Most of what I hear, I don’t get to speak of.

I listen all day.

Most of what I hear, I don’t get to speak of.

I sit nearby people as they mourn, fret, rage, weep, laugh, battle, celebrate, and sometimes, rest.

Here is what I plan to do here: Tell you what I have learned. Write about the gifts and burdens my clients and my work have given me. Let you know what it is like, for me, and only for me – I speak for no other clinician – to do what I do. What it costs me, and what I receive from it.

If you are a client of mine, I won’t talk about you – but, here, I will talk about what it means to me, for good and ill, to be a therapist. I plan to talk about what I have absorbed, things I have been taught, “universal” patterns that I have seen repeated endlessly, like the painted foot steps on a ballroom dance studio floor.

Admittedly, my professional universe is a small and specific one – New York City, from 1995 until the present. It is further confined in space to three offices, where, over the past seventeen years, I have had the opportunity to partner in therapy with an incredible range of people: chronic schizophrenics, addicts, sex workers, dying children, teens in foster care, billionaires, oligarchs, high school/college students, movie stars, the almost famous, the impoverished, the incarcerated. I’ve treated war veterans, policemen, firemen, rabbis, priests, doctors, songwriters, criminals, lawyers, Ph.D. candidates, manual laborers, teachers, restauranteurs, business-folk, bartenders, artists, theater people, union workers, strippers, physicists, fashion designers, teachers, housewives, and loads of other therapists.

I see straight, gay, bisexual, gender queer, transsexual and none-of-the-above people. I’ve had the honor of meeting with people from many different races, religions, social, economic, and cultural backgrounds, and have been grateful to continuously learn about the painful ways that race and privilege create reality in our communities. I’ve worked with people who have come to NYC from every continent. I’ve listened to people in every kind of imaginable family constellation: people in divorced, remarried, arranged and polygamous, openly non-monogamous, as well as adulterous relationships. Single parent, two parent, step parent, multiple parent and foster families; people raised by extended families, adoptive families and reunited birth families; two mommy and/or two daddy households, people raised collectively – in cults, communes, orphanages, group homes, and residential treatment facilities.

I’ve had clients die on me, survive death by the skin of their teeth, try to kill themselves, and threaten to kill me.

I’ve sat with the bereaved, the chronically sick and those in chronic pain, insomniacs, binge eaters, people who have compulsive plastic surgery, multiple personalities, cutters, anorexics, alcoholics, the divorced and divorcing, the profoundly lonely, the dying to get married, the frenzied on-line daters, the work-obsessed, and the work-inhibited. I’ve watched people struggle through depression, PTSD, PMS, obsessive-compulsive disorders, anxiety, obesity, ADHD, bipolar disorders, learning disabilities, relationship crippling sexual fetishes and sexual dysfunction, panic attacks, compulsive lying, destructive gambling. I’ve watched people negotiate every kind of crisis imaginable, 9/11 survivors, responders, and widows. I’ve heard the deepest thoughts of people with psychosis, and those with psychic abilities. I’ve sat with the abused, the abusers, and the masochistic. I’ve waded through the dreams of people lost, stressed-out, trapped, enraged, numb, explosive, delusional and dull. I’ve borne witness as my therapeutic partners face down family conflicts, cut off their abusers, fret about their children, recover from sexual abuse, quit or lose their jobs, fall entirely to pieces and transform their lives.

It doesn’t leave me with a lot of small talk outside of session.

At cocktail parties – which I avoid – when people find out that I am a psychotherapist, they often ask me what my specialization is. I usually say: “Nothing” because to answer “Everything” sounds too grandiose.

I am a generalist. I don’t specialize. I partner with people. I bear witness. Then I draw from my own life experiences, my own treatment, my intuition, my training my studies, and I synthesize that with all of the data, narratives, dreams and metaphors of the hundreds of people I’ve treated over the past decade and a half.

I point out patterns I have seen before when I see them again. I learn from my own failures and the struggles of the incredible people who have chosen, however tentatively, to place their trust in me. After listening as closely as I can, I gather whatever images, impressions, ideas, patterns, lessons and themes that have presented themselves in my brain, and offer them up when they seem pertinent. If my reflections are not on point, or I am mistaken or mis-attuned, I ask that my formulation be returned to me, corrected, adjusted, tweaked, so that I can fine-tune my understanding further. I want to see my therapeutic partners, and hear their stories, as precisely as possible.

I have had many teachers, many mentors, many guides. I’ve worked with my own analyst since I was 22. He was 25 when he began seeing private clients. (I thought he seemed much older than me at the time.) We have grown up together through our entire clinical lives and I cannot confidently separate my own truths from the ones that I have received from working with him. My belief in empathy and my willingness to extend warmth, affection, admiration, and to love my clients, is inherited from my work with him.

