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Mindset

The Tonic of Therapy: Candor and Compassion Served Straight Up

If you want to know what people really think, find a good shrink.  I have no vested interest in anything other than your ultimate wellbeing.  I have all kinds of freedom to call it how I see it.

My signature therapy cocktail is compassion and candor.  It’s a tonic I serve up shaken, stirred, and sometimes straight up.  Understanding the strength of the shot of support or challenge that a client needs at at any given moment, on any given day, is part of the art and science of what I trained to do. At times, I recognize it’s best to have someone sit back and slowly sip.  In other cases, it may serve someone to have me say “bottom’s up” to hard truth.  They take a gulp.  It burns on the way down.  But usually, they come back for more. We all, on some level, crave truth. Even when it is not nice and neat.

When clients come through my door we talk about all kinds of things. Moms and money. Spouses and siblings.  Bad dates and dogs.  Sex and insecurity.  Bosses and balance sheets. Fathers and food. Tinder and Daniel Tiger.  Purpose and procrastination. Why and how.  Motivation and movies.  Sleep and salary negotiations. (spoiler alert:  my answer is always “Ask.For.More.”) Shame and doubt. Regret and terror.  Grief and vision.  Jealousy and desire.  Pleasing and perfection. Feelings and thoughts.  Acting and slowing down.  Promises and broken expectations.   Priorities and possibility.  The meaning of life and every day existence. Faith and fear.  Living and dying. 

There are many different treatment approaches and philosophies applied by clinicians trained to practice psychotherapy. I believe in evidence-based medicine.  I don’t practice a one-size-fits-all cookie-cutter approach. In more than a decade of clinical work, I have yet to sit with two individuals who are identical in story, psyche, temperament, or situation.  I encourage the people to find a therapist who tailors a response to a person rather than a problem.

Depending on whom you see, your therapy may be more about your past, present, or future.  Personally, I see value in squaring all three.  It can be useful to reconcile what has happened  before with the current reality that is.  Reflecting on what is happening now, someone can start to show up today understanding how they are actually actively creating their “what’s next?” every single day.  Skeptics may question the value sitting around and “just talking about it.”  “Don’t you need to go out and do?”  Yes, but first you need to untangle, understand, and develop a plan.   After each session, you need to determine how you ultimately will act and take agency for your own life. 

Your individual goals for our time together matter to me.   There are strategies for addressing symptoms.  I want you to discover the ones that work best for you.  I can teach and educate.  If you want, therapy can also be so much more.  You can invest in doing the work of understanding what creates your symptoms so that you aren’t spending the next decade or two playing psychological whack-a-mole when the same pesky mental monsters pop up.  In the ocean of self-awareness, ultimately you decide how deep you want to cast your net.

Therapy is a stage for observation, understanding, and rehearsal. It is experiential. If a pattern, dynamic, or behavior is happening in therapy, it likely is occurring outside, too.  Humans move through life defending, deflecting, avoiding and aggressing in bids to protect themselves.  These strategies sometimes come at significant cost. Through my interactions with a client, I often discover what may be implicit and automatic but problematic in the relationships, work life, health, and bank accounts of the person sitting on my couch.

You can and will disagree. I will get it wrong.  I will disappoint. When I do, I want to know.  Please.  These blips (or, sometimes boulder-size bumps—seeing how I am human and all kinds of imperfect) on our relational roadmap create an opportunity for you to practice telling someone you did not like what they have said in a productive manner.  I should be one of the safest people you have in your life to practice having hard conversations with when something uncomfortable arises.

Conflict is inevitable in all human relationships. It exists on a continuum. Imperfections in how we show up in the world will evoke natural reactions from those in their wake. If I’m running a few minutes late for a session (which I absolutely hate), I would anticipate you may have a reaction. (I grow irritated and impatient and waiting in my physician’s lobby after my appointment time has passed). It behooves all of us to figure out how to do the relational work of conflict better. Avoidance, passive aggression, or explosive eruption seldom serve someone as adaptive response when toes are stepped on. People need practice in saying what they are thinking and feeling, rather than behaviorally acting out in an attempt passively communicating messages. The second strategy often doesn’t work real well. Tell, don’t show. Ironically, it’s easier said than done. That’s why we practice in psychotherapy. We may fight and make up.  (Yes, fighting with your therapist is a thing.)  If you can learn how to become skilled and competent in managing conflict, disagreement, or disappointment with me, you grow in confidence that you can do it differently in a way that won’t be so costly in your interactions with others.

