In Conflict

Anger (v) c.1200, “to irritate, annoy, provoke,” from Old Norse angra “to grieve, vex, distress; to be vexed at, take offense with,” from Proto-Germanic *angus (cf. Old English enge “narrow, painful,” Middle Dutch enghe, Gothic aggwus “narrow”), from PIE root *angh- “tight, painfully constricted, painful” (cf. Sanskrit amhu- “narrow,” amhah “anguish;” Armenian anjuk “narrow;” Lithuanian ankstas “narrow;” Greek ankhein “to squeeze,” ankhone “a strangling;” Latin angere “to throttle, torment;” Old Irish cum-ang “straitness, want”). In Middle English, also of physical pain. Meaning “excite to wrath, make angry” is from late 14c.  ~  ( http://www.etymonline.com)

So someone is always angry at me about something. At least one person a day, often more than that.

Often enough with good, fair reason and because of something I have done or not done, said or not said. I am running late. I push when I should have held back, or held back when more was needed from me.  I can make my own errors, stumble about, bang into a painful bruise. Sometimes I am clumsy, slow, frustratingly thick-headed. Or lost in my own projections, operating on an erroneous assumption, or stuck in my own subjectivity.

Sometimes people are angry because they have been sold a bill of goods, hopefully not by me, although I am probably also a participant, that psychotherapy can offer them a cure, some relief, when the truth is less certain. Sometimes it can and sometimes it can’t.

People get angry that I don’t have the magical powers to take their pain, their confusion, their ambivalence, to heal the wound away.

Some become angry that I don’t just know. Right away, instantly, what is needed and how to provide it. Sometimes people become angry because they have told me what they want from me, and they believe that I am withholding, refusing to cough it up.

Some want to control, extract, command that I fill their need to their exact specifications and are enraged at the dereliction of my professional duties when that need remains thwarted, unfulfilled, exposed, empty when I can’t. Or won’t.

Some become smaller, exceedingly polite, self-diminshing in order to metabolize the anger that a mis-attuned moment has activated. And then I have to drag  it out of them:

“I wonder if something I said made you feel angry?”

“No. I am not angry….”

“Well, something shifted in our conversation and it seems like maybe I said something that hurt? Maybe anger is a strong word for you? How about annoyed?”

“Well, okay. Yes. Maybe I was a little annoyed”

Some become angry because I can see the pathway in, I have gazed at a vulnerable and naked space in them – and they want to cast me out and drive me away. Some are secretly terrified that I will go and their anger helps them organize a pre-emptive strike. Sometimes anger helps people self-regulate, manage their dependency, separate.

Sometimes the anger that emerges in session, or is directed toward me is obviously displaced, patently unfair. A lashing out. And still, somehow, it is almost always understandable to me when I can hold, or uncover the subjective context that it is embedded in.

Usually I am a participant. I bear at least some responsibility. At the very least I lit the fuse, even if I didn’t build the bomb.

Sometimes the client is angry or disappointed that I have my own wound. And they have found the very spot where my needs, my history, my trauma, my vulnerability lives and they want something from me in the exact pocket of my psyche where I have nothing to give at all.

Some attack or express contempt for my core values, my stance, my beliefs, my sense of what is right. Some reject the models of psychotherapy I have embraced, the patch of ground I stand my professional identity upon.

And of course, I get angry too.

I breathe and do my best to stay cool. I contemplate the tightness in my chest: What am I responding to? Where do I feel strangled, offended, tormented, grieved, distressed? What needs to be opened up between us in order to be released from this constriction? Where has our relationship grown too narrow?

If I am caught off-guard, or feel too reactive, too agitated, I  may ask to table the discussion until I can think with a cooler head. But the arrival of anger must never be ignored or forgotten. It is a sacred signal and attention must be paid. We must return to it, examine it, discover its gifts and lessons once our nervous system and our heart-rates have settled.

Anger and aggression have important, constructive functions too: to establish boundaries, to protect privacy and autonomy, to fight for justice, to correct imbalances, to guard vulnerability, to take risks, to hunt for prey, to compete for resources, nurturance and provisions, to challenge and surpass ourselves.

And sometimes to forcibly remove obstacles to intimacy and wholeness.

In relationships, anger points our attention toward the tight, narrow, constricted, strangled, tormented, wanting aspects of ourselves and others so we can broaden and console our hearts, release our fears, open wide our souls.

As frightened as we are of it, anger is a sacred energy – and a central one in the psychotherapeutic process.

I don’t ever intentionally provoke a client’s anger, but I am not fearful of it.  I don’t avoid conflict, because I know the gifts that it can bestow.

I try to inform every new client that comes into my office that anger has a place in our work:

“There will be times when I  disappoint, disturb or upset you. I won’t have done it on purpose, although it might feel like I have. Sometimes you may not notice it while you are in session – as most of us are taught to be agreeable and polite and avoid talking about such things – but it may strike you after you leave – on the subway ride home or even the next day. You may notice something sticking in your head, something I said or didn’t say that struck you the wrong way, that feels off, or annoying, or wrong. You may think to yourself  ‘Why the hell would she say or do that?’  If you notice any feelings or thoughts like that it will be extremely valuable and important, if you can, to bring that back in to our next session, or even to jot down a quick note so it doesn’t get lost in the weeks events- so that we can remember to talk about it. It may be hard and uncomfortable, but its really valuable  – and its an essential part of how therapy works.

