How to Land Your Kid in Therapy

Aside

Stumbled across a great article on how “over-parenting” has lead to a generation of therapy-goers.  If you have the time (it’s a 4-pager), it’s a well-written and thought provoking piece – I very much recommend it.

Here’s an excerpt:

Here I was, seeing the flesh-and-blood results of the kind of parenting that my peers and I were trying to practice with our own kids, precisely so that they wouldn’t end up on a therapist’s couch one day. We were running ourselves ragged in a herculean effort to do right by our kids—yet what seemed like grown-up versions of them were sitting in our offices, saying they felt empty, confused, and anxious. Back in graduate school, the clinical focus had always been on how the lack of parental attunement affects the child. It never occurred to any of us to ask, what if the parents are too attuned? What happens to those kids?

via How to Land Your Kid in Therapy – Magazine – The Atlantic.

Curiosity, and why we need more of it in our lives

Therapy, when you think about it, is a rather unique relationship. In a short period of time therapists often will transition from being complete strangers to having clients sharing some very personal stories and feelings. When I began my training as a therapist one of the first ideas that was focused on was the importance of nurturing and maintaining an open curiosity within our sessions. In being curious we acknowledged how much was unknown to us about our clients’ lives and invited our clients to help us understand their perspective.

Since then I’ve found that the idea of curiosity has often been on my mind. Curiosity wasn’t something that I thought about much prior to that point however. When thinking of the qualities that an aspiring therapist needed to cultivate, it was qualities such as patience, understanding, or compassion that were talked about but curiosity…not so much. Especially when looking outside of the therapeutic context, curiosity isn’t often listed as at the top of people’s virtue lists.

In our society we praise people for being kind, or brave, or wise but not often for being curious. Curious George may be a loveable character for many people, myself included, but you don’t often hear people aspiring to be like him. Curiosity is sometimes highlighted as being one of the characteristics of the young but as much as we idealize youth, we are less likely to praise youthful traits later in life. Continue reading

What is a Therapist?

Aside

Over the years as I have continued my studies in psychotherapy, I have often been amazed at how varied and diverse the profession is. I started off with a general idea of what it meant to be a therapist and since then have found not only that my idea has grown in scope and complexity but that there are many different paths that people have taken towards the same goal. There are many different roads towards becoming a therapist and each bring their own perspectives and ideas on the profession. Often one is no more effective than the other even though they may differ greatly.

Since I have begun working as a therapist, this awareness has been reinforced by the diversity of perspectives and expectations that clients have of therapists and the therapeutic process. Depending on their background, their past experience with the mental health and their goals for coming to therapy, their concept of who I am, or what my role is as a therapist can look pretty different.

Rather than just talking about the different perspectives that people have of therapists, I thought it would be interesting to use this blog as an opportunity to hear from different people’s perspectives and highlight some of the similarities and differences that exist.

In the comments section below, write the first thing that comes to mind when you think of the question “What is a Therapist?”.

It could be a word, or an image, or a feeling or a more elaborate description depending on what feels right to you. In this there’s no right or wrong answers, only different perspectives.

Because I Have a Voice

“Why Should I listen to you?” “Because I have a voice!”

Though it is a movie filled with many great lines, this exchange between Bertie and Lionel in the King’s Speech was the one that stuck with me the most. If you haven’t seen the film (and I’d highly recommend that you see it if you haven’t) it’s about king George the VI before and at the beginning of his reign as he worked to overcome a stammer. King George, or Bertie as he was often called in the film, was the sovereign of the United Kingdom and the dozens of other countries that made up the British Commonwealth and yet the most powerful reason why he should be listened to was not because of his crown or title but because he had a voice and it deserved to be heard.

I’ve been thinking about the power of people’s voices for a while now and watching this movie brought it back into the forefront for me. We all have our own voice and with it can bring our thoughts, feelings and inner selves out into the world. A person’s voice can be an incredibly powerful mechanism for change within our world. Speeches made by leaders and teachers can inspire people or rally them to a cause. They can spread fear and hatred too.

The power of people’s voices is not limited to leaders and public figures, each of us have a voice that is significant and that can impact our world in our own way.  Sometimes it’s sharing a new idea or new perspective. Sometimes, it’s taking a stand for something that we believe in, or with a friend in need of support. Sometimes, the power of using our voice is in sharing with those around us how we feel and what we value so that they can know us better and we in turn can come to better know ourselves. Continue reading

The Secret Life of a Family Therapist

Therapists are the keepers of secrets.

