things you want to know about your therapist but are afraid to ask

September 9, 2018

A Therapist’s Heroes

I met a personal hero in my early 30s. A dim recording of our 40-year-old 40-minutes still exists.

My life has been lucky, in part, because of unexpected encounters such as this, and for other reasons, too. I grew up in a time when the world of little boys overflowed with heroic TV and movie figures. Most displayed physical bravery, but there was right in what they stood for: as the Superman television series told it, “truth, justice, and the American Way.”

I’m not the only serious kid who took the message seriously. Our fathers fought in World War II and Korea. Duty and sacrifice were expected of us, as well. The boundaries of acceptable behavior were clearer then. Now exhibitionism and self-congratulations — characteristics once frowned upon — squirm and twist themselves into chest-beating greatness. Meaningful apology is absent in much of public life.

We choose our heroes uncritically as kids. Most parents bask for a while in the admiring gaze of their children. Adulthood brings a more nuanced view. Today’s media offer few people with the purity of The Rifleman, Paladin, and The Lone Ranger — the principled Westerners my generation of boys watched in the ’50s and ’60s.

That world, as it enlarged, compromised us all and we compromised ourselves. Some of this is inescapable and doesn’t involve the loss of your soul. Still, there are things I wish I hadn’t done, adult times when I wasn’t my best self. Regarding other actions and inactions, I’ve made a quiet peace; grateful for the knowledge, humility, and experience the shortfalls brought me. Not to excuse moments of cruelty, failing resolve, or license, but as I look around the globe I notice some company. So it is that I try to do better.

I wonder if we are poorer for the missing simplicity of the remarkable characters TV paraded past the mid-twentieth-century optic nerves of my generation, as we search today’s narrow daily world for models in matters of living.

*****

Who was the hero who greeted me on March 18, 1978? A gorgeous man and a great one. Not outsized, as POW John McCain was, because of refusing a chance to free himself from continuing torture. Preferential treatment and desertion of his comrades meant cowardice, and the airman suffered for his steadfast valor.

Carlo Maria Giulini, instead, was a symphony conductor/hero, who also knew what mattered. He exemplified virtue in action and his art. Unlike Giulini, few of us are both good and great, a combination irresistible to his admirers.

Integrity is a always a pricey thing. The Italian musician said no to rather different opportunities than the combat pilot: promotion of his career and financial gain because he convinced himself full readiness to honor men like Bach and Tchaikovsky was more important.

The Maestro believed love for the music was not sufficient, but required understanding of the intention of every note on the page. Only upon fulfillment of both demands did he permit his private search for beauty to become public in performance. Years would go by even if it meant — as it did — never leading compositions he loved. “I’d rather be three years too late, than three minutes too soon,” he said. Here was a gentle man made of steel.

*****

We lost an extraordinary person in John McCain on August 25, 2018, a statesman saluted by sham mourners whose expensive clothing disguises a lack of character, and others who recognize what they lost and attempt to improve themselves because of his example.

Late in life, McCain might have uttered the words Tennyson put in the mouth of the aged Ulysses to his surviving companions of the Trojan War, before they embarked on their final voyage:

We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

John McCain’s daughter Meghan gave a distinguished eulogy. Such sadness is common enough at funerals, but not by itself a reason to view it. Listen to her devotion and private knowledge of the Senator who was her dad, her eloquence in describing what made him special and necessary. Those qualities compel our attention and respect as a kind of civic duty.

Such men as the congressman lift us by the standard they set. Imperfect, but noble. They reach beyond themselves in service of a greater cause. The best among us do not rate self-interest as the dominating value in their lives.

Here is her speech. I hope you will watch and try to do better, as we all must if our world and that of our children and grandchildren is to be better:

——

The top photo is of Carlo Maria Giulini. The second image is from an Interview with John McCain done on April 24, 1973. Thomas J. O’Halloran was the photographer. It comes from the Library of Congress via Wikimedia Commons.

September 5, 2018

A Therapist’s Private Life: An Indelicate Moment Requiring Delicacy

Some things ought not be mentioned in mixed company. Perhaps, therefore, those of refined sensibilities should not proceed further. The tale, if I can call my saga that, might prompt shock, sympathy definitely, and wonder — about who I really am that I should place this in public view. You have been warned. By reading, you are indemnifying me against psychological damage you might suffer.

Sunday, September 2, 2018.

I was minding my own business. The last three words are chosen with care. Confused? OK. Let me get closer to the matter. I stood in the smallest room in my home — not, I must add, before the mirror or the sink below and in front of it. Those still with me should recognize your number is smaller than when I began the paragraph.