It helps me to understand you as precisely as possible, to be a better therapist for you. You may point out things that I haven’t recognized or considered- or that I had a different perception of. Sometimes you may be distressed by some real limitation or blindspot I have, or even some core value that I hold that you disagree with. That is okay too. I can’t promise that I can always change or stop it whatever has been upsetting, but I can promise that I will always do my best to examine my part of any divergence that  comes between us and I will absolutely care about how it makes you feel. And if we can talk about it frankly, it may give us a chance to find a new way through, a new solution, a new space.”

It seems that whenever I have neglected to invite anger to enter into the process as a welcome guest, conflict barges in unannounced and unexpectedly, harming the therapeutic relationship – sometimes irreparably. Anger and conflict are experienced then, as definitive proof that something is wrong in the therapy, rather than as a vital component, a therapeutic mechanism of healing and connection.

Or, the relationship proceeds walking only the most avoidant and  domesticated paths, making the woods and the wilds of our innate aggressive impulses appear more terrifying, a place too dangerous to ever venture.

Conflict is part of the therapeutic process, not a failure of it. And part of this job is to initiate people into the generative, creative, and intimate uses of anger, and to learn how to move through the angry states in our psyche and our relationships in order to live, to love courageously, fearlessly, and honestly.

And Jacob was left alone; and there wrestled a man with him until the breaking of the day.

And when he saw that he prevailed not against him, he touched the hollow of his thigh; and the hollow of Jacob’s thigh was out of joint, as he wrestled with him.

And he said, Let me go, for the day breaketh. And he said, I will not let thee go, except thou bless me. ~ (Standard King James Version Genesis Chapter 32: 24-26)

Even when seems to have knocked us out of joint, conflict can bring blessings. Owning our anger explicitly, consciously, and constructively makes us more whole, and less afraid of ourselves.

And other times my job is just to survive it, withstand it, not be destroyed by it, and not let my love or my empathy be destroyed by it. To continue to have compassion for the distress that is present in front of me, to take all the responsibility I can for my part, and to understand that the rest is not about me at all.

If I can. I can’t always.

And sometimes even that is not enough.

It does neither of us any good for me to merely withstand abusive energies. Limits must be set. There are things I can’t accommodate. Angers I cannot absorb. It is my responsibility in those moments to set limits, protecting us both. I cannot let a client who needs me, harm me or compromise my integrity or we are both lost.

Anger is at once an energy which destroys and derails, and one which creates, strengthens, and fuses and purifies, through its refiners fire and alchemical heat.

Part of my job, as I see it, is to initiate clients into the constructive, transformative, generative uses and processes of anger.

Any one can get angry- that is easy- or give or spend money; but to do this to the right person, to the right extent, at the right time, with the right motive, and in the right way, that is not for every one, nor is it easy ~ (Aristotle, Nicomachean Ethics, Book II, 1109a.27)

If we can manage to wrestle through conflict squarely and bravely together – operating in good faith – or setting limits when anger has temporarily washed good faith away – certainly it is not difficult to see how to carry those processes out into the world, into other relationships.

The word wrestle, derives from “wrest” from the Old Norse, meaning “to bend” and the healing forms of anger make way, when we have listened to each other deeply, for us to release our tormented tightness and constriction, and discover how to bend toward each other.

What is external occurs internally as well, so our well negotiated conflict also becomes model, a mirror to help us sort through purely internal arguments between conflicted self-states.

It is exactly as if a dialogue were taking place between two human beings with equal rights, each of whom gives the other credit for a valid argument, and considers it worthwhile to modify the conflicting standpoints by means of thorough comparison and discussion or else to distinguish them clearly from one another.  ~ C. G. Jung, The Transcendent Function.

How else will we change each other? How else will be transformed?

If we avoid what we fear in ourselves, and in each other – what will be possibly be able to learn about ourselves?

The shuttling to and fro of arguments and affects represents the transcendent function of opposites. The confrontation of the two positions generates a tension charged with energy and creates a living third thing… A movement out of the suspension between opposites, a living birth that leads to a new level of being, a new situation. ~ C. G. Jung, The Transcendent Function.

But first we must embrace the wrestling match.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hard Times


Let us pause in life’s pleasures and count its many tears,
While we all sup sorrow with the poor;
There’s a song that will linger forever in our ears;
Oh hard times come again no more.
Tis the song, the sigh of the weary,
Hard Times, hard times, come again no more
~ Hard Times lyrics by Stephen Foster

I didn’t mean to write this, or intend to write anything – it is probably unwise to publish it, but I suppose I will anyway. Frankly I’ve been thinking I should take a break from writing altogether for a bit.

I’m just not so filled with easy inspiration, or reassuring confidence, or heart warming feel-goodisms.

