Change

Changing as I stay the same.
Showing posts with label ethics. Show all posts
Showing posts with label ethics. Show all posts

Wednesday, April 22, 2020

The Pandemic Pull




It’s a confusing time to be alive, amiright? I honest-to-God feel like I’m living in some kind of macabre TV show, a Groundhog Day/The Good Place/The Walking Dead mashup.

Every day brings a new challenge, usually in the form of an ethical or moral conundrum. We don’t want the economy to collapse, so we want to open up—but if we open up too soon, we may amp the spread of virus and overwhelm our healthcare systems. We yearn to see our family and friends, but wouldn’t be able to live with ourselves if we unknowingly carried COVID-19 to anyone we love. We want to support our local food places by ordering take-out, but are we bringing virus home on the food containers?

The very hardest thing for me lately, though, has been the polarity of my emotional responses. They are, in layman’s terms, “all over the fucking place.” Those who know me well know I’ve never exactly been a “medium emotion” kind of gal—I tend to have big feels. But this? The reactions that are coming with this pandemic bullshit? I’ve never felt so drawn and quartered, so pulled in very different emotional directions all at once:

I am in love with humanity for the sacrifices many have made to protect people at risk. I am disgusted with the many who continue to act in ways that puts their entitlement, shortsightedness, and lack of empathy on display. I am so grateful to be able to work: for the sense of agency and usefulness, the structure, the income. I am exhausted with the weight of others’ despair, anxiety, and grief. I want to be as connected as I can to my family and my world. I want to be alone as much as possible. I want to swallow the news cycle whole. I want to never hear the words “uncertain times” again. I am doing enough. I am never enough.

(I honestly get tired just reading that paragraph.)

If I were my client, I'd say to me, “You don’t have to choose. You don’t have to be either happy or sad, you can be both. People are neither entirely good nor bad, they’re both. Let it all in. Make room—I know you can. Let all the feelings make you bigger, so that you have more space in you the next time something is hard.”

And yet. Suggesting to anyone that they can hold all of these pandemic feels at once—the rage and the compassion, and sorrow and the hope, the restlessness and the acceptance—it’s a big ask. It’s so much holding. It’s exhausting. And I’m feeling it.

And I wonder if you are, too. 

Tuesday, June 9, 2015

Breaking the rules

I broke one of my own rules for being a therapist today.

I cried.

You wouldn’t know it from watching how “therapy” is done on TV, but therapists have a lot of rules to follow. Some of them are set for us by ethical codes of our profession—things like “keep client information private and protected” (duh) and “don’t have sex with clients” (double duh).

And then, most therapists have these other rules that we place upon ourselves, things that have less to do with the general ethical codes and more to do with our own personalities, preferences, and theories of how we help people.

“No crying” isn’t a hard and fast rule for therapists. In fact, it’s subject to some debate within our field. I poignantly remember getting close to tears once with one of my very first clients. Because I was still in training at the time, I brought it up with my peers and supervisors. Through discussion, I came to more fully appreciate a powerful truth: that therapy is not a one-size-fits-all endeavor. I learned that probably each of us would handle this in our own way, and that this was okay, because we each have our own unique personalities and ways of helping people. And that day I set my own personal standard on crying in session.

But today, I deviated from my personal standard and cried. I will usually let myself get to “misty eyes,” and that’s my cutoff. That’s where I internally say to myself “Alright, this isn’t about you” and tuck in the tears. Today I couldn’t. My eyes filled up and a couple of tears spilled over. I wasn’t sobbing or totally losing my shit in any way. Yet it was definitely crying, and I know my client saw.

I like to think that I chose that no-crying standard for benevolent reasons—to benefit and protect the client. I want to prevent therapeutic interactions from becoming “the Allison show”—that is, the heart of therapy should be the client’s experiences, not mine. In order to really be effective, I need for clients to know and believe that I’m hanging in there with them, no matter what they’re talking about and what pain they are expressing. I fear that if they see me cry, they might start to think they are hurting me and start holding back on me. This is the last thing that I want, as people are often already holding back a lot in their lives outside of therapy, in order to protect themselves and others.

Yet, as with so many things in life, there is another way to look at this. And this other perspective could make me out to be a hypocrite (again, damnit!).  In my point of view, crying is simply an expression of sadness. I also believe that letting others see our emotions is a genuine and hence courageous thing to do -- showing others who we are and what moves us is one thing that helps us others feel connected to us. (I say these things to people all the time! All. The. Time.) So, in showing clients that I’m moved by what they have said, am I possibly modeling an appropriate expression of emotion and maybe even aiding our connection?

*big gulp, tiny voice* And, is it also possible that the real reason that I don't let myself cry in front of clients is because I dislike others, client or not, seeing my vulnerability? (Damnit.)

IDK, being a therapist and making therapisty decisions is hard.

What I do know is that my emotional control in therapy has been tested lately. I've heard some of the saddest stories that I've ever heard; often situations that are very personally relatable. And while I do work hard to keep my own personal baggage out of the therapeutic interaction, at the end of the day I'm still human. The things that people say, that I witness through listening to client's stories with my heart and playing those stories through in my mind-- they affect me. Some stories are told with such immediacy and detail that the hardest thing in the world would be to not see it through my client's eyes. Sometimes the pain in the room is so palpable that it steals my breath, like I’ve been socked in the gut.

To be both naturally imaginative and empathic is a blessing-- these attributes make me who I am, and they are the backbone of my work as a therapist. Yet these very same attributes are the ones that keep me up at night and that allow me to imagine terrible things happening to me and those that I love-- and they're the personal characteristics that are making me cry in session! Stupid paradoxes everywhere!

Anyway, yes, the tears have been happening and I think they’re likely to keep on happening. Sometimes they will behave themselves and stay in my eyes, and other times they may go rogue on me and escape. As you can probably tell from the rest of this post, I’m still not 100% sure how I feel about this level of personal sadness being out in the open for clients to see. I'm well aware that there is processing that I can and will do with clients if I cry, and that this can give me a sense of where to go from there. I'm just still not sure I should be letting it happen in the first place.

Instead of the nice tidy resolution that I seem to go for in these posts, today I’m going to have to leave stuff hanging. I’m still working on figuring this whole thing out. Maybe I’ll stick with my old no-crying rule. Maybe I’ll come up with a new rule. I'm just going to roll with the ambiguity of it all today, and find solace in knowing that I’m working on understanding.  Life’s messy, folks.

And in the spirit of dialogue and progress, I’d like to end this post with a question: If you were (or are) a client in therapy, what would it be like for you if your therapist was so moved by something you said that s/he cried?