Dear Young Therapist: Perspective is Everything

When I was in fourth grade I became somewhat obsessed with learning about the native people of the Americas. I poured through all the age-appropriate books in my school and public libraries, wrote age appropriate papers, and made a few age appropriate art projects. 

Somewhere tucked away in a box is a coffee stained crayon drawing that I made depicting the life of Seminole Indians. Mr. Sturgeon, my fourth grade teacher pictured on the left, wrote me an apology for the coffee stain. 

I was particularly fascinated with the people who lived in Central and South America: The Aztecs, Incas, and Mayans. The age appropriate books I read showed images of the savagery of the Aztecs. My young mind was particularly aghast over their sacrifice of humans to their sun god. I was horrified at the descriptions of beating human hearts being removed from people with flint knives. I worried about how that must have felt for both the sacrificed as well as the priest wielding the knife. 

It was such a strange juxtaposition--being attracted and repulsed at the same time. 

What I didn't know in fourth grade was that the history I was learning was from the perspective of the conquerors. We tell stories of native peoples as savages, in part, to reinforce a white Western European superiority. 

Myriad are the things that weren't included in suburban grade school lesson plans.

I got to thinking about all of this while reading the book 1491: New Revelations of the Americas Before Columbus by Charles C. Mann. There are three interesting passages worth mentioning here. 

The second myth is that in its appetite for death as spectacle the Triple Alliance (Aztec Empire) was fundamentally different from Europe. Criminals beheaded in Palermo, heretics burned alive in Toledo, assassins drawn and quartered in Paris--Europeans flocked to every form of painful death imaginable, free entertainment that drew huge crowds. London, the historian Fernand Braudel tells us, held public executions eight times a year at Tyburn, just north of Hyde Park. (The diplomat Samuel Pepys paid a shilling for a good view of a Tyburn hanging in 1664; watching the victim beg for mercy, he wrote, there was a crowd of "at least 12 or 14,000 people.") In most if not all European nations, the bodies were impaled on city walls and strung along highways as warnings. "The corpses dangling from trees whose distant silhouettes stand out against the sky, in so many old paintings, are nearly a realistic detail," Braudel observed "They were part of the landscape" Between 1530 and 1630, according to Cambridge historian V. A. C. Gatrell, England executed 75,000 people. At that time, its population was about 3,000,000, perhaps a tenth of that of the Mexica empire. Arithmetic suggests that if England had been the size of the Triple Alliance, it would have executed, on average, about 2,700 people per year, roughly twice the number Cortés estimated for the empire. France and Spain were still more bloodthirsty than England, according to Braudel.  
In their penchant for ceremonial public slaughter, the Alliance and Europe were more alike than either side grasped. In both places the public death was accompanied by the reading of ritual scripts. And in both the goal was to create a cathartic paroxysm of loyalty to the government--in the Mexica case, by recalling the spiritual justification for the empire; in the European case, to reassert the sovereign's divine power after it had been injured by a criminal act. (Mann, 2005, pg 145-156)

One wonders who the savage was. It's also extremely interesting to note that the population of England in the 1500s was only a tenth of the size of the population of the Aztec Empire at the same time. 

In what may have been the first large-scale compulsory education program in history, every male citizen of the Triple Alliance, no matter what his social class, had to attend one sort of school or another until the age of sixteen. Many tlamatinime (he who knows things) taught at the elite academies that trained the next generation of priests, teachers, and high administrators. (pg. 146)
Imagine that. Every male child had a compulsory education. Meanwhile, Europe was trying to pull itself out of the dark ages and only the most wealthy of boys had access to education. Perhaps only about a third of the population was even literate.

The native people of the Americas had a rich intellectual and philosophical tradition that most of us have never even heard about. Our high school and college curriculums, still busy promulgating the myth of the Native American savage, teach a history of ideas and thoughts that are completely rooted in white Western European thought.

I'm embarrassed to say that it wasn't until I got to graduate school the second time that I started discovering intellectual traditions from other parts of the world that had been hidden from me.

Though I shouldn't have been, I was shocked when I recently signed up for an edX class from the University of Texas/Austin. The course, Ideas of the 20th Century, could better be called White European Ideas of the 20th Century. From what I've seen so far, the only ideas the course views as worthy to teach are ideas rooted in white European thought. It's as if no one from any other continent had any thoughts that pertain to the development of who we are.

Of course there are lots of ideas and rich intellectual thoughts that have grown out of every corner of the world. The book 1491: New Revelations of the Americas Before Columbus offers just one example of the Triple Alliance leader, teacher, and poet Nezahualcóyotl. If you'd like to hear about the language he spoke and wrote in, Nahuatal, try here or here.

