therapist

When Therapists Stumble - Finding the Opportunity in Disconnection

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How many of us have been in the middle of a session with a client when, all of the sudden, the air in the room changes and we realize that things have taken an unexpected turn? Perhaps we’ve tried to guide the conversation in a direction that the client did not want to go or maybe that uncomfortable counter-transference has crept into the room. Our palms are sweaty, the blood is rushing to our faces, and we can feel our voice start to shake a bit. Regardless of what prompted it, the reality is that a rift occurred within the therapeutic relationship, and now you’re feeling the ‘yuck’. What do we do when this inevitable phenomenon happens?

Whew, just in writing that I can feel my anxiety increasing as I don’t know that there are many things more uncomfortable that can occur during a session; I’m confident, though, that I’m not the only therapist that has experienced this. For me, it’s helpful to ground myself first and foremost – I grab my little fidget spinner, take a quick look out the window, or do a few strokes on my beard to get myself back into the room. The first few times that I experienced this, I would immediately think that I had done or said something that caused the flow of the conversation to change. Perhaps I did; maybe I did push things in the wrong direction or it’s possible that I had verbally or non-verbally responded to the client’s last statement that was perceived as invalidating. I’ve learned, though, that making the situation about me plays in opposition to the point of each and every session. Therapy sessions are not about me, they’re about the client and the relationship that forms between myself and the client. Part of my job as a clinician is to model healthy relationships and healthy communication. With this in mind, the rift that occurred didn’t involve just me; it involved the both of us.

Now comes the hard part – bringing this ‘yuck’ out into the open. Of course, every situation is different so, naturally, every response will be different. Regardless of this context of the situation, I always try to remain authentic and honest. I may say something along the lines of, “well that flopped”, “something shifted; did you notice that too?”, “I think I need a minute to get my thoughts together”, or “I think we’re both having some feelings about this right now, would it be okay if we talk about that?” If I had done something that caused the rift, I’ll own it, and if the shift occurred on the client’s side, I’ll provide them with an opportunity to talk about it. I’ve learned that there is no rule book for navigating through these situations. Experience seems to be the only thing that fosters more comfort in sitting with the uncomfortable. I can’t help but think back to my grad school days and hear my first field instructor saying, “We’ve got to find comfort in sitting with the discomfort.”

If any of you have been following my previous blogs, you’ve likely picked up on the fact that authentic and genuine communication is one of my core values and key pillars in therapy. In bringing this ‘rift’ out into the open and providing a safe space to discuss this relational break, I try to model effective communication to the client. Not only is it helpful for the two of us to find a resolve to the situation, my hope is that the client will be able to utilize and take that experience outside of my office walls and apply it to personal relationships. There’s also tremendous value in utilizing the uncomfortable situation in a positive manner for the both of us. The modeling of conflict resolution is tremendously important for a client: by demonstrating my ability to appropriately and effectively talk through the ‘yuck,’ I am able to teach my client healthy ways of resolving relational rifts.

Breakdowns within relationships are a normal and expected thing to happen; therapeutic relationships are not immune to this. We, as therapists, have the ability and obligation to use these uncomfortable experiences as teachable moments. Moments to show our clients that we care enough about them that we will hold their discomfort while we talk through and resolve the uncomfortable, yet expected, ‘yuck.’

 

ProTip: Being a Male Therapist in a Female-Dominated Field

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My February 2018 blog, “Should I Work with a Male Therapist?”, seemed to spawn a lot of conversation and provoke a great deal of interest from other therapists. The biggest question that I’ve been asked is - “How do you do it... How do you convince parents/females/other therapists that it is beneficial to work with a male therapist?” I could sure reach back to my grad school days and fill this blog with stats, quotes, and empirical evidence outlining the benefits of working with a male therapist, but I’ll save you all the doldrums of reading a research paper. Today, I’m just going to be me and share my story and experience as a male therapist working in a female-dominated field.

