My relationship to my career as a therapist is complicated. I worry it will sound cliche but for me it is a calling–I derive great meaning from my vocation. However, living in a corporate capitalist system (with a single income) requires that we grind out a living in order move ahead. In short, the volume of work I have to do often burns me out and, sadly, I can begin to resent my work (I like to think that even when I resent the hours I put in that I still do pretty damn good work but it’s not always true). I relish the times when I still feel excited about learning both in and out of session. Since I am in one of those periods I would like to share some of the experiences of the week.
On Tuesday I had an experience that reminded me of the comfort and skill I have developed over the years. I used an intervention that, out-of-context, may have seemed risky and impulsive but within context (of that particular client and our specific relationship) it was actually a very grounded move. Intuitive? Maybe. I often get confused about what that word really means. What I did realize and relish after the session was seeing how my skills and feel for the work has developed over the thousands and thousands of hours I have acquired “in the chair”.
One of the things that keeps this work exciting, however, is that just as you are patting yourself on the back, something will happen to humble you. If you can stay open (not take it personally and beat yourself up) you can still put it to good use. Nevertheless, it is humbling.
I have a client I have seen for coming up on four years. She is a cis-gendered woman who is 22 years old. I have known her since she was a freshman in college (she is now beginning her senior year). She grew up in a home with a verbally abusive narcissistic father and just got out of a three year relationship with a narcissistic boyfriend. This client tends to try too hard to be liked and to please others. She has made strides in this area. However, a few months back I realized that, in spite of caring for her, I was no longer looking forward to our sessions. And now in retrospect, I think I was avoiding looking at that because (and this is no excuse but it is honest): I started to give up and feel defeated. I want to explore both this and what happened in our last session.
Our session was going “okay”. At least in the sense that the client was reporting things that clearly showed some of her growth: dating situations in which client bowed out because she noticed that the person was domineering. For whatever reason (probably because I had the energy and I am relishing the work right now) I realized that this client annoyed me by not pausing to let anything I said “land”. Or, to be more precise, she gave no evidence of anything landing. I quickly checked in with myself. I thought about how my client very likely has ADD and that this was a variable at play. However, I also felt in my gut that there was something more. So I brought it up with the client. The client admitted that she tried to prove herself in life and that a part of her was probably trying to show me that she was a “good student” by hurrying up and giving me an answer or an opinion. Then the client surprised me.
She told me that she remembers that I use to do more “reining in” during sessions. That I wouldn’t let her “get away” with staying on the surface. She said that lately she noticed that she was getting away with not using the session time and that I was allowing this. She was right. I hadn’t felt good about my work with her in a while. I was bored. I had given up. I made sure she knew that she was right. I told her I had become complacent with her and had not been doing my job as well as I could.
It’s important here to note that I felt grounded as I admitted that. That is to say, I did not feel defensive. I did not feel dysregulated. Strangely it felt as though my young client had validated my experience (which relaxed me) and brought me face to face with what I had been avoiding. I thanked her for the feedback and asked how it was to give it to me. She told me it was “scary” since she is used to men who invalidate her experience and then try to argue with her. I thanked her for being brave. I then asked her if we could stay with the topic at hand. She agreed in spite of her fear.
I asked her if we could look at how we were co-creating the situation. I made sure to create a safe context (due to client’s tendency to feel as though she is to blame for things) by quickly bringing in the idea of circular causality. The trick here was to get her to see her part while ultimately acknowledging that it was my job to have spotted it, not hers. Or rather, that I had indeed become complacent by not bringing up my transference-counter-transference issues earlier so that we could have addressed them months months ago.
I told the client that over time I had grown tired of my interventions not landing. I explained that part of why I grew tired of this so fast is that I bring my own issues to the table that make me impatient to see that I am impacting people; that I have a compulsive need to know that I am helping. I explored with client how we had seemingly landed in a circular trap. I grew tired through my belief that my input was not landing and mistook it as me no l,onger having an impact on her; she began to realize she could avoid facing difficult things since my exhaustion kept me from challenging her. Her avoiding difficult things, in turn, made me tired and bored. And so on and so on (the circle can be entered into from any point as it is not a linear causality). The client agreed that this made sense. For good measure, I reminded the client that though we had co-created this dynamic, that it was my job to have looked at it and brought it up sooner but that I now realized I was being even more avoidant than she was being.
The client and I ended the session with a resolution that I would go back to reining things in; to doing a better job of controlling the flow of the session. She asked me to challenge her again. She asked me to even challenge her when it looked she was simply “speeding by” my feedback. I agreed to this as well.
I’m proud of myself for having turned something harmful into, hopefully, something helpful. But why did I wait so long? And to be clear, I’m not being hard on myself. I ask it from a place of curiosity. And the answer is both simple and complex. My abandonment issues find subtle ways of expressing themselves in my work. I sometimes fall into a fall sense of comfort because the work version of me really is far more grounded and confident than the outside-of-work me. But even so, my issues still sneak in there and impact the work. Furthermore, my burn out, which is no fault of the client, also made me grow tired and complacent. I wonder if I would have looked at my part in my boredom if the client had not challenged me. Of course, the client challenged me in part because of the work we have done. And I think that is the point of this whole entry–this work keeps you humble. Even as you appreciate yourself for the work you’re doing you’re reminded that it is easy to sleep-walk; to be complicit; to collude. The client and I were involved in a re-enactment. Together we saw or way out of it. But I don’t know that I could have done it without the courage she accessed in order to confront me about it.
Edit: And as if to prove my own point I just realized something I missed an opportunity in our interaction. Now that the client and I have made our dynamic explicit, the responsibility of naming it could be a shared responsibility. Though it is my job to create those opportunities, I need to ask the client if she is willing to make it a more collaborative process.