How do you demystify the therapy process for clients?

April 6th, 2011

By Christine Smith

Guest Feature Article Author: Christine Smith, LICSW, is a clinical social worker in private practice since 1990 and currently works with families in Nantucket MA, specializing in martial and couple issues, family stress, struggling teens, child behavioral problems. With her extensive psychiatric experience she is currently on-call at the Nantucket Cottage Hospital for psychiatric emergencies. http://nantucketfamilycounseling.com/

It seems that everyone wants to know what goes on inside the therapist’s office. People secretly wonder if a session resembles a chapter from Sybil, untamed and insane. Movies, television and reality series often try to depict the scene, with an awkward resemblance of accuracy, but somehow always missing the mark.  Dr. Phil and Dr. Drew attract a huge audience; even I am drawn to the drama as they delve into families’ lives inside the screen in my living room, rushing through treatment with five commercial interruptions.

People nervously crack a joke if I am introduced at a party as a “therapist”, quick to point to their friend standing next to them stating, “This guy really needs your help”. Men in white coats, Prozac moments, loony tunes; all flip verbiage said with an uncertain tone by people who secretly wonder if they too are a little crazy. Like I am a clairvoyant that can see right through them . . .  analyze this. And although I am one of the silliest girls around, I never can quite bring myself to laugh. I guess one doesn’t laugh at their passions.

I have been in therapy for over thirty years now. I do this for a living, everyday, hour after hour. To me, it is serious business. Taking a stranger in, staying right there with them, as they take the first incredible step to put their crumbling life back together. It’s hard to describe what happens on the proverbial couch, every person so different, some situations tragic, others not so much.

People do not come to therapy when things are going well. Usually, the person feels as if it’s pretty much the end of their world. Hopeless, helpless, in unbearable pain, a bottomless pit . . . the term “depressed” falls short of an adequate description. Discovery of a spouses’ infidelity, a child’s drug addiction, cancer, a friend’s betrayal, alcohol or drug abuse, loss of a job, financial worries, death, and a hundred other scenarios, lead them to me. None of the stories or the feelings are ever quite the same.

As a therapist, I spend countless hours sitting with my patients, listening, talking, reflecting and just being. Sometimes I touch their shoulder, their hand, pass them the box of tissues or make them a cup of tea. In the sanctity of my office, we talk about what it feels like to live, what it would feel like to die and what it would feel like to make a dartboard out of their nemesis’ face. We talk about who would attend their funeral, who they are going to call today when they need a friend and why their ex-husband never really looked good with gray hair. I have painted little girls’ nails, put hair spray on a chemo wig and scrubbed makeup off a gothic teenager. Some bring in their dogs, their kids, their parents, while others have only their plain loneliness to offer. I have sat in silence, in tears or in laughter. It’s all a little crazy. Hour upon hour, as the healing process for those most wounded is indeed the slowest. It sometimes drags and it can be dark. Indeed a black hole. I can’t leave that space they are in, because I have signed on to hang in with them. A lot of people in their lives have bailed because of it. It’s a fine line between helping someone with toxicity and absorbing it yourself.  I think, “Is this person ever going to get better?”

And the answer is, yes, they invariably do. Not with all the king’s horses and all the king’s men, but by the will to survive and an inner strength that therapy helped them access. When the bleakness lifts, it’s as if they bring in a little more light each time they walk into my office and sit on that couch. I slowly begin to see a twinkle in their eye, a glow, a spark, although fragile and tenuous, emerging.

This, for me, is the magic of therapy. It saves people’s lives. All of the conversations that we have had, most with no immediate results, begin to add up and overtake the faulty oppressive thoughts that first brought them into my office. They begin to make sense, notice other people, and look forward again. They can now laugh at situations as well as themselves. Truthfully, life can be ridiculously funny. They no longer think about dying, because they have too much living to do.

Their need for time with me begins to dwindle and they are able to connect with me now only every other week, every month, and finally, “I’ll call you if I need you”. Said hesitantly at first, most are somewhat sad to say goodbye.  Occasionally, sometimes years later, I do run into someone at the store or on the street. The most common reaction is a big hug, smile and a “great to see you”. I can barely remember the shadow of that soul that I first encountered in my office. But it is the same person. Just whole again. It is amazing.

This is therapy.

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