First and foremost, let’s talk about the concept of convincing others to work with you.  As therapists, we all ‘sell ourselves’ to a certain extent regardless of the age/identified gender/or presenting problem. How do I do this? Well, plain and simple, I remain myself – not someone that I think the client/parent wants to see, but just me.  I meet clients where they are and model authenticity and honesty. After all, isn’t this one of the core tenets of what we’re supporting our clients to do? Rather than trying to convince clients of working with me, I assist them in recognizing the potential benefits of working with a male therapist. In remaining objective with the client &/or parent, I’m able to remove my blinders and biases so to genuinely hear any possible concerns or trepidation. I’ve found that I’m able to have genuine and rich conversations surrounding the individual’s/parent’s initial thoughts on working with a guy. I refrain from attempting to convince of anything, rather I present the facts as well as my professional experiences and successes as a male therapist.

Much of my work with clients, regardless of their ages, focuses on authenticity – letting your real and true-self shine through.  I embrace this same mentality for myself. I’m just me and I’ve come to embrace that my authentic-self is my best-self. This is the individual that I bring into each and every session and I like to believe that it is through this display of authenticity that I’m able to connect with all individuals regardless of age or gender identity.  As therapists, we all navigate through our journey in becoming licensed professionals by launching into our own world of self-reflection. With this, I’ve spent a great deal of time and energy looking back at my own reflection and learning to appreciate and love the person that was staring back at me. Sure, the journey wasn’t always glamorous and I had some pretty significant “yuck” that I had to work through on my own, but I made it through.  This, I believe above all else, is what has made me the professional that I am today and who individuals trust to support them as they work through their own life struggles.

Now, let’s get to the million-dollar question “how do you convince others that it’s okay to work with a male therapist?”  Before I launch into that, let’s take a step back and look at our own beliefs and biases. What are your own thoughts/beliefs in working with or referring a client to a male therapist?  Do your beliefs change at all depending on the identified gender of the client? How about the age of the client? If the answer is yes to either of these questions, there’s some internal belief exploration to do.  Yes, I possessed my own thoughts and biases regarding male therapists and internalized my own anxieties in working with adult and adolescent female identifying clients. The identification of these anxieties was paramount for me in finding success as a male therapist.  I began asking myself questions: “What is it about working with a 13-year old girl that provokes stress for me when I’m at complete ease in working with a 13-year old boy? Why am I feeling trepidation when speaking to a parent of a high school daughter but feel utter confidence in speaking about their son?”  I could dedicate an entire post just to these emotional disconnects, but for the sake of today’s post, I want to draw back to the concept of authenticity. As long as I’m remaining true to my authentic-self, my support and compassion does not waiver depending upon the identified gender or age of the individual that is sitting on my couch.

As I highlighted in my initial post, there are numerous benefits in working with a male therapist.  Here are a few of the take-aways from that post – male therapists can:

  • provide individuals with a safe man to speak with

  • model healthy boundaries and dynamics with a guy

  • display that males do have the capacity and ability to appropriately and effectively show emotion express feelings

  • dispel concepts of hegemonic/toxic masculinity

This all begins, though, with the therapist’s self-reflection and self-awareness.  Just as I’ve come to embrace my authenticity, I encourage each of you to embrace yours.  We ask our clients to bring their true-selves into each session therefore it’s only expected that we bring ours.

Today’s post is focused on my experience as a male therapist and how I’ve navigated through any hurdles or potential obstacles that I’ve encountered.  Branching out to a broader level, I’ve also had to be mindful of the systems surrounding me and how these structures impact my success. I’ve purposefully left this area out of today’s blog as I feel that it warrants its own post so be on the look out for a future edition of this topic and my adventures.  The new year just may bring about some new trainings/workshops/webinars on Succeeding as a Male Therapist in a Female-Dominated Field.

LifeTip: What do you mean I have to stop therapy?

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The therapist-client connection is a special one, and my clients are very, very important to me. There are a million reasons why goodbyes happen in therapy, but I have found that they all are painful on the surface, just in different degrees. Why? Most of the time, I run away from saying goodbye. My brain says, “but I don’t want to do it,” or, “I don’t like that!” in my most young, child-like voice, because the part of us that gets most affected by goodbyes is our very young self. The self that wants to be deeply connected to another person. Under the surface, however, goodbyes can provide healing and relief so it’s worth moving through the pain to get to that place.

There are two types of termination (a fancy word for goodbye) as I have come to experience and understand:

  1. When you (the client) decide to stop therapy (b/c of schedule changes, school ending, deciding you just want a break from all the talking)

  2. When your therapist makes the decision for whatever reason (schedule changes, decision to close their practice, a move, other life changes-having a baby, etc).