Not forever on earth; only a little while here.
Be it jade, it shatters.
Be it gold, it breaks.
Be it a quetzal feather, it shreds apart.
Not forever on earth; only a little while here. 
Nezahualcóyotl (1402-1472) 
Like a painting, we will be erased.
Like a flower, we will dry up here on earth.
Like plumed vestments of the precious bird,
That precious bird with the agile neck,
We will come to an end. 
Nezahualcóyotl (1402-1472)

So young therapist, you might be wondering what this has to do with our craft of psychotherapy. 

Increasingly, and without much thought or discussion, psychotherapy has become a colonial force. Our ways of understanding people, cloaked in the vestments of science and authority, have supplanted other ways of understanding the human experience. Our ways of knowing as a therapist, almost entirely rooted in white European thought, have been promulgated around the world. 

We make the theories, use them to describe and diagnose normal and abnormal, and enforce them through our therapies. Psychotherapists have, in many ways, become modern day conquistadores.

Kenneth Gergen writes:

My concern extends as well to the slow eradication of alternative discourses of understanding the self, and the alternative forms of action that are invited by these discourses. We are losing, for example, the rich discourse of deficit provided by various religious traditions. The discourse of "guilt," "need for spiritual fulfillment," and "getting right with God," does not invite therapy and medication, but prayer, spiritual consultation, and good deeds. There are also many common vernaculars, or grass-roots terms, that can be enormously serviceable. Being "hung up on her," has entirely different implications than being "obsessed;" having a "case of the blues" is indeed an honorific term, in contrast to having a "depression." "Working too hard," having an "overly indulgent chocolate craving," or "loving sex too much," invites dialogue with friends, loved ones and colleagues, as opposed to entering an addiction program. As "quick to anger," "highly excitable," "fear of flying," "unrealistically suspicious," "too active," and "shy" are increasingly translated into a professional terminology so are the capacities of people in their local surrounds to deal with the normal infelicities of life in a complex society. Much needed at this juncture are instigations to grass-roots resistance, movements not likely to kindle the interests of professional psychologists."

So young therapist, are you paying attention the ways in which your practice includes the colonization and hegemony of Western psychology? Are you aware of the ways in which you are wielding your power to describe and name behavior--and dictate what is acceptable and unacceptable experiences--based on your own personal world view? Do you regularly and without thought substitute your judgements and understandings for those of your patients? Are your interventions based on problems you want to solve or those your patient wants to solve?

A final thought from the Task Force on Indigenous Psychology:

Psychology, like any other language game, is a living conversation, for which translation is the key to the perpetuation and permutation of the discourse. As Western psychology is translated into other cultures, the more we make sure that the influence is going both ways, and the more we allow conflicting voices to inhabit the terms we use in psychology, the more likely it is that alternative ways of doing psychological science will emerge.

Can you find the courage to listen closely to your patients and let their own wisdom emerge?

For more letters to a young therapist see Dear Young Therapist: Don't Be Afraid of the DarkDear Young Therapist: That Time My House Burnt DownDear Young Therapist: Cultivate Patience and Listen to the MusicDear Young Therapist: Consider Your De Rigueur Requirements | The Post-Doctoral Tie IncidentDear Young Therapist: Are You Ready to JumpDear Young Therapist: Perspective is EverythingDear Young Therapist: Sometimes We Can't Put Humpty Back Together AgainDear Young Therapist: Sometimes Race and Sex MatterDear Young Therapist: Don't Be Afraid to Love; and Dear Young Therapist: Allow for the Unexpected.


Dear Young Therapist: Sometimes We Can't Put Humpty Back Together Again

Meeting Humpty Dumpty/Joanna Pasek
Humpty Dumpty sat on a wall,
Humpty Dumpty had a great fall;
All the king's horses and all the king's men
Couldn't put Humpty together again.

We don't like to admit that things that are broken cannot always be repaired. We develop empirically supported interventions that demonstrate our facility for erasing symptoms of mental illness and curing the ills of the psyche. Chemists and biologists develop powerful substances that right the wrongs of the miniature chemical metaphors for mental illness inside the synaptic cleft.

We wrap ourselves in god-like metaphors of power, control, and authority. We heal the wounded. We restore the broken to a state of wellness. We right that which was wronged. 

We try to place all of the evils, pains, and terrors of our world back into Pandora's box with the hope of this cure called psychotherapy. Our way out of mental illness, a hope for a different future, has become interwoven with these notions of restoration and repair. Returning things to the way they were.

I've grown convinced this is not always possible. Even if it was, I'm not sure it is advisable. 

