“Are you okay?”

And then after:
“You look drained…”

And again, later in the day:
“Everything alright?”

The successive greetings from clients through out the day remind me that I am more transparent than I would like to be.

Some personal crisis has erupted in my own life: a death of a family member (there have been many over the past 15 years) an illness, a hospitalization, or an up-all-night concerning disruption in the lives of my children, a painful conflict, a fraught battle, or terrible news in my community. Something has pressed deeply on an old wound or a fresh injury has hurt me enough to be visible – but has settled sufficiently for the moment that I can, should, need to set it aside to get into the office, and show up for the tribe of people that gather around my promises to them.

I may still be exhausted, and shaken, but I need to be present for the people I have committed to nourish and nurture, who trust and need me, who bring me their own vulnerabilities and wounds to sort through and soothe each week.

There are times when we don’t carry our caseload, our caseload carries us.

During my first parental leave following the adoption of my oldest child, a therapy group I lead for years continued to meet in my office, with another therapist. They watered my plants, held down the fort, and kept me oriented and tethered to my professional identity as I faced down the tsunami of joy, terror, and role-reorganization that attends the happy crisis of new parenthood.

In the wake of a painful crisis: urgent follow up phone calls, or worry driven emails, or even some quiet contemplation in between sessions can trigger more tears, wiped away before opening the door. Or perhaps I’ve napped on the couch to escape, granting myself a forgetful reprieve from whatever the painful event – alarm set to wake me a full 15 minutes before the next arrival.

The buzzer rings. Smooth my hair. Breath pulled in deeply through my nose, blown out sort and fast: shake it off, put on my brave face and open the door.

But perhaps the puffy eyes and red nose linger. Or maybe it’s the dark circles underneath my eyes. Or maybe just an air of vulnerability. Or the lowered energy revealed in my voice or my carriage.

Some don’t notice. A gift, a gimme, a free pass. Everything is as it was, and as I would like it to be. I get to rest in the sweet pretend that am fine, and expected to be as normal as I ever am. I, and my real life, blessedly don’t exist while I am lost in the other’s story.

Some see – I can tell they see – but won’t say anything. Others ask as a polite convention. I assume that they are necessarily protecting themselves and I join in the illusion. I grab a tissue and mutter something like “lotta stuff’s going around out there” before sitting and putting my feet up and getting down to work. They nod, relieved not to hear anything more.

The connection we make, as far from my own suffering as possible, is so relieving, reorganizing, strengthening. Perhaps it is far more than merely escaping myself for the moment. It may be that the very nature of human connection, of intimacy however lopsided – is nourishing and comforting.

The experience of understanding another, and of being understood – of speaking a common language that we have created together, coming together for a common purpose, makes me feel well again.

I am expected to be well. To be intact. To bear up. To be able to think clearly and feel deeply. And the expectation summons my strengths, and makes them available for both of us. What a gift, to have people you care for summon your strength when you are most in need.

Conducting therapy through my own crisis states reminds me that the arc of grief, of loss, of crisis and disorientation has a shape, a course, that I am familiar with, and need not be afraid of.

I watch my fellow travelers sailing through their own rough seas, and their courage activates my own.

I certainly fatigue more easily riding on top of my own tempest. Waves of intrusive pain break through in the quiet moments and I am unhappily reminded of myself and my external circumstance. But it feels better to be present in the room, and so I come back quickly, and thankfully.

Some clients have known me for a long, long time. We have seen each other through births, deaths, and acts of war, fortunes great and terrible, joys and tragedies. They know right away, and offer kind words of encouragement, condolence, concern or support. The briefly turned table, the split-second opportunity to care for me, is sweet and meaningful for us both. As touching and healing as a child kissing a parent’s boo-boo.

Some see I’m off or under right away and need to know. They need to know that it isn’t something worse, something that will cause me to abandon them, or lose track of them, or contaminate the supplies I am providing. Some people were profoundly injured when their caretakers moved into states of disinhibiting depletion – unable to protect others from primal sadism and abuse. Some had family who collapsed out from under them, or dropped dead with out warning. My state is read as a signal of worse to come. Denying it will be crazy-making. We will spend sometime exploring the fear I have triggered. But it also requires some reassurance and some confirmation of reality:

“Yes” I say, “I’m dealing with something. But I’m okay. Really.”