My husband and I are in midlife and are, like many of our peers, sandwiched in between caring for our elders and our children. All of whom, for the time being are in significant and legitimate need of our support through some more and less challenging medical realities. Testing, appointments, evaluations, treatments, follow up, referrals. We are in the thick of it and it looks like we may be for a while.

A summer which felt like it was ripe with openings, fortune, potential and new growth crashed into a shocking and frightening fall which will unavoidably open up to a tiring cold winter.

It happens sometimes. We’ve faced such things before, and will again. I’ve seen and supported clients and friends and neighbors as they’ve passed through similar hard times.

Just as all human beings do.

But psychotherapists are supposed to be invulnerable, no? Fully actualized? Enlightened? Able to absorb anything that comes their way?

And who would want to see (or read) a psychotherapist in the midst of hard times?

Better to source out some therapist who is perky and happy! Who feels in control of life! Who can make you feel better!

Yet, sometimes life gets heavy. Sometimes there is work to be done. Sometimes we are pulled in many directions. Sometimes our choices are narrowed down by circumstances beyond our control. Sometimes a great deal is required of us. Sometimes, despite our plans and intentions, our possibilities restrict themselves to a very few or none at all. Sometimes our external freedoms become constricted. Sometimes the wolf is at the door.

So, for me, this isn’t a silly, playful, easy season filled with boundless, bouncy energy.

I am sometimes weary. I am sometimes overwhelmed. Sometimes I want to run. Sometimes I am incredibly proud of myself and my ability to keep moving, to get done all that I need to, and stay connected to myself and others. Sometimes I want to spend a day in bed with the covers over my head. Sometimes I am swelling with appreciation for the tender comforts around me, the honesty and intimacy and contact that the relationships in my life, personal and professional, offer me whether they know it or not.

Sometimes this season has offered me glimpses of deeper truths, timeless ones, that transcend and soothe through the rough and jumble of the road I am on for the moment.

I am all right. I’m okay just as I am. Where I am feels healthy and appropriate. To be too cheery right now would be denial of reality, a self-deception, and would pull me further away from the phase of life and the external challenges I am passing through for the foreseeable future. But certainly not forever.

Many days you have lingered around my cabin door;
Oh hard times come again no more. ~ Stephen Foster

Happiness doesn’t last forever, but nor does sorrow, and neither does trouble. All states have gifts to offer, lessons to teach, blessings to bestow.

Things get heavy sometimes. Its just a fact.

Sorrow has its season.

Even for psychotherapists.

Energy retreats, retracts, and peace can be found in small, still moments, in quiet spaces deeply internal. Fake smiles, chit chat, false reassurances would make me less present, banish me, send me away, exhaust and deplete me more and make me abandon myself, thinning out my resources to connect to others.

“How are you?” Some clients routinely ask – usually I respond, honestly, “Fine! How are you?” Now my response is more subdued, but still honest. “I’m okay. And you?” or “I’m hanging in. What is happening in your world?”

Though her voice would be merry, ’tis sighing all the day,
Oh hard times come again no more. ~ Stephen Foster

To do this work I need to be in contact with myself, and I need to stay in contact with myself, and remain loyal to my own energies, even when it is not comfortable.

Through my professionally arranged face, through my slower, quieter responses, through the circles under my eyes, (which can betray me – no matter how much “concealer” I apply) some still feel the shift in my energies. Some, especially those who come for time limited short term work, to focus on a single issue, or who use therapy as a problem solving space, take it as their cue that it is time to finish up, assuming that if I am offering less, that it is a signal that our work is complete.

Some clients know part of the story, as medical appointments for family members have caused me to cancel, reschedule and rearrange appointments more than I have ever before. Some know the whole story because they dream of it, or read me so closely, and so hard that it frightens them more not to be told what is happening.

Some don’t know anything, or know a little, but need me to protect them from thinking too much about me – as it is hard enough for them to stay loyal to their own experience.

Some become angry with me, without knowing why, because they sense, unconsciously, in their pre-verbal places that part of my psyche is working on my own challenges and conflicts. For those who had depressed or preoccupied early caretakers it is especially threatening, as they are sure that if they sense any dip in my energies that I will become unable, unavailable, to sustain my caring, loving attention.

There are those who are immersed in much harder trials, more consuming, more traumatizing, more violent conflicts, more emergent circumstances and more acute crisis than mine and it snaps my perspective into place, as I move my own experience further down the triage list – and immerse myself in the need that is in front of me with the skills I have accumulated over many years.

Some, who perhaps I have enabled by being more active than was necessary when my tank was full to overflowing, are being given more space to take up the reflective, interpretive work as their own, as I hold back to listen more, perhaps offering less direction or guidance than I might in a more buoyant time.

And there are many moments through my workday which lift and inspire me: A client falling in healthy reciprocated love. Another who feels ready to marry. The birth of babies through hard pregnancies, the courageousness of a client trusting me enough to share the ways that they do not yet trust me. The bravery and integrity of another in the face of danger. A piece of creative work shared, beautiful and transforming. The incredibly powerful, awe-inspiring imagery of dreams. Undeniable growth, accomplishment, achievement, mutual admiration, appreciation. Closeness in all forms, shapes and sizes.