However the goodbye happens with your therapist, here are some general tips for handling this experience:

-Say all the things your brain is thinking to your therapist. I promise we can take it. It’s our job to hear all the things.

-Stick it out. Don’t run away. Come back. (I think that’s enough said, but I’ll clarify- goodbyes are super hard. Most humans have an instinct to run away from hard feelings, so your instinct will be to run away and never come back to another therapy session. Fight it. Come back so we can talk about it all).

-Make memories with your therapist. I know you have done incredible work together, even if you only saw your therapist for a few sessions. With my clients that I’ve seen for many months, we might make a memory book of things we have said to each other, we might make friendship bracelets, we might make a piece of art together.

-Ask as many questions as you need to ask. Ask some more. Cry. get angry. Yell. say that you feel nothing, and that you don’t care. Everything you say and do is normal.

-Clients have asked me, “why can’t we talk or communicate after our last session?” My answer is simply that it’s because sometimes relationships just have to end. The therapeutic relationship (I know, it sounds weird, but it just means-relationship between therapist and client) is a special one, one that is different than a parent-child, or friend-friend relationship, or even a teacher-child relationship. As a therapist, there are rules about communication afterwards for my license (kind of like rules for a doctor or a lawyer) that I have to follow.

In the end, I might not be able to fix every feeling about our goodbye, but I will always tell you this in our last session: “You matter to me. You are important to me. I will never forget you. I will never forget the unique person you are. I believe in you.”

When a goodbye happens that you weren’t expecting, it can feel like you don’t hold any of the cards, or you feel a bit powerless. But here’s a secret that I want to let you in on:

You are a powerful, magical being. You will survive this. You can tell me you won’t survive, and I’ll talk about that with you, but you are still a powerful, magical being through it all.

If your therapist needs to say goodbye for any reason, you’ll get the option to continue on your therapeutic journey with another therapist, or the option to take a break from therapy and rest a while. Maybe you go back, maybe you don’t. But a wise colleague said this to me, and I’m gifting it to you: the magic isn’t in the therapist, it’s in the therapy and the client itself.

I am not the secret ingredient (even though I am made of glitter and sparkles and I will always love you)- the work is. Your life is. Therapists are guides, we are listeners, we are helpers. And, you will find others who will listen, who will help and assist you in ways you never knew you needed. Carry me with you, be brave and go forth.

First Session Feels

As a therapist, there’s something exciting about a first session! Have you ever felt that way? Ready and eager to meet someone new, learn about their story and see how you connect? Or maybe nervous and unsure, questioning your ability to meet the client where he or she is, wondering whether you will be able to help. The stakes can feel high when there’s the added pressure of building your practice and you want every client that walks in your door to stay forever! Perhaps you’ve felt this whirl in the pit of your stomach when you were early in your career, or after making a move to a new city and establishing fresh roots, or even if you’ve been in the game for quite a while and still wrestling with the uncertainty and unknowability that comes with being in private practice. There seems, at times, so much to “cover” in the first session. History. Policies. Confidentiality. Goals. Oh yeah, and rapport building. It’s sort of an art in and of itself, don’t you think?

As we’ve been developing our Improv for Therapists workshop, we’ve done quite a bit of research on the topic (we’re just as new to this as you are, we promise!) and found a lot of qualities in improv that we value as therapists. Improv asks us for openness, flexibility, attunement and self-compassion. This honest blog post about whether or not to pursue improv reflects on real-life doubt, worry and facing the risk of jumping in and meeting your feelings, all of them, with compassion and thoughtfulness.

So what does this have to do with the first session? Well, when you have that first face to face encounter with someone, it really is all improv. You are getting to know them. They are getting to know you. And you are finding the balance of how to introduce all the necessary “first session things” with the grace of connection and heart. Openness. Flexibility. During this first session you figure out the pace and rhythm of this new relationship. When do you lean in and ask more questions? When do you step back (but not out) and allow patience for more to be said on another day? Attunement. All the while you check in with yourself and back to the feelings that stir within you. Self-compassion. You are human, and each first session is an opportunity to connect with another human, while staying gently mindful of yourself and all of your first session feels, and to meet them all with openness, flexibility, attunement and compassion.