Within the process of therapy, clients often share knowledge that is very private and personal. They share their fears and anxieties, topics that are sometimes very hard to share openly with other people in our lives. The therapy room can be a safe place where people can take off the masks that they wear or to share thoughts and memories long kept hidden. A place where secrets can be shared and processed while still being kept safe.

Even before I began seeing clients, the significance of the secrets that people share in therapy was something that I was made keenly aware of throughout my education and training. Confidentiality is often a central theme in any therapy course, reinforcing the importance of protecting the private information shared with us by our clients. In addition there’s the importance of acknowledging the trust that clients are placing in us in sharing their stories as well as their courage in telling it. Even with all the checks and balances, sharing a story that has long been kept hidden can still be a significant challenge and as a therapist it’s always important to be reminded of this.

As therapists, not only are we responsible for honoring the secrets shared with us by our clients but in addition, we have the responsibility of guarding the secret of participating in therapy itself. The decision to attend therapy is often seen as very significant and often it’s a very private decision. In addition, there can be social stigma associated with attending therapy and sometimes the well meaning concern and curiosity of others in our lives can make it harder for clients to protect the content of their therapy work when their attendance is publicly known. This, I’ve discovered, is even more important in couple and family therapy work when different components of a family system can be involved in therapy at different times. Creating a safe and open space for dialogue is a central component of any therapy work and ensuring that clients are confident in the privacy of their work with you is of key importance to any therapist. Continue reading

Experiencing Hope and Resilience as a New Therapist

When I’ve talked to people about my decision to enter into the family therapy profession, I often get a comment that goes something like this:

“It’s got to be depressing sometimes listening to people’s problems all day.”

As I began my Master’s program last year, and anticipated the therapy work that I would begin as part of my practicum, this was one of the many sources of anxiety that I felt myself. Would I be able to protect myself and remain positive when working with people faced with all kinds of difficult challenges. People rarely come to see a therapist when they’re feeling happy and everything’s OK. Some days reading the news can be depressing enough, would I be able to handle spending hours each day talking with clients too?

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I’ll see you around

this sad goodbye bear is going goodbye

“You must have the worst job in the world,” a client once told my supervisor.

I would be quite inclined to disagree, obviously.  However, the context in which these words were spoken lend them a strong element of truth.

There are probably lots, but I’m hard pressed at the moment to think of many jobs outside of the helping professions where you habitually build significant relationships with people, who are more often than not in a state of distress, see them change, grow, improve (or worsen),  hear some of their closest secrets, their worst fears, and at the end of the day, without fail, have to say goodbye.

And I’m quickly discovering that this is one element of being a helper that, for lack of a more descriptive word, sucks.  It’s balls.

It’s one of those things that you read in the intro to counselling textbooks and think that you’ve got a handle on, that you’ll know all the right things to say, that you’ll know how to take care of yourself when a client walks out of your office for the last time visibly trying to hold back tears after you’ve stumbled through saying goodbye.

I feel like there have been a lot of those lessons, the ones where all of a sudden what you read or learned about makes sense in a totally different way once you live it.  And you’re left thinking “ahhhhh… that’s what they were talking about!”  Except it’s just not possible to really know what they were talking about before you experience it.  You think you do.  But you don’t.  I’ll have a post of some of these lessons sometime in the future.

But one has to ask: why do we put ourselves through this painful process of saying goodbye, when it goes against every human impulse to remain connected, to just say, “I’m sure I’ll see you again, somewhere, sometime”?

Because there really is every impulse to say something to that effect.  Something about saying “goodbye” is so final, so definitive, such a reminder of our mortality, that to face it head on can be incredibly anxiety provoking.  Endings are uncomfortable, and experiencing one often brings up memories of endings from our past.

One of the most salient such memories for myself is having to say goodbye to my grandfather on his deathbed.  What could I possibly say that would communicate what I feel?  And how?  I’ll always remember how awkward that moment was, and how really, I couldn’t think of the ‘right’ thing to say.  How, more than anything, I felt embarrassed, and then guilty that this was the strongest thing that I felt.

In the situation I’m in now, at the end of an 8 month practicum, saying goodbye after goodbye after goodbye to the very people I had previously been trying to get to know better, to build a strong therapeutic relationship with, it’s hard not to be reminded of all the times I wish I had done a better job saying goodbye to other people in my life.