While we seek mirth and beauty and music light and gay,
There are frail forms fainting at the door;
Though their voices are silent, their pleading looks will say
Oh hard times come again no more. ~ Stephen Foster

And then there are actual gifts that come with hard patches.

When the ability to engage in the Extraneous is eliminated, the Essential reveals itself more quickly and incontrovertibly.

Priorities become crystal clear. And when you trust your exhaustion, you know that it will steer you away from the superfluous, unnecessary.

And when you feel alive and engaged you know you are in the presence of something vital and healing for all involved.

I can feel when I am barking up the wrong tree almost instantly. I can tell when it is better to wait something out, rather than bang my head against the wall. I can spot any opportunity for relieving contact with the healing processes of Life as they move continuously between and around us all.

I have more compassion for myself: if I have a harder time organizing, scheduling, getting my bills done, or it takes me a beat or two longer to understand what is playing out in the room, I know that I am doing my best. I accept and take responsibility for my errors without being tempted to punish myself for them. I am doing what I can do. I can model self-compassionate behavior, a way of being that is less concerned, for now, with pushing past limitations than accepting them.

I may now have less energy for heroic maneuvers, for flashy interpretations. I will not be leaping over tall buildings in a single bound or pulling a rabbit out of a hat in the season ahead – I am currently unable to be seduced by inflation or grandiosity, it is just too tiring – and life is simply too humbling at present. I cannot over-extend, bite off more than I can chew, or take on anything that could prove to be too much later.

I am in exquisite and direct contact with my own needs, and the fact that I am finite.

I treasure and value the impact and the necessity of stillness like never before.

And I understand “self-care” less as a discreet activity or a scheduled event and more as an on-going way of being, moment by moment, in the presence of people who need me – as I negotiate the balance between their needs and my own and attempt to honor them both.

We will all pass through such times. And we can receive something from them as well. And if I can do nothing other than try, and fail, and try again to model an experience of being simultaneously intact and overwhelmed, of staying in caring and compassionate relationship to myself, my family and my clients, perhaps, through hard times that is more than enough.

Never to ask for easier circumstances, but for greater strength, and to accept gladly, (when they come) rest and ease along the road. ~ Pierre Ceresole

This is What Happened

Someone asked me to write this. Sort of.

They asked me if I could state, in tangible terms, the kinds of healing that I have seen take place in my work as a therapist.

And I can’t. Because it didn’t and doesn’t somehow seem to be my prerogative to codify or co-opt my client’s experiences to say how I think they have been healed, or not. That is up to them to define. I have no idea what they think has helped about therapy unless they tell me.

Sometimes they point to powerful defining words – for good and ill – that  I said, years, even decades earlier, that I have no recollection of ever saying.

I do this to my psychotherapist too. If you’ve read my writing over time you’ve seen me do it, and you should know he is a very good sport about it.

Is healing always even the goal?  Sometimes the goal is just surviving.

Some weeks, it is an extraordinary accomplishment and more than enough that we are all still here, and still pursing hope, meaning and connection and living out of our values in the face of  life’s suffering.

Certainly I’ve seen people transform their lives in front of me: Leaving abusive scenarios behind, finding love, healing relationships with partners, becoming parents and more attuned parents, getting through school, sorting through confusion, negotiating and resolving crises,  mourning deaths and other unfathomable losses, facing down fears, coming out of all kinds of closets, changing careers, owning their true identities, at first managing, and eventually shedding symptoms and anxieties.

But I don’t think these accomplishments were because of me. Sometimes the client does though. When they thank me, I try to stay gracious and not too self-effacing and accept their gratitude as a sign of appreciation of my sticking near them through it.

But often that is all I am doing. Staying near. Bearing witness, and letting what I am seeing change me. Staying out of the way, and trying to clear some thickets here and there that may be blocking their true path. Babysitting their most vulnerable needs until they are ready to value and care for them on their own. Making a dark time a little less lonely, and a little less terrifying. Normalizing some stuff that they worry is crazy.  But the growth is theirs and may have happened without me.  Maybe I made the unfolding a little easier. So I try to accept the gratitude – but it always feels strange to do so.  Like a plant thanking me for its growth and harvest  when all I did was water it once or twice a week.

But here is what I can talk about – and will try to do so briefly. Briefly. Ha!

I will try to talk briefly  (that is hilarious) about almost thirty years as a client in my own psychotherapy.

I arrived in New York City in the year after my 21st birthday, to work in the theater and to  be near a boy – who I thought was a man,  a few years older than me – but I see now was just a boy. The boy fell in love with someone else, and for some reason didn’t tell me. I don’t know why. We weren’t living together, we weren’t committed – perhaps he felt bound by an underlying and crushing dependency that I barely contained – as I lashed  myself tightly to any peer, friend, lover that I could, hoping to survive the sinking ship of a family that I had left behind. Perhaps he feared that if he left he would sink me. And  he was kind of right. But he still should have left for the girl he did love rather than making me feel increasingly crazy, confused, burdensome and complaining about my “jealousy problem.”

