabled child in a destroyed area of Queens, someone else’s elderly stubborn parents refusing to leave the Jersey shore, the exhausted communities of cops and FDNY and their families weathering the storm without them. I could see in my visual and imaginal memory folks I know and know of living high in towering urban housing projects, cold with no lights, in the dark.

Floods archetypally and collectively represent the washing away of one epoch, and the birth of another: Noah, and before him Gilgamesh, with their big boats, matching doves with tree branches and their same rainbow promises that the Lord of the Universe would abide by a new contract now that the old one had been washed away.

Personally, in an individual dream, floods are symbolic of great waves of unprocessed emotional experience – that floods out our capacity for thinking, for analysis, for strategy.

This flood was symbolically all of this and more.

This was real, happening to real people, in my real extended, personal, and professional community, to human beings and families that I was really connected to, had intimate knowledge of, and attachments to.

There was no opportunity to derealize, to pretend it was happening to random “others” somewhere else. This was happening to my chosen family, my closest friends, my neighborhoods, my clients, my communities, my city.

When you work close and warm using your own Self, in the heat of transference, intersubjectivity and alchemy, cold distancing isn’t an option, even when it might be useful in helping you to keep your bearings, or protect you from getting washed away.

Tuesday – a day of shock and awakening:

In the morning, after little sleep and a little breakfast, we went out to explore what had been lost. We stopped counting downed trees when we lost count on our square block. We went down to the river which, although still swollen, had retreated back to its banks. We traced the waterline by the shattered windows and ruined store fronts that we passed.

My husband and I hiked across the Brooklyn Bridge in the lingering rain to see if our office had taken in water. Our superintendent had spent the night, turning off the electricals to prevent shorting and fires. He estimated only a foot or so in the basement, although we had been in zone A, and Wall Street, one block away, had been completely flooded.

I reached out to several people on my caseload who I knew had been in significant danger, and sent a mass “bcc” email to all letting them know that the office was out of commission and I would be scheduling walking/talking sessions for clients in Brooklyn, and phone sessions for clients that needed to talk on Thursday and Friday.

Responses came trickling in – many who thought they were “fine” with or without power, or “not effected at all” on high ground. And as many stories of crisis, trauma and loss: photos of clients homes destroyed, tales of watching rising waters out of windows, cold and blacked out apartments, people evacuated unable to return to their homes, people trapped in their homes by water, by downed trees, by cold, dark stairwells.

People rescued and assisted by kind neighbors and strangers.
I fell in instantaneous love with every Samaritan who selflessly assisted a client in need.

Wednesday- a day of giving, taking and disconnection:

After a fear-free nights sleep, we woke up activated:

Wednesday was Halloween, and I could not stomach the thought of talking my kids door to door, in fancy costume, begging for candy – when there were people unhoused and unfed and unclothed in our own communities a few miles away.

We went through closets and gathered all of our extra blankets, coats, wool socks, sweater, canned goods, bottled water, hurricane candles, extra batteries, flashlights.
On line I found Redhook.recovers.org run by OWS, and was directed to a church that was gathering supplies and taking deliveries to Red Hook and the Rockaways.

I contacted all the people in our co-op and our neighborhood, sent notices out on email and facebook, asking for donations of batteries and flashlights, blankets, coats and sweaters.

I asked people to drop off supplies in our vestibule, and said that we would be glad to transport any supplies all week.

One family, among our closest friends, responded immediately, ran up to their apartment and brought down their canned goods.

All others stared at us blankly. “I don’t think we don’t have any extra batteries… ” one lied vaguely. Some were more direct: “I am going to keep my own bottled water.” Some offered useless items instead: ” Hmm – I might have some summer clothes…”

No thanks – they need food, warm clothes and coats because its cold outside and their homes are gone, also batteries and flashlights and water.

People looked at me as if I was doing something unbecoming, annoying, impolite.

I tried hard not to judge their response and also not to turn it in against myself. I knew from other disasters and from 9/11, that this was my typical activated response to the devastation around us.

My professional practice as a social worker and a therapist is to imagine something about the core needs of others and cultivate the most supportive, effective response. Its what I do all day – why should others react in the same way that I do?

I’m certain many that rejected my outreach found, and will find in the long weeks ahead their own ways to respond over time – with goods, services, time, money.

Everyone is allowed their own response to shock, me included.

Maybe they didn’t have the opportunity for this to feel real to them, maybe they had no experiences of or relationships to people in the communities that were directly impacted, maybe this didn’t feel personal to them, yet, this time.

Maybe we can’t respond to anything easily or effectively if we haven’t forged a personal connection somehow.

We stopped by our local mini-mart and they donated a full cart of canned goods for us to transport, bless them.

The kids worked hard through the day sorting, bagging and boxing supplies along side of us. They gave generously, appropriately, and I was touched by their maturity, industry, and autonomy. Proud to bursting.