The question is one of proper handling of equipment. Human, fleshly equipment. How many thousands, maybe hundreds of thousands of times do men use this device for one of the two activities we are required to perform with said attachment. Put differently, I had lots of rehearsal. I knew how it worked, how the object should be held, where to direct its attention. Even without time spent at a firing range. I had some practice in using a garden hose dating from a Chicago childhood, but this experience came only after acquiring my washroom competencies, not before.

I finished. As you know, the process requires the replacement of said mortal apparatus back where it belongs, a familiar vanishing act. Most of the male persuasion wear zippered pants, though I realize string and buttons made their civilized appearance long before Herr Zipper created the metal or plastic method of opening and closing two pieces of fabric.

Allow me to correct the record. Whitcomb L. Judson, the type of name you don’t encounter much anymore, deserves the credit. His gadget’s first large-scale display was at the 1893 Chicago World’s Fair, some buildings from which still exist, including the Museum of Science and Industry. With such knowledge, I’m sure your visits there will never be the same.

Employing Judson’s invention, either closing or disclosing, does not demand brain power or concentration. You can’t do it in your sleep, but you can without sleep or preoccupied; and often when conversing, as sometimes happens when two men mind their own business while facing adjacent porcelain receptacles.

Ah, what arrogance! What foolishness! Too assured, confident, and mindless.

If you haven’t guessed what happened, here it is: the star of this essay (and I’m not talking about the whole of myself) — got snagged on the metal zipper for just an instant at, shall we say, its most sensitive point. An eye-opening moment. I should have remembered why the interlocking segments of the zipper are called teeth.

I am not much of a singer. Despite my limited musical skills, I immediately hit a high note only dogs can hear. In another second, I de-snagged the snag.

Carefully.

Some blood appeared at the accident site. To be specific, one drop. I felt better in a few more moments, soaping myself first.

Emergency rooms see far worse.

Now an apology. To my ex-patients, in particular. I suspect some of you never thought I owned this appliance or — occupied with weightier considerations — didn’t ponder its quiet presence in the room we shared. There were others, however, who — briefly at least — maintained focus on the additional function for which this machinery was designed and hoped to work their magic on it and on me. In either case, you might not have wanted to be reminded.

So sorry.

Now back to the six people who are continuing to read. Those who peruse counselor blogs are not all aware that therapists are regular folks. Our staged performances can fool you. Yes, but I am an iconoclast, a man willing to betray our slight-of-hand and step off the pedestal on which we perform, this for the sake of truth and a laugh.

Promise me something, dear reader. And by now, I do mean singular. Please do not tell my grandson any of this. He is just learning to master his small portion of the paraphernalia with which God equipped him.

I’m done, but worried a bit. Will you still respect me in the morning?

——

The perceptive among you will notice that the images above are almost identical, an Animated Zipper closing, the other opening (reversed). The creator of both of these is Demon Deluxe (Dominique Toussaint). They are sourced from Wikimedia Commons.

September 18, 2016

When Therapy is Long Does Your Therapist’s Patience Grow Short?

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Some phrases never grow old, never become routine. “I love you” is one.” So is “I don’t want you anymore.” It is not that we’ve never heard the words before, but that they are so powerful and fraught with significance (or so hard to say or mean so much) either to the one who utters them or the one to whom they are delivered. In therapy the dread-laden expression is different: “I can’t do more. I need to refer you. Treatment has been long. The lack of progress means we must stop.”

Yes, perhaps it is said differently or becomes evident not through language, but impatience or facial expression or indifference. Where once enthusiasm and intensity bloomed, now the counselor seems to be enduring you, too conscious of the time, growing weary of your moments together. Two of my readers, Claire and Rosie, asked me to write about what permits a therapist not to take this dreaded path, the one leading to his desire to dump you — hoping you “never again darken my door” even if he doesn’t say the precise words I just used. Thanks to them I will try. I speak for myself, but know many therapists who would agree with much of what they will find below.

  • I like people. I like stories. I like individuals, not groups. I try to provoke meaningful conversations even with friends, not small talk. The time I spent with my patients was the perfect environment for me to look into a person’s history, history being a favorite subject from my early school years on.
  • I learned to notice small signs of progress. Sometimes we advance in microscopic steps. We reach a plateau on the mountain climb of treatment and then must catch our breath or wait for the storm to pass. The old Chinese saying tells us, “A journey of a thousand miles begins with a single step.” Therapists measure their work in moving toward a goal, not reaching it in quick time.