But I guess that’s just human nature.  It’s easier to avoid the hard feelings.  To ignore the discomfort.  To say, “I’ll see you around sometime” when we know that we damn sure won’t.

It’s time to reclaim goodbye.

Finally, a therapist in the family

This spring when I shared the news with friends and family about my acceptance into a master’s program their response usually comes in two parts. The first, as expected, is some form of congratulations, which is always greatly appreciated and nice to hear. Often following this is some version of, “So you’ll be able to help me” or “Free counselling for family members/friends right?”

In most cases these responses are so outlandish or humorously delivered that it’s easy to share a laugh about it and move on. Every so often I get a comment that has a hint of seriousness and in a few cases the people are genuinely asking to meet with me once my training in complete. These conversations are a little more awkward than when it’s all just a joke.

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1-800-DOCTORB. The B is for Bargain!

It just struck me as rather… juxtaposed… that I’m sitting here right now, doing some research for this post on none other than Dr. Drew of MTV fame while simultaneously listening to one of the best records ever recorded, Abbey Road by the Beatles.

I suppose that one could be doing a lot of silly things while listening to such an album, and the listening experience would still be quite pleasant, if not fantastic.  It was just a thought though.

I tried to find an embarrassingly bad picture of Dr. Drew, but he has proven so striking that not even 3 pages of google images yielded any such results. So I leave you with this "I'm listening thoughtfully and still looking cool" image.

Something about Dr. Drew very much rubs me the wrong way.  I was convinced for so long that there was no way he was an actual doctor.  Sadly, wikipedia proved me wrong.  Anyway, I’ve become quite interested in how therapy is represented in the media (in fact, I realized after it was too late that it would be an interesting thesis topic… oh well).  Dr. Drew seems to be the exact opposite of what used to be therapy’s most popular television icon…

Alternatively, this was THE FIRST result on google images for Dr. Phil. Don't look too closely at the bald spot. It'll burn into your retinas.

Despite the obvious visual improvements and lack of funny accent with Dr. Drew, I can’t help but think that we’ve gone from one extreme of terribleness to the other.  Dr. Phil, as we all know, began his TV career with the help of Oprah, meaning that his target audience was probably middle class females between the ages of… I dunno… 30 to 50.

Dr. Drew, on the other hand, seems the epitome of cool.  Dr. Phil was on Oprah, Dr. Drew is on MTV.  Dr. Phil got a daytime talk show, Dr. Drew got shows on everything from Discovery Health to radio to shows like “Celebrity Rehab with Dr. Drew,” “Sex Rehab with Dr. Drew,” and “Sober House.”  His target audience is clearly young, attractive, upper class yuppies.  I’m pretty sure Dr. Phil had some kind of terrible divorce or something.  Dr. Drew has three kids (triplets), probably a hot younger wife, and apparently he’s some kind of opera singer.  That’s one fail at life for Dr. Phil to at least three wins at life for Dr. Drew.

Irrevocably cooler, yes.  But an improvement?  I’m not so sure.  I mean, I’ve never watched a full episode of any one of Dr. Drew’s shows (I either get too angry or too saddened to watch), but his carefully groomed, perfectly plucked, and youthful image just somehow seems wrong to me.  Does this man look 51 years old?  Does he?  Dammit man, does he!?  It’s not right!

Am I jealous?  Is this some kind of twisted man-crush?  Why… the cruelty!

I started this post with the full intention of making him out to sound like a quack, and look at what’s happened.

Okay – all I ask is that we stop naming these TV “doctors” by their first names.  It’s not right.  Dr. Phil.  Dr. Drew.  We have to stop this pattern before it gets out of hand.

Dr. Dave.  Hmm…

Lyrical Analysis

I’ve always been into trying to figure people out, but since training to be a therapist, it’s hard not to think sometimes that this curiosity (that was once merely a habit and is quickly becoming a means of livelihood) can get out of hand.  Particularly because so often, there are no real answers, only hypotheses that can feel at times like a stretch.  That’s not to say that there’s no enjoyment to be had in it.  Some of the most bizarre, hard to understand, and seemingly inapplicable theories are often the most interesting and indeed, the most rewarding to conceptualize from.  But one problem that I’ve had since my early undergraduate days is with the alarmingly high incidence of one particular reaction when people find out I’m a student of psychology.  They want to know if I’m analyzing them at that second.  Now I always respond with something to the effect of, “are you paying me this second?”  Better yet, they ask if I know what they’re thinking.  Now that I think of it, maybe I do…

So allow me to indulge and feed the stereotype that all psychology types are walking psychoanalysts, on the lookout at every opportunity for clues that yes, you do actually want to murder your dad and sleep with your mom.