It is a responsibility I take seriously to say the things that other people in your life may be thinking or feeling, but don’t say out loud because they fear the stakes are too high. I am not a people-pleasing psychologist. You won’t always love what you hear me say. You may get angry.  That’s okay.  I can take it.  You’ll likely initially respond to me the way you often do with other people in your life who stir fury.   You may even leave. There’s a chance you will fire me.  I don’t fear that outcome. What I fear is not having the courage to stir you deep enough.  What I fear is lukewarm mediocrity and status quo. I can’t help you the best way I can if I care more about you being my client than I do about your growth.

You are responsible for your experience in this world.  I can’t want anything more than you do, and I can’t do the work on your behalf.  One of my objectives is to empower you to build the bridge between where you are and where you want to be.  I can help you switch lenses so that you can see a bigger future and push you to believe in yourself enough to go create it. 

Your world is full of people who can dispense advice.  I’m not confident you would actually appreciate or want one more person spouting off you rational suggestions that, on some level, you already know.  You’re intelligent.  You know the “right” answers.  You’re just struggling to figure out the disconnect between knowing and doing. Sometimes I may be more directive, but rarely will I be prescriptive.  You must ultimately decide. 

You will do the heavy lifting.  I will (hopefully) ask smart questions that make you think. The ones that go beyond the shallow surface. Some may make you squirm.  Sometimes I need to lean back, so that you can discover and start to feel what it is to lean forward, in, and up.  This may frustrate you, but a crucial part of my job is creating space so you can find new answers and take authorship of your life. 

I will try to talk you out of going to therapy if . . .

Do not go to therapy because someone is “making” you.  Please.  Please please please. Therapy under duress never ends well.  You ultimately must step into a shrink’s office because at least part of you is sick and tired of being sick and tired.  Your readiness and motivation to make meaningful change in your life and relationship may wax and wane.  That’s okay.  But in the end, whatever you do, do for YOU. 

Therapy is a significant investment of time, energy, and resources.  Save yours if you aren’t ready to dig deep so that you can have something far bigger and better than your current status quo.  Part of my boilerplate is asking if someone truly wants to do the work of being in therapy.  Yes, therapy is work.  I only want to partner with someone who is highly-motivated and willing to commit to going all-in on the endeavor.  Sadly, plenty of options exist for people seeking one-foot-in-one-foot-out engagement.  Often that dance doesn’t do much beyond dizzy someone in circles and possibly drain their bank account.  If you are in the market for watered down experience – you’ve got the wrong girl.

Selecting your therapist is a bit different than choosing your dentist.  Research shows that therapeutic outcome is largely impacted by something called “therapeutic alliance.”  This means that the most important factor in whether you will meet your goals is whether you work well with your therapist (most days).   Over time it is important to establish trust.  You need to be able to play with all cards face up on the table when seated across from your therapist.  Consider whether the person you are sitting across from leaves you feeling safe enough to tell the truth, your truth. Your therapist shouldn’t always leave you living in your comfort zone, but he or she shouldn’t spike your spidey senses either.

Therapy is about learning, growing, healing, and transforming through a relationship.  Training, experience, and credentials of your clinician all count, but some things you won’t be able to determine from data you could mine from a CV.    Finding the couch that is the comfortable for you will make all of the difference in determining the outcome of your experience.  Clients are consumers of therapy.  Listen to your gut.  Ask questions—as many as you want.  Pay attention to whether you feel both supported and challenged.  The clinician’s job is to understand the art and science of how much of each you need in a given moment. 

In therapy, sometimes change is profound.  More often it is subtle.   Nuanced.   Here’s the thing:  when you have an experience that in some way shifts your internal compass a couple of degrees, it can entirely change your ultimate destination.

Where do you want to go?

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May 22, 2020

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