I had other problems, certainly. I had inherited them. My father had come from a deeply abusive, very wealthy and epically pathological family – and spent his life trying to expel his pain with unnecessary surgeries – over  20 times under the knife – narcotics, religion and rage. He remarried to a woman with three sons who became his real family and I was at best a tolerated guest. My mother had left him when I was ten, after falling in love with our parish priest, who was also a terrifying narcissist, and ultimately “defrocked” by the Episcopalian diocese.  He also eventually left, taking the house out from under us.

So maybe that is why the boy was scared to leave me. But he agreed to go to couples therapy. So we went. We were matched at a fee for service clinic with a young man fresh out of his internship, maybe about the boys age – 25 or so – much older than me,  so I thought. I don’t remember much of these sessions, except that they eventually  helped me to tell the weak scared boy to go, for Gods sake.

And then I sunk. Which was necessary. Which was practically mandatory – because I thought, up until that loss, that the life I had inherited was sustainable. That it was wacky, funny, unconventional perhaps, but I was sure it was all fine.  And that life would keep unfolding that way and that I could keep making a funny story about it at cast-parties after rehearsal, and that there was no harm done.

And suddenly, it was clear to me that something had happened again, that I never ever ever wanted to happen again, and that there was plenty of harm done. Plenty.

I began seeing the 25 year old therapist myself twice a week. I began noticing that I had symptoms, which I had never noticed as symptoms before. I would spend hours getting dressed, unable to see myself accurately in the mirror not because I was fussy about clothes but because I  unable to tell what I looked like.  I was not a night owl, I had regular, and pretty severe insomnia, terrible nightmares, intrusive memories, flashbacks, night-shame from my increasingly obviously not-so-normal childhood.

I began trying to tell the kind young therapist the story so far – to recount, recall  and reorder for myself  what exactly had happened. I came in to each session and told some other part of the story. I told  him, and myself for the first time what it actually felt like, parts of the story that I had ignored, the distressing, disturbing, terrifying, traumatic memories that swirled in my head instead of sleep. There was no familial or social relationship that would have listened. And my own shame and dissociation made it impossible to tell even if there had been.

This was it. Psychotherapy created the space for me to locate myself in the middle of a swirling tornado of chaos and confusion.

It took me years to tell it all. I barely noticed the young therapist because the need to tell it all was so overwhelming.

At the end of seven years, I said: “I think I am finished telling you what happened.” And I noticed that he was still in the room. And that he hadn’t left, or become terrified himself, or ever once looked away. That he had stayed through all of it. That I finally had a witness, who had heard the whole story, who had traveled from my first home, and then after my family exploded, back and forth, between my parents houses with me – who had made it through with me, and this meant that perhaps, I had made it through as well.

Then there was the present to deal with. How would I protect myself and how could I exist outside of the chaotic family that I loved and was attached to? How could I separate and individuate – and jump into the void and all the unknowns of adulthood  from a platform so unstable? How had I been and how would I continue to repeat this story?  How had I projected it on to others? How was I, without realizing it, recasting the characters from the original script in my adult narrative? How could I do something new, create something healthier for myself? Would I even recognize, or be attracted to available relationships when I encountered them? Would I always over-adapt to compensate for the wounds of others?

The flashbacks receded. I slept soundly through the night most nights. I could get dressed and leave the house easily enough. The panic attacks faded away. I don’t know when. I wasn’t paying attention. I didn’t come to therapy for symptom reduction. I came to save my soul.

And eventually this (although for many years this was too terrifying): How did this all show up in my relationship to my therapist himself?  How did fear, distrust, anger, injury, paranoia, anxiety, chaos affect my ability to see him clearly, to connect to him? I began to actively use the therapy as a chance to watch the slow-motion replay: I could see my error, my out-of-bounds, my avoidance, my need, my indirection, my suspicion, my fear as it effected my participation, my attachment, my authentic presence in  therapeutic relationship right in front of my eyes. I saw what triggered my reactions and over-reactions, and learned  that forgivable acts can activate memories of unforgivable ones.

This felt like a super-power, x-ray vision. With this discovery I was suddenly able to see myself, and others  – and assess if I was giving what I should, if I was receiving what I needed. I could sense balance and imbalance, sustainable mutuality, and untenable lopsidedness in my relationships. I began to seek out others who could sense and speak of this too.

My joys and sorrows were increasingly responsive to the real events and stressors in my daily life – and less and less and less  about an unprocessed past bleeding out all over a messy present. I created reliable, loving, respectful relationships with friends, and chosen family in the present and the salvageable and loving members of my family of origin.

I mourned for all of those I had to let go.

I took up the profession for myself somewhere along the line, graduating from social work school just after I turned thirty, and eloped, marrying a man I had met five years earlier, the summer before graduation.  And I continued in therapy to deepen my examination of how my limitations and history were activated and projected into the therapeutic relationships in my own office and to keep my relationship with my husband and my in-laws – another family! – growing and healthy. And that parallel process – of being a psychotherapist – and being a client – strengthened and healed me even more.

And the relationship still exists, and always will. I don’t know how a 25 year old boy was able to contain a deeply traumatized 21 year old girl. But he did. And we have grown up together, and practiced parallel to each other now for over twenty years. I see him when life permits or requires. And that is less important than all that is absolutely permanent between us.

