*** Warning: the following is more blog than blurb:
I believe that empathic failure is the root of much of what ails us. Feeling disconnected, misunderstood, contradicted, alone, stigmatized - whether having started recently or if the seeds had been planted long ago, is often resultant from a failure of others or ourselves to make genuine empathic connection with our support systems. In this way, in coming to therapy, it is my single most important job to ensure that that connection is sought and sustained; that here, in this space at least, you can be seen for who you are, what you’re feeling and what you think, while being accepted, understood, and cared about. There may be many angles from which to examine or work on our lives, but working towards that empathic connection and understanding is the base from which the work begins.
I strongly believe that empathy and empathic connection is what makes for good therapy. Empathy is not a feeling, as is sympathy. Empathy is vicarious introspection, an exploratory activity to feel and understand the others experience. All of our issues come in the context of our history; what we’ve learned, how we have learned, our feeling in the moment as well as more generaly, and in the context of our goals and what we would like to achieve. Intimately tied to this, of course, is our sense of self, ego strength and identity. So where as there are short term tools (CBT, DBT, Solution Focused Therapy) that we can use to address what to do in the instance you feel or are pulled in a certain way, ultimately its the “why." The “why” that we do what we do that is ultimately what needs to be addressed.
People have reported coming back because they feel cared about and heard. And, I can say with all sincerity that it’s true. This is the best job I could possibly imagine having. This is based on my ability to be helpful, but more so, the witness that I can give to my clients lives. It is an incredible honor to be trusted to hear what is most personal to my clients - and not just trusted to keep a secret, but to connect with what you are saying, to seek understanding, to share in your experience. I believe in the concept of client-hood over patient-hood. Semantics are very important. 'Patient' can be stigmatizing as well as creationary with respect to the belief that one is ill outside of diagnostic criteria. Patients go to doctors, as opposed to clients going to a professional for a service. Albeit, a service to help them feel better. A quick note about psychiatric drugs: sometimes. Having worked as a social worker in clinical environments for nearly the past 20 years, and having spent four years post-masters as an inpatient social worker in a locked unit, I know that there are conditions where medication is indicated if not necessary. Truly. However, I urge you to seek proper diagnosis first. I can help you with referrals and strongly encourage psychotherapy in conjunction with medication.
I find that very often people are unsure what psychotherapy is, wondering, perhaps, what tricks are up the therapist sleeve, perhaps fearing or leery of being manipulated in one form or another. And it makes sense to me that people would be resistant to that. This is after all, technically, treatment of mental health issues, through talk therapy. In as much, people often think that “Something must be wrong with me to go,” or “I must be broken in some way to need therapy,” or, “I can take care of myself.” I trust that with time you will find that in this space you are unconditionally cared for and supported; talking through issues in a way that you could not with a friend, family member, or even significant other. A place to unburden. Unload. That you didn’t have to have been ‘sick’ to come to therapy, or that coming to therapy didn’t imply that you were. Many report the experience of being told to go into therapy; hearing feedback from friends, family or coworkers… or strangers for that matter, sometimes for years and years, that they have to go for help… For therapy. Often the resultant thinking is: “I don’t need to go into therapy. I don’t need to talk about anything… Why do I need to go into therapy?…” Or: "I wont help. No one can help me." So, we'll explore the reason you’ve come. Why is it that you came? Even if, on a conscious level, it was “fuck’m. Sure. I’ll go once, if that will make them happy.” Or: "It wont work, but I have to try something." Whatever it took to get you out the door and to this office, you came. And that speak volumes to who you are, your value in yourself, and how hard you are willing to try for betterment. This may be subconscious, but it is there.
What can a client expect in coming to see me? I know that for many, even those having tried before, entering therapy can be extremely hard if not terrifying. Sharing what is closest and most barring of ourselves is something all of us are protective of. Important in the first session(s) is the ability of the therapist to build connection, signaling that it a good fit for you to do work here. Where to start? The base social work premise - start where the client is at. What that means to me is multi layered, but at it’s base is what is important to you in the moment. Of course, I need to know in order to be effective about where you come from and what has shaped who you’ve become. In the first handful of sessions time is often spent talking about where you have been and about the ingredients that make up who you are. But again, what is often important is our present circumstance, the reason you came in to talk - if what you brings you in is crisis, we may need to triage this first. What we learn to do together, in as hopefully as short a time as possible is connect your past experience with your present. What does this remind you of, where are these experiences parallel with earlier ones, how have you coped with it?
So with all due respect to how personal and injurious our pains are, a lot of the work we do is to help normalize your experience. To say “of course you have a level of anxiety.” To say “of course you have a degree of depression.” To say that “of course things, that life itself, is hard.” Things, life, is hard. As such, you have a right to feel these ways. These things are part of the equation for the human life. Part of what we have to go through. What I hear you saying is, however, that the volume is a little, or very, turned up. That there is a little, or way to much anxiety. A little or way too much depression or sadness or confusion. That these are interfering in your life. This is where we start. The goal is not… bliss. This isn’t reasonable, nor attainable in a sober way. That what opiates are for, and sadly why so widely abused. And so, it’s hard. It’s hard sometimes to hear that what you’re going through is normal. Normal, is often, tragic. Normal is often very acute. Normal is very hard to deal with. Normal is not… issueless. Normal is not to be forever content. A lot of people come in under the impression that they are coming with issues, feelings or situations that are outside of the norm, out side of the curve. This is often is true. But it’s relatable. My own tragedies in no way prepare me for some of the things my clients have come in to talk about. I’m aware of this. And I have to be sensitive to this. But, it is a human thing to be in pain. It’s a human thing to be traumatized. It’s a human thing to be scared, perhaps terrified. To not want to deal anymore. To not know or not want to know whats coming next. To be anxious. To be sad, or depressed, sometimes quite darkly. We get lost sometimes. These are traits that we all should be able to click into - and this is where empathic connection vs empathic failure comes in. Granted, there is a lot that goes on in the office. I can help you guide yourself through conversations. I can give you tools to work with specific emotions. However, talking it through is important if not irreplaceable. I submit to you that it is the idea that you are truly heard in everything that you have to say that is most curative. So, is anything ‘wrong’ with you? Maybe. Maybe but not in so far as something is wrong with all of us. Is something a little too turned up? Is something getting in the way? Are you prevented from living a productive, meaningful or… ‘happy’ life? Perhaps. So, lets work on turning down the volume on these things. Lets work on putting the events in your life into a context that is better understood. Putting the things in your life into a context that makes sense so we can see how we have arrived here, and why these things have pained us. Given this, you deserve to identify that you are in pain. As such, you deserve your pain. It is ok to have been hurt, and for pain to have been the result. These feelings don’t just go way. To what standard are you holding yourself to? That you should be without pain, or anxiety, depression, hurt, loneliness? To what standard are you holding yourself that you should be better than this, that you should be ‘ok’? Your experience is valid. Come. Lets work on turning down the volume.