I started getting interested in picking apart song lyrics not long ago.  In particular, songs that make mention of therapy, and there was one by one of my favourite bands of the last decade that I thought would be fun to have a look at from the special perspective of one of my favourite theories of psychotherapy.

The song: “Dead Letter and the Infinite Yes” by Wintersleep.  The theory: Existential Psychotherapy.  If you’re not sure what that is, an explanation is really beyond the scope of this post, so do check out the wikipedia article.

I found a letter it read
“Our existence has serious side effects”
Turned on, turned on the television
It’s telling me the world is collapsing
I think it’s coming and it comes so fast
I’m hearing whispers of an infinite yes
And I don’t know why it is
Our bodies are dead, why you look so sad?

And my therapist said
“We’ve evolved through a series of accidents”
There’s been talk of chemical imbalances
Restless sense of detachment, nausea and/or violence

I think it’s coming and it comes so fast
I’m hearing whispers of an infinite yes
And I don’t know why it is
I feel it coming, I think it’s real and significant
I think, I think, I think a little too often
That’s what my therapist said
We’re alone in this wilderness
Left to choke on the pills and to feed on the viruses
I think it’s coming and it comes so fast

I think it’s coming and it comes so fast
I’m hearing whispers of an infinite yes
Our bodies are dead, why you look so sad
Our bodies are dead, why you look so sad

There are several key themes here that jump to life right away.  Note the 4 existential givens, as set forth by Irvin Yalom, arguably the Grand Poobah of American existential therapy: the inevitability of death, the paradox of freedom and responsibility, ultimate isolation, and meaninglessness.  The issue of the inevitability of death is fairly obvious from the first verse: “the world is collapsing,” “our bodies are dead.”  Even from the title of the song we are alerted to the issue of death by the inconspicuous mention of the Dead Letter.

Aloneness… isolation.  ”We’re alone in this universe, left to choke on the pills and to feed on the viruses.”  A picture is painted of a cold, indifferent, and ultimately meaningless world.  Perhaps the “infinite yes” speaks to this – a sense that no matter what, the answer is always the same.  Our efforts to prolong life, to self-preserve, are ultimately in vain as the reality of life – that it ends in death – only moves ever closer.

The subject of the song is presumably seeing a therapist of some kind.  We can deduce that whatever is ailing our protagonist, one of the proposed treatments has been medical – this theme permeates the song: “our existence has serious side effects,” “talk of chemical imbalances,” and “restless sense of detachment, nausea, and/or violence” listed as if side effects on the side of a pill bottle.  And in the end one is left to “choke on the pills and feed on the viruses.”  Clearly our therapist didn’t pay special attention to any kind of therapeutic relationship here.  One is left with a feeling of abandonment.  Of foreboding.  The end of the world itself seems to be inevitably approaching with increasing speed.

But the issue remains: how is the song’s subject choosing to live inauthentically?  According to our chosen theory, this is the means by which we encounter difficulty.  It might be possible that the songs object, the one who looks so sad, may play a role in something here.  Our protagonist seems concerned about this sadness, and puzzled.  At the same time, it may be that this is all okay, that it is accepted, and that no ‘difficulties’ are being experienced.  After all, the song carries a tone of indifference to what seems to be happening.  It is the emotional reaction of the other, this puzzling sadness…

Our bodies are dead.  Unlikely that this is meant literally.  But we could take a shot in the dark and say that perhaps this is a larger statement about the world, that the physical has lost meaning, after all – what separates us from the amoeba?  The tree?  The rock?  Fundamentally it is not a physical difference, but a mental or even spiritual one.  Cells die every second.  Our bodies are dead.  Our worlds will collapse, which means that the finity of life – the fact that it will be cut off, snuffed out, pulled away – gives us something akin to purpose.  It is as Yalom said: “Although the physicality of death destroys us, the idea of it saves us.”

And so in a way we can conclude that our protagonist may in fact be alright.  And alright in existential terms does not by any means mean happy, free from anxiety, or anything like that.  Rather, it means to experience life as it is, moment by moment.