So: Can I say, in tangible terms, how I have seen psychotherapy heal, as a psychotherapist?

I guess the answer is yes.

It’s the Relationship…

I sometimes dread being introduced to other psychotherapists.

“Hi! Nice to meet you – you are a therapist too?!  That’s great – I do CBT, Motivational Interviewing and Behavioral Activation – what do you do?”

Uh.

Umm.

Shrug.

“I have an office…”  I’ll vague out and drift off.

When faced with the alphabet soup of “evidenced based psychotherapies” I find myself lost and speechless.

I don’t begrudge or devalue any of those interventions for the therapists and the clients that find them useful and meaningful.

But that isn’t what I do.

None of  the methodology, measures, the cognitive distortions or neuropsychological reprogrammings would have pulled me from the quagmire I inherited – there were only a few simple things that had any chance of aligning me with my soul’s mandate and the pursuit of meaning in my life: Image, Words, Metaphor,  Relationship.

I can’t eliminate behavior, and wouldn’t even dare arbitrate which behaviors are healthy or unhealthy. I can’t fix a damned thing. And I don’t practice therapy that fixes anything, because, frankly,  I never wanted to participate in a therapy or enter into a relationship with a therapist who wanted to fix me.

I can’t make anyone’s  problems go away, including my own. And as I get older, and watch myself revisit the same conflicts and complexes in  subtler forms I wonder if “change” in the sense that most people imagine it when they speak of psychotherapy, is possible at all, and if it is even desirable.

Healing is a word that means more to me than “behavioral change”  but only if “healing” primarily means  living with ever deepening compassion for our own, and other’s wounds and vulnerabilites.  I am not a “healer”  who knows how to make wounds disappear entirely, if at all. Scars, sensitivities, vulnerabilities, residues, susceptibilities, remain, even if the bleeding stops.

And often enough life gets better and worse and better and worse  on its own – with or without psychotherapy.

So what do I do?

Its not just other therapists that want to know  – clients also want to know “what kind of therapy” I practice – and they are especially entitled to an answer, and one that is not cloaked in mystification.

And here even the language of depth therapies fail me:  I do not “do” psychoanaylsis or analytical psychology, existential or Buddhist psychotherapy  – although these models and many others feel useful and meaningful to me at times in making sense of my own experience.

So I have an office. I sit in it. People come to see me, or sometimes we go walking together.

I care when the people who come to see me are angry, murderous,  numb, disappointed, in agonizing pain, terrified, lost, stuck, bored, nauseated, lonely – even when it is very hard, very painful, or when they feel these things because of something I have done, or something I have not done or cannot do.

Sometimes when things turn brutal for someone I care about  I’ll  just hang on for dear life. I don’t give up. I don’t turn away. I am not pushed over.

I stick around. I listen and I don’t retreat, and I am not easily scared or chased off.

I try to picture in my mind’s eye the people, places, things, and images that I am hearing about or sensing. Sometimes images, feelings and pictures seem to  float up in my own mind, drawn from my own life experience,  themes from stories I have read, myths I have heard – and I put these into words to see if they are connected to the pictures and feelings that are bubbling up in the person near to me. I remain curious and committed to understanding the words and pictures and sensations that are being communicated to me as precisely as possible. I surf through the waves of my own watery unconscious and the unconscious of my therapeutic partner. I keep my filter down and my aperture open wide.  I try to stay connected in the bumpy, rocky, scary, severe, extreme places where most social relationships will not venture. Where even  familial relationships can’t, won’t or don’t go.

I lend my self out. Not my “healthy ego”  – my Self, my heart, my dreams, the pictures in my head.

There are many of us who work in this way, and who could work in no other way.

I do this because it was done for me, and this meant the world to me.

Once, many many years ago, when I worked on a unit that served severely mentally ill adults, a psychiatrist pulled me aside to offer me some encouragement. “Do you know why your clients are doing so well?” she asked. “Do you know why they are getting better? Its not because you make sure they are compliant with their medication. Its not because you set clear behavioral objectives and treatment goals. Its because you love them like you belong to them. It’s because you take them into your heart like they are your own. You give of yourself, and they feel that and it makes them stronger.  I don’t know why everyone just doesn’t do that.”

At the time I didn’t know what to make of what she said. But I didn’t then and don’t know now how to work any other way.

A few years later, at that same job, I would come to understand the need people had to work from objective and objectifying stances rather than out of their subjectivity.

On the unit we all had small safety windows in our offices – so therapists and mentally ill clients could feel both safe together talking with the doors shut. As I sat at my desk to take my lunch break, and get some paperwork done, I felt several pairs of eyes peering at the back of my neck. I looked out the window to see four or five of my clients lined up to peek in on me, one after another, while I ate.

I opened the door:

“What’s up ? Can I help you guys? I’m on a break right now okay?”

“Come on” one of the older guys said to the crew “we better go so that we don’t use her all up!