But, at the end of the day, and for the rest of the week, our vestibule would remain empty. Not a single donated can or a battery or an old coat.

And this thought too: I must also consider, and with thoroughness, that my rush to offer up goods and services may not have been particularly helpful at all. Perhaps my boxes of canned goods and rice and beans and coats in all sizes and blankets are sitting somewhere, in a cold basement or the back of a van, or an evacuated shelter – burdensome and unused.

Perhaps I simply created the illusion of being useful, because I needed to be of use.

There are times when the most useful thing is to sit still, and stay out of the way.

And perhaps others succeeded at that where I failed.

By nights end I need to check in with my husband: “Do I seem crazy or off-putting or too agitated when I am asking for donations? Because I feel like people are staring at me like I have three heads? Is anxious impatient energy pouring off of me? Was I inappropriate or demanding?”

“No” he said, “you were asking normally – I think you just have to ask a lot of people and thats how it goes – between our friends, our things, and the mini mart we gave them a lot of stuff, and I’m glad we responded the way we did. You are just always the canary in a coal mine – and remember what happens to them!”

Thursday – a day of gathering and outreach

On Thursday we began hearing from chosen family – our children’s god mothers and god fathers – whose homes were without power. It was growing colder. The darkened parts of the city were feeling edgier, less safe each night. Walking uptown to harvest power was creating irritable crowds at the power outage borders – as hundreds searched for places to charge their phones, buy hot foot and drink, and more batteries before heading back into their darkened homes.

They came to stay until power and heat were restored – which comforted us as much as them. It felt healing, soothing, strengthening to have our tribe gathered.

We were anxious about our clients well-being. Without an office available, I scheduled any client that wanted or needed to talk on Thursday. I had walking/talking sessions for clients who lived in Brooklyn, I had sessions behind the locked gates of our community garden, I had phone sessions in my room while one of the godmother’s turned our daughter’s room into her temporary office. For the first time ever: a half-phone/half-text session emerged as a treatment modality when the cellular system refused to allow our phones to stay connected.

It was both comforting and exhausting to try to cobble together jerry-rigged pseudo-structure out of the chaos, and brought into sharp focus how much injury the city, its inhabitants – and its infrastructure- had sustained.

When a twitter friend forward me the information that Zelda the turkey had survived, with a photo of fat, happy turkey on top of a dumpster – everyone in the household cheered as though Noah’s dove had just returned bearing an olive branch.

Friday – a day of gratitude and taking stock

The house remained warm, kid- and friend-full, and I spent the day feeling enormously grateful for the reading on ecotherapy and ecopsychology and climate science I had been led to explore over the past several months.

I felt prepared by the reading I’d done, startled by the timing of the events, heartbroken for others, for but not surprised, or stunned.

Even more grateful that I listened to my own inner leading and had organized a study group of smart and thoughtful clinicians that will soon be gathering together to look at the way that our disconnection from a wider awareness, and our denial of the consequences of our collective behavior effects our community’s and our culture’s mental health.

I need more than ever to find words, in the company of a like minded group, to speak to clients about our collective denials, our estrangement from realities, our defenses against science, our minimization of disturbing realities.

It was a day for me to starting waking up to our own disturbing realities and secondary losses as well: two self-employed private practitioners, with our office out of commission, it was becoming clear that we would feel a significant blow to our businesses and household finances.

Many clients have sustained unfathomable losses, and will need pro bono and reduced fee support. Some may move, as many did after 9/11. Others will lose their jobs, some have lost businesses, many have also lost, and will lose several weeks of income themselves. Paying for therapy becomes a low priority or an impossibility.

I have made a policy of never abandoning a client because of financial crisis, I reduce or suspend fees, perhaps reduce sessions if large balances are still accruing, or schedule on an “as needed” basis, until the crisis is negotiated.

I hope I can afford to maintain that policy going forward while also caring for my family.

A weekend of celebration and passing it on:

Saturday with our extended chosen family gathered we had a full day of joyous celebration, and permitted ourselves to forget all that was happening around us.

Because a fantastic force of nature, far more generative and creative and consequential than Sandy, arrived on this planet 8 years ago when our daughter was born, and that deserved to be celebrated no holds barred.

Sunday we returned to reality, and used our car and our gasoline to shuttle donated supplies to Red Hook, the Rockaways and Breezy Point.

Monday and beyond….

This week, we have returned tentatively to work, in a building intact, with power but with no phone, wifi, or heat. The night time view from my window is eerie: One window looks out on buildings filled with light and flickering TV screens. The other window faces a chasm of darkness, pitch black, unlit, unoccupied buildings

Clients seem to fall into four different categories of response
(I have seen similar responses before, including my own, in the days and weeks after 9/11):

1) Those who are totally and directly affected, and know it, but who are very busy coping, and not feeling much yet. They are in the throes of loss of home, loss of businesses, loss of community, loss of neighborhood, loss of place and root. They are wandering through their days, displaced, unmoored. At particular risk are those who have survived trauma and disaster before:

Standard disaster/post-trauma/crisis intervention training is extremely helpful here – and there has been a great deal written about that elsewhere. But it is probably not complete or sufficient in and of itself, as climate-driven disasters are likely to continue to unfold, in some form or another. This is about all of us coming to terms with a new way of life.