...and for those we can't repair? We call them treatment resistant. We tell them they don't want to get well. We tell them they are not ready to get well. We find any number of ways to subtly make them responsible for being broken, for not allowing us to repair them, or for having experienced a trauma from which there is no repair.

I don't think that's advisable at all. 

On any given day any number of survivor stories pass by my eyes on the internet about those who have experienced sexual abuse. As our seemingly endless "war on terrorism" slogs on, I see an increasing number of wounded soldiers displayed for pubic consumption. Stories like these make me angry and sad, hopeless and hopeful. Thousands of tales of lives broken by sexual and physical trauma. Thousands of tales of lives restored through the power of hope, courage, caring, and empowerment. 

As someone recently mentioned to me, some do come out of a traumatic experience stronger. Some find a certain kind of beauty in the growth that occurs after a trauma. Some isn't all. In fact, some is a far way away from all. 

Every 65 minutes a veteran of the US Military commits suicide.

Adults who have experiences sexual abuse are twice as likely to have a suicide attempt. 

What happens when that which was broken cannot be restored? Who speaks for those who are broken and either cannot or will not be repaired?

A huge industry of self-help groups have grown up around the books A Courage to Heal and Victims No Longer. While both books, in many ways, put childhood sexual abuse on the map, they both also perpetuate a disturbing trend toward a wish to repair that which remains unrepairable. An industry has grown up around us depicting survivors of sexual and physical traumas as strong, proud, and invincible warriors. I wince every time I see this meme replicated. I realize saying this may make me somewhat unpopular in some circles of the sexual abuse healing industrial complex.

I think we've lost our way, young therapist. In following our culturally prescribed roles to be powerful healers we've forgotten that not everything we touch can be restored. Sometimes, no matter how hard we try, we cannot put Humpty Dumpty back together again.

I'm not even sure it is important that we even try.

It is not that I am against strong, proud, and invincible warriors. I think those who find their journey takes them to these places are mighty fine. They've found their voices and found ways to make their lives a life worth living. 

What about the ones who find that no measure of gold or silver can hold the pieces together again in a fashion more beautiful than that which existed before? What of those who tried kintsukuroi and found they have nothing but a pile of pretty broken pieces?  What of those who, like Humpty Dumpty, have fallen and learned that all the kings horses and all the kings men cannot put them back together again?

Who speaks for them?

“If people bring so much courage to this world the world has to kill them to break them, so of course it kills them. The world breaks every one and afterward many are strong at the broken places. But those that will not break it kills. It kills the very good and the very gentle and the very brave impartially. If you are none of these you can be sure it will kill you too but there will be no special hurry.” -- Ernest Hemingway

Somewhere along the way, young therapist, we've forgotten that our most powerful tools are not those which fix broken things. Our most powerful skill is our presence and our attention. 

Don't get lost in the illusion that therapy is about fixing the broken parts of people. It's nice when we can fix things. Don't get me wrong. It's just that fixing isn't our most important task. Somewhere in our training and acculturation as a therapist we learn to stop listening and get lost in our own theories of how to fix things. We move from being having a role of a midwife of dialogue to the role of a high-tech mechanic. 

The map is not the territory. -- Alfred Korzybski

The description is not the described. -- Jiddu Krishnamurti

The map is not the thing mapped -- Eric Temple Bell

Sometimes we therapists have a very helpful map to offer. Other times our maps are a hinderance and obscure the road ahead for our patients. In the end, the best maps are those which our patients create. The ones we have to offer are just temporary aids. 

Therapy is about helping people see the broken parts of themselves. Therapy is about being witness to that which was broken. Therapy is about co-creating a space where our clients have a place to feel fully broken, to feel helplessness and despair, and for clients to discover in their own ways the contours of the territory ahead. 

Don't forget to listen, young therapist. Create the space for people to be broken. Allow your patients the dignity of the agency to decide what lay ahead. 

Help them find their own maps and their own territories. 

Do not accept any of my words on faith,
Believing them just because I said them.
Be like an analyst buying gold, who cuts, burns, 
And critically examines his product for authenticity.
Only accept what passes the test 
By proving useful and beneficial in your life.
--The Buddha 

I can describe the mountain, but the description is not the mountain, and if you are caught up in the description, as most people are, then you will never see the mountain.
-- Jiddu Krishnamurti

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Dear Young Therapist: Don't Be Afraid to Love

"Graduation" by Caroll Lewis
Dear Young Therapist:

Love is a word you've probably not heard in your training. It's probably not appeared in your textbooks, been a topic in seminars, or come up in conversations with your clinical supervisors.