I was getting used up, although it was never because of  them. The agency and mental health system I worked in wasn’t designed to support those who worked like me. It was designed to socially control the greatest number of people for the least amount of money. Commitment, abidingness, endurance, resolve, availability, intuition and meaning were far less important than outcomes and measures, and the elimination of unwanted behavior.

Although it is true, then and now, that I must always be vigilant not to give too much, not to give more than is required, or needed. I remain careful not to ever give in a way that will make others feel indebted to me or that leaves me drained or resentful. But that is my job, my responsibility to regulate. And if, and when, I give more than I can afford, or more than others need of me, it is my job to correct and compensate for, and never ever because others have used me up.

On my long morning run just after an introduction to a perfectly nice evidence based psychotherapist who had recited his alphabet soup of what he “did”, I heard these words rising up from my beating heart:

“Its the relationship that heals it is the relationship that heals the relationship that heals. This is my fervent belief and this is where I put my professional faith”

When I got home, I googled a bit trying to locate the rhythm and the cadence of these familiar words and realized that this mantra had resurfaced, slightly paraphrased, from a book I had read only once over twenty years ago:

It’s the relationship that heals, the relationship that heals, the relationship that heals – my professional rosary.  ~ Yalom, I. (1989), Love’s Executioner, London: Penguin Books, p.91

My acupuncturist once said to me: “I don’t know how you do it. How you work the way  you do.”

I don’t always manage as well as I would like.

When my own life becomes a challenge or crisis erupts for me, or when I foolishly attempt an “objective” survey of the scope of what I have undertaken I can overwhelm myself: Caring for my elders, for my children, for clients. When I attempt to itemize the breadth and depth and range  of all the different forms of care-taking I am immersed in, when I look at my days and weeks and attempt to catalogue all the pain, fear, vulnerability and dependency that is attached to me I sometimes fear that I can be used up and that I could drown in a flood of other people’s needs.

But, when I breathe, and move through my day moment by moment – I see that I am more buoyant than I realize  and that I am tethered not only to my teachers, mentors, guides, and therapists, who stayed afloat with and for me, but that I stay afloat with, for, alongside and because of  the deep and real relationships I have forged with those who pass time my office.

Image, words, metaphor and relationship cannot use me up. They fill my heart and keep me afloat.

It’s the relationship that heals the relationship that heals the relationship that heals.

Both members of the therapeutic couple.

All of us. Always.

Looking Back

Death will not part us again, nearer to heaven than ten thousand ancestors who dream of me… ~ Rickie Lee Jones

The ancestors possess this in-between quality of the flown soul and the hovering presence ~ The Book of Symbols

Until a short time ago if you googled my name, without initials, credentials or qualifiers you would find only text and images of my most infamous and tragic relative. My name would summon a black and white photograph of a lovely blonde woman, posed formally, in a light-colored taffeta gown, with stiff bows and many strands of pearls. To me, she resembled my father, and how beautiful he might have been in drag. I never knew her, and although she lived in a perpetual vegetative state since my early adolescence – since before the internet existed – her life, her story, preempted my digital footprint until I reached the half century mark of my own life.

I often wondered what clients who googled me would make of it, when my name emerged on their screens attached to her story. Would they glean our association, guess that I was/am her namesake? Probably not. I never met her and my relation is distant enough, and further obscured by an adoption – that it is in no way obvious. It is an inconsequential, silly, tangential anecdote, a piece of Martha trivia shared sometimes at dinner parties when I’ve had a glass of wine or two.

Yet, when I realized that I had dethroned the preceding and deceased Martha Crawford in the digital archives, I found myself examining the psychological legacy I had inherited from our common ancestors and my peripheral relationship to her.

The ancestors are those who have “gone before” (from the Latin ‘antecedere’) all the life that has ever been, leaving behind the traces of kinship ~ The Book of Symbols

When clients first come to therapy, the first thing that a responsible psychotherapist does is to “take a history” enquiring about the biopyschosocial events, achievements, traumas, and milestones that compose a clients history from birth to the present:

“When did you first have these symptoms? Who are the people in your family of origin? How old were you when your brother was born? When your parents divorced? When your mother died? What was school like for you?”

Many clients resist, annoyed, wondering why I am asking about stuff from long ago that “obviously” has nothing to do with what is going on in the present.

Others are protective: “Look, I’m not interested in blaming my parents for my problems. My parents were great.”

Blame is not the point – I am scanning for patterns, for repeating themes, for unfinished business, for unexamined loyalties to the way things used to be, that have grown into present day obstacles, or, at least, are no longer useful.

Thorough clinicians often try to reach back before birth: “Do you know the story of how your parents met? What do you know about your mother’s childhood? What was your father’s relationship with his grandfather like?”

Family systemic therapies look back as many generations as possible, creating complex genograms, family trees graphed out, dotted with triangles, circles, and squares.

I remember in social work school family systems class, as we were all asked to chart out our own multi-generational family histories – the students’ gasps of surprise as patterns suddenly seemed to pop off of the page – recurring generation after generation.

I had my own realizations: My paternal great-grandfather had died when my grandfather was nine years old, my grandfather had divorced and abandoned my father when my father was nine years old, and my parents divorced, my own father seemingly incapable of fathering any longer when I turned nine years old.