For those that press further: “You’re perceptions are totally accurate. But don’t worry, I promise I would have rescheduled if I wasn’t okay. Listen, if I seem to you like I am under, my energy seems low – it is. If I’m not where you need me to be, please tell me. But, frankly, it will help me feel better to hear about you.”

And it will.

I know what is required of me.

I am vulnerable. But I am here.
And I am grateful.

copyright © 2012
All rights reserved Martha Crawford

15 responses

  1. Thanks.
    This one was actually very easily written. It just came out in one piece – I suppose because its something I wish I could tell all my clients, and I rarely have a chance to express my gratitude to them.


  2. As one of those clients who fears death and disaster falling onto my therapist, sure that it will sweep her away from me… I appreciate your touching explanation. It’s comforting.

    Although I watch my therapist’s moods with anxiety, I also care about her deeply, and it hurts to see her struggle knowing that my role is not one that can provide comfort, or reciprocate some of the same love and compassion that she has already offered me.

    I do try, though. I think… that I try to find a balance between letting her know that I have noticed, of seeking reassurance that she will not disappear, and of letting her know that I hope she is ok, and also of stepping back to allow her the privacy to live her own life without worrying about how it will affect me.

    Not really that good at any of those things! But it is comforting to glimpse the experience from the other point of view, and hope that my presence in her office is still wanted.


  3. This came at the perfect time. During my session yesterday, I learned my T is having surgery. Circumstances suggest this isn’t some form of long-ago scheduled surgery. My T will be out two weeks -meaning I won’t really see him for three weeks.

    Since my T has had cancer twice it scares me not knowing what this surgery is all about, but I didn’t want to pry. He said it would be okay. So, I’m really trying to trust that everything will be okay.

    I’ve been with my T two years and care about him a lot -not just as my T but as a person who has his own life, family, friends, etc. I know life is life and some things just can’t be controlled. But, I try to remember that saying about most of what we worry about never happens. I’m trying not too worry… too much. I’ll be praying for him and trying extra hard to be okay while he is recovering (makes me feel like I’m somehow helping).

    Take care,

  4. This post is extremely timely for me as well. At my last session, I immediately felt how off my therapist’s energy was and it definitely unnerved me. She didn’t look or act any differently, but that difference in the energy between us was immediately noticable (for the first time in almost 5 years of seeing her). I am more sensitive than most when it comes to feeling other people’s feelings (I consider myself empathic), and it took all of my willpower not to say anything but I did recently have the chance to ask her if she was okay and she was honest with me, which I greatly appreciated. As “M” very eloquently stated above me, I know that my role is not to be a comfort provider for her (which is SO DIFFICULT for me – it is so strange to have a relationship that is one-sided that way), and I was also concerned about allowing her her privacy as well.

    My experience and your post both illustrate a unique kind of bravery required as a therapist. It’s one thing to be dealing with personal issues when you have a desk job and it’s quite another to deal with them when you’re already dealing with emotions (in such an intimate space). This was so important for me to read right now – thanks for such an honest piece. It really touched me.

  5. Thanks for all the kind comments.

    I think that the process of psychotherapy, and intimacy in general is about tolerating the paradox of being both vulnerable and intact simultaneously.
    Crises in the therapist’s life are vital opportunities for us to model that for our clients, and continue to build our own ability to tolerate that paradox.

    Its nice to hear that the writing is serving to deepen other’s
    therapeutic relationships.

    thank you all for reading and sharing your thoughts.


  6. I am so happy to have found this blog. As a beginning clinician, it has been helpful, reassuring, and educational. Thank you for writing.

  7. First-time visitor to your blog. Thanks for this post, it has reminded me it’s ok to be human and up & down, ‘even’ in our work…..

    Best wishes


  8. Thanks for reading –
    I think its important to be able to normalize and be authentic, honest role models to our clients through our own energetic dips and crises.
    I know in my own therapy – the momements when my own therapist was in a state of authentic vulnerability following a significant loss or due to medical issues – that I was amazed by his ability to remain in connection and not have to hide or deny his depletion. Its a model I am grateful for & hope to pass forward.


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