Thursday, January 21, 2010

Notes From My “Ideal Reader” (Or, at Least One of Them)

A therapist friend said my book should be required reading for clinicians in training. I’ve yet to grapple with how to get the book to budding clinicians so I was thrilled when, via Twitter, I made connection with Sharon Sanquist who is studying for a Masters in Social Work—and has read the book.

What spoke to her was that I conveyed the process of therapy from the perspective of either sides of the couch. Indeed, every therapy session is really two distinct but interconnected narratives—that of the clinician as well as the client. Sharon says that, like me, during a session she often takes an imaginative leap to try to consider what the client is experiencing, and was glad to see how this proved productive in treatment.

She also related to literary descriptions of experiences usually only described in clinical terms. One example was how my then therapist and I worked in Self Psychology mode, building a core from the ground up, attempting a psychological revision of my life story. These sections articulated “how empathy can be meaningful in building up a person’s sense of self,” she said, which is important as many seeking therapy have “lost their sense of self”.

Finally, she reflected on the complexities of medication and how clinicians can drop the ball on it: “Some say that medication is stuffed down people’s throats. But sometimes those who truly need it are the ones who aren’t getting it—often those who have developed effective coping mechanisms but are really struggling. Such people may see taking medication as a weakness and need to have it suggested by someone else.” In many cases, she says, considering medication earlier in treatment can spare someone months or years of suffering. (Don’t I know it!)

Sharon also started in a different profession: banking. While one wouldn’t think of banking as preparation for clinical work, she said she often found herself doing a lot of handholding and helping to reduce the anxiety inherent in the getting-a-mortgage process. I guess many roads lead to therapy!Sharon is a dynamo in keeping up with trends and ideas in psychology and social work. Her Twitter link is:

Thursday, January 7, 2010

Holding On Too Long (Therapy Version)

One of the great things about publishing a book is that you get to find out what stories you're telling--the ones lurking beneath the narrative you intended to write. A theme several readers have responded to is the danger of sticking to one approach or strategy well past the point that it's helpful. This brief Q & A is adapted from a post on Jen Haupt's Psychology Today blog One True Thing. I thought this was a good begin-the-year message (as in, New Years Resolution: if it's going nowhere, ditch it.)

Do most people realize when they're hanging onto strategies in their lives that aren't working?

Often no, because we find virtue in the act of holding to whatever course we’ve decided upon. We may end up putting more emphasis on the strategy—whether it’s using a particular health modality, following a diet, or a sure-fire way to succeed at work—than on the results. And when we check on our “progress”, that too can be deceptive. That’s what happened to me with psychotherapy. If I felt bad, I could say, “This must be the pain I need to experience in order to be okay.”

What's the pay-off in staying in a bad relationship?

I co-authored a book on honesty and deceptive in marriage (Tell Me No Lies) and this was a revelation: people lie to each other in order to keep things the same. Basically, people bond in a way that feels good, and then do anything they can—lie, tolerate abuse, abandon dreams—in order to maintain that feeling. So the payoff is having access to that good feeling, or at least the illusion of getting there again. There may be a point when that payoff isn’t enough, and that’s when you do something. But it is amazing what people will live with.

What life strategy did you have to give up in order to get better?

The main one was the willingness to give complete power to another person, in my case a therapist. The other was the quest for “answers”—some kind of epiphany or catharsis that would free me up. But letting go of that quest ultimately proved more liberating.

What's the first step people can take in giving up strategies, relationships and habits that are destructive?

A willingness to question whether things are working. It sounds simple, but we’re often fearful of losing our nerve—or even losing our identity, which can become bound up in a given way of doing things. It’s also good to have reality checks in your life—and to listen to them.Here's Thembi enjoying a relaxing read in a sunnier season.