Keeping mercy for thousands, forgiving iniquity and transgression and sin, and that will by no means clear the guilty; visiting the iniquity of the fathers upon the children, and upon the children’s children, unto the third and to the fourth generation. ~ Exodus 34:7 King James Version

Working at a day treatment program early in my career, I sat with the aunt of an African-American client who had severe limitations in his ability to communicate about his own history. Together we sketched out a genogram on a legal pad as I asked her about who had married whom, how many children they had. Suddenly she asked me a question, gesturing to my name plaque on my door.

“Your middle name, is that a family name?”

“Yes” I answered, “why?”

“I just wondered…” she drifted off, her brow furrowing. She tapped her pen on my page as she then wrote in the same uncommon family name, my middle name, into her family tree. Surprised, I couldn’t wrap my head around her question.

“What do you wonder?”
“Any of your ancestors live in the South?” she enquired.

My heart froze, as I realized what she was wondering. I suddenly noticed that the naming patterns in her family and in mine were shockingly similar: the client’s mother (aunt’s sister) was named Martha, and their maiden name was the same as my unusual middle name. There were uncles and brothers who had my brothers’ names, and my own aunt had the same first name as the woman sitting in front of me. As I looked over the page I saw grandparents and great grandparents with similar (or exact) and fairly uncommon first names. My mind scrambled, my heart pounded as I rapidly flipped through that branch of my family tree as I knew it:

“No. Midwestern Quakers, Iowa, Minnesota, South Dakota – many many generations… Its funny, I see not only my name, but lots of my old Quaker relatives names, here, and here, and here, in your family tree.”

“Oh, Quaker names…” she smiled warmly, obviously relieved and took my hand “I suppose that its just some sign that you are the right person to help our sweet boy.”

It was the beginning of one of the sweetest, warmest, most touching relationships I have ever known with a cherished client and his family.

Yet, this exchange about the historical, cultural realities of our lives – of who our people might have been to each other – of an abomination that my ancestors would have been legally empowered to inflict upon their greats and great-greats – served as a reminder of what had, in fact, been inflicted, of what had been survived, of the strengths and losses of previous generations and what had unfolded for this family in its wake. What could have been between us, and what was, and the attending irreconcilable divergences were as alive in our relationship as the synchronicity of our mirror-names.

Our historical context matters. It lives in our names, in our bones, in our privileges, in our genes, in our family stories, and in our strengths, scars, wounds and failures.

How would we have survived had we not been carried on the shoulders of the ancestors? How would we have found our way had we not been guided by the psychic deposits they have left us as signs….They haunt us if neglected. The bother and disturb us if we do not honor their living presence. ~ The Book of Symbols

I’ve had many clients who saw their parents behavior as mystifying, intolerable, oppressive, unjustifiable. And when we looked into their deeper historical/cultural/generational histories – of curtailed freedom, poverty, oppression, famine, war, genocide – “bad” parental behaviors suddenly became acts love from another time, another circumstance. A crying child – while a family hides from a murderous army – must have its emotional vulnerability suppressed in order for future generations to exist and survive. Parsimony appears withholding and unloving until a family history, a generation or two prior, of extreme poverty is understood and acknowledged. Cloying anxiety about a child’s diet can look merely pathological if a deep family history – of not knowing when they might next eat unconsciously conveyed forward into the present – has been overlooked.

Sometimes awareness of the personal aspects of our deeper histories fade away due to simple disinterest, disrespect for what came before, from passivity, or lack of curiosity and empathy.

And we all know what happens to those who forget history.

The unconscious compulsion to repeat can extend well beyond the scope of an individual life.

The dead may be malevolent or benevolent, feared or admired, given bribes to keep them from mischief or gifts to make them happy. ~ Funk and Wagnalls Standard Dictionary of Folklore, Mythology and Legend

And there are lost and stolen stories, the broken narratives of disrupted bloodlines: Adoption. Death. Family severance.
There are unspeakable, silent legacies: Trauma. Torture. Abuse.
There are intentionally suppressed histories: Secrets. Shame. Lies.

And certainly the stories and mysteries that surround both the Other Martha, and my grandfather, the events that bound them to each other, have been a hovering presence in my life: legacies which could not ever have been predicted, inheritances painful, joyous, and surprising. And that are also in some form, being passed on to my children for good and for ill.

According to traditional Korean beliefs, when people die, their spirits do not immediately depart; they stay with their descendants for four generations. During this period the deceased are still regarded as family members, and Koreans reaffirm the relationship between ancestors and descendants…
(http://www.visitkorea.or.kr/enu/AK/AK_EN_1_4_9.jsp)

But, I have seen too much to believe that anything is ever really lost, even when we do not have conscious access to our inheritance – our bodies speak, the ancestors whisper in our ears, live in our cells, in our genes and come to us in our dreaming.

They cannot ever be taken away from us completely, nor can we escape them.

They are with us always and everywhere,
whether we like it or not.

copyright © 2013
All rights reserved Martha Crawford

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 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.

copyright © 2013
All rights reserved Martha Crawford

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

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