I’d take some anxiety in order to be able to say the same about myself.

Scientology on Psychiatry

I have a severe level of rage.

I stumbled upon a video today about how scientologists are attempting to blame psychiatrists for all terrorist activities, including 9/11 and the holocaust.  At the end of the video they talk about a pamphlet called “mental health abuse – chaos and terror.”  So I googled this and started looking at the official website, aimed to expose the “crimes of mental health practitioners.”  The site is run by a group, ironically called the Citizens Commissi0n on Human Rights (CCHR).

Human Rights??  You’ve got to be kidding me.  The president of the CCHR, Jan Eastgate, has such idiocy as the following to say in her address on the main page.

Seventeen million children worldwide are prescribed antidepressants that cause violent and suicidal behavior. This includes children younger than one year old who are now being prescribed mind-altering drugs. Millions more of our young are prescribed a stimulant that is more potent than cocaine.

I’d be interested to hear how antidepressants cause violent behaviour and suicide.  In all the hundreds of thousands of cases of antidepressant use, how many people got better compared to those who got worse?

Inmates were terrorized with electric shock treatment, often as punishment and without consent. Psychiatric lobotomies and other psychosurgical procedures destroyed minds and lives. Powerful neuroleptic (nerve seizing) drugs caused irreversible brain and nervous system damage making patients sluggish, apathetic and less alert. Furthermore, patients were assaulted and sexually abused—all under the guise of “therapy.” Any claim of a scientific basis was a hoax.

First of all, what is a scientologist doing worrying about firm scientific bases?

Now, I’m not one to say that the history of psychiatry doesn’t contain some pretty disturbing stuff.  However, the same can be said of the practice of medicine in general.  But in order to discredit a psychological treatment, you have to look at it’s use today.  And you do have to take all things into consideration, including the empirical research behind it.

Take Electro-Convulsive shock therapy (ECT), for example.  A lot of people get really defensive about ECT because they see it as a violent, damaging and inhumane procedure.  But upon closer inspection, it’s not hard to see the benefits of the treatment.  For one thing, it is one of the most effective treatments for things like depression and anxiety that are resistent to all other forms of treatment.  Unilateral ECT can be virtually side-effect free (something that cannot be said for much more common treatments such as psychotropic meds).  Sure, some people have died, but this is due to the use of anaesthetics, like any minor surgery would use.  It’s now an outpatient procedure and due to advances in medicine like effective muscle relaxants and the like, the fact that a seizure is even happening can be quite difficult to see.

Of course, no one really knows how or why it works, so naturally there is a lot of controversy surrounding it.

But I digress.

One of the most alarming claims made on the website is the idea that “psychiatric rape” is a common practice and that it is justified as a kind of therepeutic intervention by offending therapists.  Now, let me be perfectly clear.  In cases where any sexual activities occur between a therapist and client, even years after the fact, it’s just wrong.  There is never a case where it is ok, due to the extremely one-sided emotional interactions that are a part of therapy and the ensuing power dynamics.  Even when things are perfectly consensual, there’s just no way that a healthy relationship can develop.

But to single out psychology as the only profession in which inappropriate sexual contact is dangerous is absolute absurdity.  Therapy is a helping encounter, and those who practice psychotherapy practice in a helping profession.  Hmm…  I wonder what other helping professions have ever bred inappropriate sexual contact?

Interestingly, in her section on how psychiatry is destroyinig religion and hope, Jan Eastgate recommends that “Men of the cloth need to shake off the yoke of soulless materialism spawned by psychology and psychiatry and put religion back into the hands of the religious.  Indeed, religious leaders must take this responsibility, not only for the sake of religion’s survival but also for the survival of mankind.”  If you’re going to make an argument against psychiatry based on sex offenses, seems to me you would think twice about declaring religion as your saving grace.

And what does Scientology have to say about the treatment of repeating sex offenders?  Because I happen to know that behavioural psychotherapy sure has a lot to say.

I know that psychiatry has its problems, not the least of which being the backing of the giant pharmaceutical companies.  It’s an interesting debate and once in which my mind is certainly not made up.  But if Scientologists think that they have the answers, all one has to do, really, is to think about the founding principles of what they believe in, and you’re ready to look elsewhere for worthwhile information.

I don’t even know what else to say, other than go check out the website if you’re in need of a laugh.