2) Those who were not in the direct path, but feel disturbed, disorganized, anxious about what is to come – or guilty and hesitant to permit themselves to “feel bad” when they are so “lucky” – or who sense that everything has changed although they have “no right to complain” because “nothing bad really happened” to them:

For these clients it is important to validate that it is healthy, and normal and appropriate to feel distress when your community is profoundly wounded. Some worry that their non-personal distress is a sign of personal weakness or low grade hysteria rather an expectable experience of empathic connection to those around them.

“I felt a great disturbance in the force, as if millions of voices had cried out in terror….” Obi Won says when a distant planet in a nearby galaxy explodes. The quote is resonant and memorable collectively – as if we too can imagine sensing such massive, collective, disturbances with Ben’s sensitivity. How much more powerfully do we feel such disturbances when the millions crying out are those we encounter every day, when we have been seated side by side with them on the broken commuter trains and subways?

3) Those who were not affected, or were secondarily affected, who are involved in advocacy, who are working to assist others and those actively grieving the injuries to their community and environment:

– sometimes to the point of burnout or exhaustion.

These clients first and foremost need their perceptions validated and their grief supported. This is particularly difficult for therapists struggling with their own estrangement and denial. These may, or may not need help discerning their own limitations, their need for self-care, and managing survivor’s guilt.

Too often, these responses are pathologized as mere activations of events or injuries from childhood, when they are a healthy, appropriate and related response to real events in the present.

4) Those who were not directly externally affected, and who are not internally affected by the disaster either:

Some might report that they had a relaxing time away from work, might describe the city slow down as a “vacation”, some might even describe having a good time partying and see the event as having little or nothing to to with them.

Some may have cursory awareness of the losses around them, but are not moved, distressed or upset for anyone else, or for the community – beyond being glad that they themselves were not in harms way.

Others among the unaffected, living just miles away, may have paid no attention whatsoever to the disaster around them, have not read a paper and ignored, or avoided coverage of the event, and do not even know what has happened all around them.

To be sure, some of these have marshaled panicked defenses: flung themselves into manic hedonistic binges, strapped on their narcissistic armor or thrown up walls of primitive denial to manage their own fear.

And many who imagine they are truly “fine” have suffered from (or will suffer from) other, displaced symptoms, stemming from the lack of sufficient relatedness to others to their communities and the planet. These are often clients who feel anxious, estranged from meaning in their lives, friendships and in their work, who have significant difficulties forging and sustaining empathic and reciprocal relationships.

These are clients who often don’t seem to know what other people are “for”, what their own central purposes and values are, and sometimes seem at a loss as to what it is they want from therapy itself.

How disassociated have our lives and our culture become that we can imagine that it is normal to be unaffected by devastation in our community a mile or two away, or by a feverish planet creating recurring superstorms?

Denial prevents us from preparedness, prevention, and harm reduction with regard to climate change- exacerbating the toll in disasters like these.

Why didn’t people leave evacuation zones?
Why did people stay with their children in harms way?
Why do we want to rebuild in flood-zones when the water levels are rising?
Why have we not listened to the obvious, clear scientific consensus and mounting evidence?
Why do we ignore every warning?

Just like addicts and their cohorts living in collective denial – clinging to short term comforts while accruing disaterous long-term consequences: our culture, communities, and individuals need to begin to face painful, grief-filled realities in order to reduce harm to ourselves and the living world.

Addressing, confronting, and working through treacherous resistance is the therapists purview.

This IS our job. We do this everyday. We know how to work through and around unhealthy defenses.

We need to offer up our skill set to help our culture and our clients respond to reality or our clients will continue to suffer.

More than they have already.

For myself and my practice:

I want to support my clients’ and the planet’s attempt to heal from the injuries our inflated consumption and denial has inflicted.

I want to mourn with my whole community when we are brought low and humbled with profound losses of life, of our way of living, of property, home, rootedness and place.

I want to appreciate the dark and painful relief that comes when we are reminded that we are not so powerful and we restored to our proper place and size on a planet that lived and thrived for thousands of epochs before humans and will spin and live richly far past us.

I want to cultivate gratitude for and strengthen the resilience and health in others, in my community, and the world around me.

There are people doing amazing good for each other.

There is one kooky, wild turkey happily roaming free in the middle of a concrete jungle.

There are birds, bearing olive branches, all around us.

There is comfort and empowerment in that.

Please help Hurricane Sandy victims in NYC by donating to New York Cares http://www.newyorkcares.org

or by donating to The Red Cross.

copyright © 2012
All rights reserved Martha Crawford

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