If you've talked about love at all, you've probably talked about avoiding it. You might have even been taught that love is a hinderance to therapy.

The messages about love that I've learned in the past twenty-one years of clinical practice are clear. Love is something that must not be discussed between patient and psychotherapist. It certainly is not something to be experienced--and if it is--it should be concealed and unspoken. Love is too dangerous. It is too confusing. The risks are too great. Patients get confused in therapeutic relationships and mistake care for love. Some patients, traumatized by violence, are too fragile to understand that love does not have to be sexual.

Perhaps you've been taught to be neutral, objective, relatively non-emotional, and essentially impersonal. Perhaps you've even been taught that it's useful to deprive your patients of the emotional connection they want in order to foster growth and achievement of therapeutic goals.

I was admonished by a supervisor once for gratifying a terminally ill patient's needs by expressing care for him. She was concerned that I wasn't giving him the opportunity to work through his infantile infintile (thanks CS for finding my parapraxis) dependency needs.

Later, as a postdoctoral fellow, I was taught to never tell a patient that I was proud of them. It was explained that it was too complex of a feeling and patients would get easily confused. I must not ever express love or pride. Patients need to learn to accept the limitations of the therapeutic relationship so they can learn to tolerate not getting their needs met in their other relationships.

I've also learned some other things along the way.

  • I wasn't even 20 years old when I had an internship at a rape crisis center. I was left alone in a room to be supportive and helpful for people who endured unimaginable traumas. I had no skills, no words of advice, and certainly no therapeutic interventions. I did the only thing I knew how to do: I cared deeply for my patients and loved them. I never said a word of this, of course. I had already absorbed the notion that love is an unmentionable word in clinical contexts. Still, this was the first time I became aware that expressing care and concern (and genuinely caring and being concerned) for people--in and of itself--can be healing. 
  • Two years later I was living in Ithaca, New York. It was my last day working at a supervised apartment program for adults who had developmental disabilities and mental illness. The residents threw a surprise party for me. I walked into one of the apartments to do my last check and I was surprised with a song. After a rousing chorus of "For He's a Jolly Good Fellow" each one of the residents and staff gave me a hug. Most of the residents whispered in my ear that they loved me. I whispered quietly into each of their ears "I love you too." I worried what people would think but said it anyway. It was true.
  • Two years after that I sat on the back stoop of a shelter for runaway and throwaway teens. A male resident had ran away from the runaway shelter. As he was thinking of returning, I sat with him while he raged against the world and how poorly he had been treated. I looked at him with all the love in my heart. I remained silent fearing what would happen if he heard those words. 
  • Three years later I sat with an gentleman in his late 50s. He'd been diagnosed with HIV before the virus even had a name. He was having a bad day--filled with pain from the side effects of his medications. He was afraid of dying alone. I sat next to him on the couch and held his hand. I loved him and wished I had the courage to tell him that.
  • Three years later, I met two women that forever changed the course of my career. My supervisors and teachers, Robin Cook-Nobles and Judy Jordan, regularly--and fearlessly--talked, taught, and told me that it was okay (and powerful) to love my patients in appropriate ways. I vividly remember the rainy afternoon Robin said that it was okay to love patients, and okay to talk about it. I've never heard a psychologist say that aloud before. I've never heard a psychologist say it again since leaving the Stone Center.
  • Later that year I drove to do the oral section of the second part of my comprehensive examinations. My intervention, though concealed with flashy prose and the relational cultural model of the Stone Center, rested in my love of my patient and this song. I almost failed. My intervention was not seen as a strong one. I was not doing things like I was supposed to--I failed to conform to accepted protocols. My stubbornness and belief in the inherent worth of my patient carried the day. I passed.
  • A few years after that, as a post-doctoral fellow, I worked with a rather ornery teenager. Rather than talk with me and tell me how much he disliked me and the rest of the world, he sprawled himself out on the couch and pretended to sleep. Every so often one eye would peep open to see if I was still paying attention. I sat for the entire hour focused on him, loving him, and imaging how his parents might have (or might not have) just sat gazing at him with love when he was a tiny baby. My supervisor, Louise Ryder, seemed moved to tears when I told her this story. I was too. 

I've developed a good deal of technical brilliance in the last twenty-one years of working with people. I can create masterful interventions in a variety of modalities and nimbly conceptualize people and problems from a variety of theoretical orientations. You'll need to learn how to do this too, young therapist. It's a necessary part of learning to be a good at what we do.

Technique and skill, however, are not enough. Don't let yourself dwell too much thinking you are something special. Most trained monkeys can develop technical brilliance with the number of hours we spend in supervision and class.

There are more important things that cannot be taught. They must be discovered.