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  • The work is gratifying. Where else do people come to you, rather than requiring your travel? Watching others grow — helping them grow — generates good feeling on both sides. You receive thanks.
  • The work is an honor. New counselors find the responsibility almost overwhelming: another person places his well-being in your hands. A wiser, more experienced, older doc should know (or remind himself) of the implicit tribute his patients give him by their consultation and expectation of his help.
  • I received payment for my effort. It was easier to be patient with patients in the knowledge some of my compensation came in a material way. That said, in a handful of cases, long-term clients were thousands of dollars in debt to me before the sessions ended and they achieved the life they wanted. Yes, they did then pay me, usually over time. Healers must not be so self-sacrificing that they become resentful of those they treat.
  • The patient’s life was not mine or that of my spouse or children. While clients sometimes wish to be closer to their doctor, the therapeutic distance created by him makes it possible to put treatment still-points in perspective. I am less calm and understanding with my wife and adult children than with those who sought my professional skills. I cared about the people I treated, but (usually) not to the point of a disruption of my equanimity. Thus, I tended to be patient with a lack of movement, thinking of such episodes as a rather commonplace experience not usually requiring a desperate and immediate remedy.
  • I was responsible for making therapy fresh. A therapist’s job is to bring his intense focus to every session. He must also reflect periodically on whether he has missed something important. I reevaluated my patient and my approach, made course corrections as needed. A therapist who is often bored or unable to change perspective and look anew at the client is in the wrong profession. I kept it interesting both for myself and for those who put their trust in me. A patient is not your entertainer. The counselor should be emotionally and intellectually engaged on his own
  • Of course, if you aren’t putting in the effort, you might wear the therapist down. If you are simply paying for a friend, buying his time because you have affection for him (or using him to replace a missing social life) then he should recognize this and talk to you about it. So long as you rededicate yourself to “the work” of therapy, no ouster need be expected.

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  • Progress isn’t linear. I once asked my money manager, a professional analyst of financial markets, what he expected in the near term from the stock market. He answered, “It will fluctuate.” What he said was funny, but his comment acknowledged that no one predicts economic busts or booms, much as many people claim to. Therapy doesn’t move in a straight line of ascent from start to finish, anymore more than the stock market goes straight up or down in perpetuity. There are bursts of change, but more often, periods of little movement. I didn’t expect patients to be elite prodigies of self-analysis and courage, sprinting to psychotherapy’s finish line, so I wasn’t desolated if treatment took its time.
  • The therapist discovers value in challenges. If therapy were always smooth sailing, counselors would become bored with it.  They would learn nothing new because no greater progress could be made by doing so. Since I lacked a magic wand, I had to continue to consult colleagues, read books, and attend classes. Those who posed therapeutic dilemmas generated some of my growth as a counselor and a person. Why would I wish to cast aside people who were, in effect, helping me to do better?
  • Elite athletes are useful models for clinicians. Baseball players grind out a 162-game schedule from April through September, longer if they reach the playoffs. Successful athletes learn to put today’s failure behind them, lest they worry themselves into being unable to perform well tomorrow. I was better than many in my capacity to go home and think about other things, relate to my loved ones, and set the therapist hat on a closet hook. To do otherwise would have burned me out. I was not available 24/7, nor did I guarantee rapid responses to email or phone messages. I made sure I didn’t get used up. A doctor who takes good care of himself is less likely to get tired of you.
  • Buddhists provide yet another excellent example for therapists. You know the frustration of a long static line: a line where there is but one indolent checker or ticketing agent taking care of all those in the queue. You have places to go, people to see. Yet your reaction to just this type of setting — one seemingly out of your control — might determine whether you lead a satisfying life: 1) You can be frustrated and make yourself miserable. 2) You might jump to the line’s front and complain, which will not usually make the line shorter or the ticket agent more efficient. 3) You can reframe the experience. A Buddhist would say, in fact, you should be grateful for the line and the plodding employee because they are giving you the opportunity to learn patience. A lengthy term of treatment where every inch of progress is dearly won offers the same opportunity.
  • My job was a gift. I performed work that was not always “work.” A summer job during my school years in the 100-degree heat of a metal-stamping factory taught me how soul-killing “work” can be. I later came to make a good living in clean, climate-controlled surroundings as a psychologist. My patients helped me become more patient, more thoughtful, more loving — more grateful. I was my own boss and I took meaning from the relationships and the privilege, the stories and the intimacy. I used my brain, one of my favorite body parts! Living this professional life and remaining (mostly) grateful defused many frustrations.

The task of a therapist is not to say, “You’re fired,” but to find a way through or around, under or over; whether running, crawling, pushing, pulling, cajoling, asking questions, waiting, reconfiguring, staying silent, or getting his own help. Much as some of our patients worry about being put into a dumpster, we are working to get them out of one.

Rest easy.

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The top photo is called Doraemon by istolethetv from Hong Kong, China. The second is named I’ll Miss You Dad by Cecilio M. Ricardo, Jr., USAP. The final image is a highway Sign at the Truth or Consequences, New Mexico Exit taken as part of an August 24, 2009 road trip by CGP Grey.