I’ve been supervised over the years by generous professors and teachers; one woman, whom I first met as she led my group therapy class at NYU, taught me how to use my aggression in service of truth and health in the consultation room, and I saw her privately and in group supervisions for many years. Today when I refer clients to her, I often say that her spine seems to grow down into the earth’s volcanic core. Without her powerful model, I can’t imagine how bound I would be, tied in knots – unable to confront the inevitable and destructive forces that emerge in the therapeutic process.

I’m also a theory-wonk. I’m geeky enough to spend most of my recreational reading time digesting the great theorists of my tradition: Winnicott, Klein, Fairbairn, Kohut, Miller, Eigen, Bion, Lacan,and many others. In recent years, I have stopped reading psychoanalytic writings all together, and focused most of my extra-curricular reading on analytic psychology, Jung, myth, sacred texts, scriptures from all faith traditions, fairy tale, folklore and poetry. Expanding my catalogue of metaphor seems so much more useful at this stage in my practice.

I’ll try to give my personal and published mentors credit when I can – but many of their thought discoveries have grown into my bedrock, and I hope they will all forgive me if I accidentally share a gift they have offered me without remembering who I received it from. This is not an academic work and there will be no footnoting.

I will be vigilant and protective of my clients’ confidentiality – and focus on my own thoughts and reactions. I will hold my musings back for several weeks or months – or reach back years before and after the sessions that inspired them. I will disguise and distort and transform my clients’ stories so that they are entirely unrecognizable, except for the effect that they have had on me. You may, if you are ever in session with me, read things here that I have said to you in my office. If I have written it here – not only is it something that I have said before, to many people, over many years, it is even a possibility that I have said it more than once or twice to you.

This work is inherently repetitive; it has to be. Our emotional and spiritual learning is not linear. It happens in dream time. It’s a circular process, and needs to be repeated over and over again, with some new piece of an old idea digested each time the thought moves through, yet again, yet again. I am happy to repeat things. It was all repeated and restated for me over and over and over, as it took years and years for healing thoughts to be driven into my own thick skull. I am happy, and obligated, to pass the gift forward, as often as is needed.

A question lingers: I know why I do the work I do, I know what I love about it, what exhausts me, what heals me, what re-injures me, what is meaningful for me. So why this journal, why this blog?

I suppose the simplest answer is this: I suspect that I have been happily, professionally in hiding. If I have developed any skills, the mastery was forged entirely in private places, in the presence of only one other person at a time. I cozy up in my cave, reading, writing in journals, learning from my clients, and from chosen trusted peers and mentors. No one, really, knows what I do, except the people who happen to find me. I am a secret-keeper at the fringes of town, at the end of a small, winding path, the mouth of which is hidden from view. People knock on my door regularly and I am almost always happy to be found by those who arrive.

But, perhaps, it’s time to quit skulking about, remove the camouflage, and come out with it. Maybe I’ve learned some stuff. Maybe it’s time to define myself a little more. Maybe I should be more generous and teach a little. Maybe it’s time to be of more use.

That being said, I reserve my right to retreat from the public broadcast at any moment, stumbling back to my little hut on the fringe of the tribe, and return to sitting, one at a time, listening to my best teachers: my clients.

copyright © 2011 Martha Crawford

9 responses

  1. thanks Irene and Julie!
    It is a little nerve wracking – trying to find a stance that lets me be really honest, and boundaried at the same time…
    we’ll see if I can keep it up!
    Your support means a lot!

  2. Last year, I found something that completely surprised me; Yelp reviews of therapists.
    Some therapists had over a dozen reviews. Many were multiple paragraphs long with intimate details of session work.
    It’s a little window into some caves, from the client’s perspective.

  3. This is beautifully written and I believe you have a lot to share. Much experience and a very profound understanding of it. I am currently in training to become a therapist and I already identify with the receiving so much from one’s own analyst, that it’s difficult to know where one’s own approach ends and when the analyst’s starts. I have been lucky enough to meet mentors who have helped and taught me quite a bit already and I feel lucky to have also found your blog. I will find it useful especially to see how you tell your stories as a therapist while maintaining confidentiality and I look forward to reading more from you, about what you have learned and earned and how you grow together with your clients.

  4. Thanks! Confidentiality is essential in this piece of work – which is why I create explicitly ficticious cases, speak only in the general and aggregate, and about my own experience in the work.
    The clients who have found my blog seem to feel, after intial anxiety about what it may reveal – that ulitmately it contains few surprises – that the way I am writing is overall very consistent with, and an extension of who they know/feel me to be in the office. Other, disorienting feelings, about realizing that I have a life, an identity outside the office have been very productive – and no more or less disruptive than the experiences that clients have when they discover that their therapists write books or publish in academic journals.
    Its been wonderful grist for the mill, so far ultimately driving the work forward in the cases where it has emerged….

    Thanks for writing, reading, and the kindness of your comments

    Martha

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