The Struggle with Being an Authentic Therapist

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Authenticity is a topic I discuss with clients on a weekly basis — how to be your “true self” and why people struggle so much with this. I believe the first struggle lies with knowing which version of “self” to be at any given time. A person is many selves throughout the day depending on the roles they play and who they interact with during their day. They can be the “daughter or son self” the “wife or husband self” the “mother or father self” the “boss or employer self” the “friend or foe self.” I could go on and on and on listing roles that people play each day!  These roles themselves are also constantly evolving with each experience. How can you be true to a self that is constantly changing?

One version of myself that I believe I am fairly true to each day is my “therapist self.” This was certainly not always the case, especially when I was just starting out in the field. I would take theories that made the most sense to me and for my clients then do my best to apply interventions like Aaron Beck (CBT) or Carl Rogers (humanistic psychology). I’d read and try to memorize phrases, hoping to appear very knowledgable and insightful to my clients. I am not sure if it was a lack of experience or a lack of confidence in myself as a therapist that made me feel like I had to be a certain type of therapist.

This got old. Fast. I also soon became too busy to read textbooks every night and conceptualize the best interventions for each client down to every word. By far, one of the best pieces of advice I’ve ever gotten was “the best therapist you can be is yourself.” It is sort of like that phrase “be yourself, everyone else is already taken.” This is very true for therapists as well. I could never have been Aaron Beck. Aaron Beck is Aaron Beck and I’m still me. Once I finally embraced this and let go of all of the “therapist selves” I thought I was supposed to be, my life in and out of session got easier. I started to come into my own and take the theories, interventions, and metaphors and put my own spin on them, adding my own humor and life experiences.

I also found that if am myself in a therapy session, that the clients picked up on this and were more of their true selves with me. They seemed to open more more and be more interospective. I hope  that I can create the type of space where someone can be his or her authentic self, at least for a hour. Hopefully, afterwards, they will struggle a little less with showing others that version of themselves outside of the therapy session.

Vulnerability During and After a Therapy Session

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One of the best TED talks I was ever introduced to was one by Brene Brown called “The Power of Vulnerability.” I’ve read a few of her books, but I still like to watch the TED talk every now and then to remind myself how important vulnerability is within the therapeutic setting.

I often have clients say to me in session “I’m sorry I was so emotional” or “I’m sorry I cried the whole time.” It’s interesting to me that clients feel the need to apologize for their vulnerability during session. I can definitely see why they do this. Most people were raised not to express vulnerable emotions, weaknesses, and flaws. Having to do just that while in therapy for one hour each week or so can be incredibly intimidating! I remember I had one client who said he needed to “take time” after our sessions because he was not used to telling anyone, let alone someone he didn’t really know, about his unpleasant emotions and flaws.

I am always careful not to placate or invalidate a client’s vulnerability by saying “it’s ok.” Instead, I try to thank them for trusting me enough to be vulnerable in session because that is what I need to see in order for clients to make changes in their life. As a therapist, it is often difficult for me to sit with my clients when they are so vulnerable. In a way, I empathize so much, that I start to feel vulnerable myself. This is a process for me and for every therapist.

I believe that once you can have a vulnerable conversation, one where you express and sit with your true and unpleasant feelings/thoughts, in the therapeutic setting, you can start to be vulnerable in your every day life. State dependent learning anyone? Take that client I mentioned earlier, he was exercising his “vulnerability muscle” if you will. Soon, he was able to have more emotion-focused conversations with his wife, where he would admit his insecurities about their marriage. This brought them closer and wouldn’t have happened had he not practiced and become more comfortable with being vulnerable.

My challenge to you, is to make yourself emotionally vulnerable to someone once a week to start flexing your “vulnerability muscle.” For me, this is usually admitting to someone that I do not know the answer and will have to look it up, asking for directions, or admitting I was not fully listening to a friend or family member when they were speaking. Each time I do something like this, I become more comfortable with being emotionally vulnerable and I would hope this makes me more equipped to sit with vulnerability in the therapy room. My hope is that it would also allow my clients to be more vulnerable with me in session. After all, if you cannot be vulnerable with your therapist, who is un-biased and non-judgmental, with whom can you be?

Acceptance and Commitment Therapy Portrayed in Grey’s Anatomy Scene

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Does anyone out there watch Grey’s Anatomy? If not, no judgment, if so, no judgment. I was catching up on episodes when I came across this scene that was so on the money with a type of therapy I use in session that it inspired me to wrote a post!

To set the scene for those who are not familiar, (or who have not seen the episode–SPOILER ALERT!!) Amelia, whose brother just tragically died, tells Owen that she is handling it very well and is doing “amazingly.” She also admits to have gotten some prescription drugs that she might take (she is a former prescription drug addict) due to not being able to “manage” her emotions anymore.

Owen (in a very Acceptance and Commitment Therapy kind of way) explains that grieving after the loss of a loved one is very “normal” and that feeling sadness/pain is a part of life. Instead of allowing painful emotions and feelings to happen and moving through the pain, he realized that they both run from their pain. She takes prescription medication and bottles up her emotions. He enrolled in the army again and leaves the country on duty. He expressed that they are supposed to “feel, love, hurt, grieve” and they are “supposed to break” and that that is the whole point of being alive. Owen, I couldn’t have said it better myself!

Clients often say to me in session, “I wish I never felt sad again” or “I wish I never felt heartache again.” That’s all fine, but personally, I would choose to feel painful emotions. If we allow ourselves to feel pain and work through it, we give up the struggle with the painful emotion and are better able to move past it. If one never feels pain or unpleasant emotions they also block out the ability to feel the pleasant ones such as joy, love, and happiness.

Who would have thought– all that insight in one Grey’s Anatomy clip!

Note: This clip seems to no longer be available on Youtube. Sorry!

Welcoming New Hellos

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It has been difficult for me to say goodbye to the clients I have gotten to know for the past three years. These clients have shared with me their struggles, triumphs, their secrets, and their pain. I am forever grateful for the therapeutic relationships I have formed. I learn something new every day from a client and I make it a point to tell them that –whether it is a new restaurant, book, TV show, or way of thinking about the world.

A friend of mine recently said, “Attachment is a funny beast. Through the ebb and flow of life our attachments whittle closer to our core, becoming a complex source of compassion, pleasure, and pain.”  I’ve become attached to my clients.

Many clients see their therapist as a constant support in their life, someone who will always be there, even if they are not. They get attached. Attachment makes it hard to say goodbye. To anyone who has ever seen a therapist, and had that therapist leave their place of work, please know this process is just as hard on the therapist as it is on the client.

One of my favorite quotes is by William James: “We must be willing to let go of the life we have planned, so as to accept the life that is waiting for us” and I believe I did just that. New beginnings mean new attachments, I believe I am ready. I am welcoming new hellos!