a letter to my younger therapist self

Greetings! I wrote this as a letter to my younger therapist self to commemorate my 4 year anniversary of working on inpatient psych. A lot of these ideas come from the cannon of wisdom held my many wonderful therapists, so I cannot claim to be the sole auteur. Hope you glean something from this brief offering. 

Things to Remember:  

• Your mission is to be able to treat EVERYONE. Don’t get stuck in only being efficacious with “easy” clients or the ones you relate to. Learn what your implicit biases and blocks are. Examine what you have had the prior luxury of avoiding. Don’t try to coast here, it won’t work. Moving bias aside allows for a greater connection to your Wisdom Self. When we lead from our biases we miss the chance to create transformative experiences for others. Moreover, moving through biases is self-transformational. 

• Don’t judge anyone too quickly - love vs hate are closer than you think: The human mind loves to categorize people based on good vs bad, love vs hate, right vs wrong. It makes navigating the complexities of human relationships seem unnaturally simple. Folks dealing with psychosis or any spike in symptoms can present one way one minute, and completely differently another minute. It’s a human tendency to think, “I love her! What a sweetheart! ” or, “What a bigoted jerk” upon first meeting someone symptomatic. Yet, the person who formerly behaved like a bigot might turn out to be the gentlest soul after a few days of treatment, and those racist comments stop when the psychosis has dissipated. So, do you actually hate this person who now seems so lovable? The things we think of as fixed are often in flux, and therefore we must never hold too tightly to a first judgment, preference, diagnosis or opinion. 

• Sometimes people are really hard to love. Usually though, if you wait long enough and look hard enough you will find something awesome, something amazing, something wonderful about everyone. Latch onto that lovableness. Look at your clients through the lens of love and they will feel and act differently than when they get treated like monsters. 

• Invite the REAL. 
Therapy is an invitation for authenticity. People are used to being treated by systems with overworked folks who don’t/can’t listen to gory or hard-to-hear details. Clients (especially those stuck as patients in big systems) are used to being given the message that they are too much, or what they bring is too difficult to deal with. People are starving to tell their stories and be listened to. Don’t try to offer solutions to a lifetime of someone in terror. Don’t try to make the therapy “nice.” Invite it ALL, hold for depth. Giving someone the space to go into stories met by others with fear is an enormous gift. 

• Initiate repair work: those of us with core relational wounds often hide or avoid the person we’ve offended or been offended by. Therapists have the privileged role in the dyadic relationship. We can drive conversations that mitigate or heal the interpersonal ruptures that happen. It is really scary to return to someone who has cussed you out, someone who is clearly hurting but acting out their pain and say, “Hey, let’s talk about what happened, let’s work on this.” However, these conversations can be enormously healing and transformative for a client who is used to abandonment and rejection and acting out. Change their story, change your own.

• Take people’s pain seriously but don’t treat it so seriously that you appear hard and inhuman. 
Laughter is revitalizing

• Some situations/behaiviors/persons are undeniably disgusting. So what? Feel disgusted and treat the person anyway. Denying disgust serves no one, and you’ll likely act out if you pretend everything is hunky dory.

• Get rid of your therapeutic agenda. Trying to force someone to see something they are not ready to see is a small act of violence. Decenter yourself, and make the internal shift to see what THEY see, hear what they might be hearing. Guide from there.