You'll need to learn to loveLoving patients is a dangerous method. Yet in the end, I think you'll learn that it is the only method that you'll keep by your side--day in and day out--for your entire career.

Love is the only method and theory that I have. It is the place from which every action I take as a psychologist originates from--at least on days in which I am not cranky. I suspect many other therapists, of all training and orientations, would discover the same after wading through years of injunctions against and fear about love.

When I graduated from high school my mother gave me the book her mother gave to her when she graduated from high school. In some ways, this passage started my development as a psychologist. Vicktor Frankl writes in his book Man's Search for Meaning:

Love is the only way to grasp another human being in the innermost core of his personality. No one can become fully aware of the very essence of another human being unless he loves him. By his love he is enabled to see the essential traits and features in the beloved person; and even more, he sees that which is potential in him, which is not yet actualized but yet ought to be actualized. Furthermore, by his love, the loving person enables the beloved person to actualize these potentialities. By making him aware of what he can be and of what he should become, he makes these potentialities come true.

More recently, reading Gail Hornstein's book To Redeem on Person is to Redeem the World: The Life of Frieda Fromm-Reichmann,  I came across this passage from Erich Fromm's book The Anatomy of Human Destructiveness:

To have faith means to dare, to think the unthinkable, yet to act within the limits of the realistically possible; it is the paradoxical hope to expect the Messiah every day, yet not to lose heart when he has not come at the appointed hour. This hope is not passive and it is not patient; on the contrary, it is impatient and active, looking for every possibility of action within the realm of the real possibilities. 

So there you have it. Love and Faith. The two bookends of my professional practice as a psychologist. Deceptively simple. Incredibly powerful. Often scorned by the professional community.

I'm old enough to no longer care how my fellow psychologists evaluate me. I'm skilled enough to know how to wield these twin tools of relational growth and change within the safe boundaries of a therapeutic relationship.

I'm thankful that I've never met a patient that I couldn't love or couldn't learn to love. It's from that space that I begin to see the seeds of where a person might be able to go, grow, and let go. It's from that space that I can find the confidence to let go of wanting a patient to be something I need them to be (or society needs them to be) and let them go about finding what they need themselves to be.

Still, young therapist, I don't frequently tell my patients that I love them. It is often dangerous and disruptive to use the word. Patients can become incredibly confused and conflicted. Too many therapists also become confused and conflicted.

Just because love is dangerous, doesn't mean it shouldn't be thought about.

I am not afraid to love and to say that I do when a moment of genuine honesty is the best intervention. Don't forget this, young therapist. Don't forget that our work is built on a foundation of faith in humanity and love of the person who sits across from you.

The flashy (or boring) masterful interventions and protocols you learn are necessary. Caring and loving and believing in humanity is necessary. Neither, on their own, is enough to accomplish much of anything. Joined together you have the possibility for movement and growth.

You need to both become a master at your craft and a master at loving a fellow human being--being with a patient, loving them, caring for them, and having faith in them--in combination with masterful interventions--that allows another person to find themselves.

We wither and die alone.

We grow in connection with others. We grow in being loved by another. We grow in finding that after all we've experienced, you've got the love inside--it's been there all along.

I had a dream that our hearts are like flowers
opening up every time that we love
and I'm wondering if we just try and risk everything for love
how can we ever go wrong
Nobody said it would be easy
nobody said it would be fair
all we can do is try to keep our fears from running us
just let our innocence be our cure

For more letters to a young therapist see Dear Young Therapist: Don't Be Afraid of the DarkDear Young Therapist: That Time My House Burnt DownDear Young Therapist: Cultivate Patience and Listen to the MusicDear Young Therapist: Consider Your De Rigueur Requirements | The Post-Doctoral Tie IncidentDear Young Therapist: Are You Ready to JumpDear Young Therapist: Perspective is EverythingDear Young Therapist: Sometimes We Can't Put Humpty Back Together AgainDear Young Therapist: Sometimes Race and Sex MatterDear Young Therapist: Don't Be Afraid to Love; and Dear Young Therapist: Allow for the Unexpected.
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Empirically Supported Protocol Based Psychotherapy

Necessary, but not sufficient.
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Pretty in Pink: Two Vintage Chinese Men

Two Chinese Men in Matching Traditional Dress, c, 1870s 
While this image of two Asian men does not portray the men as having a particularly intimate relationship, it does show men who usually don't find their way onto websites chronicling intimacy between men. The vast majority of vintage images that bloggers post depicting intimate relationships between men are of white men. It's rare to find images of men from other races.  

This image is also also an excellent example of how our unconscious associations with certain symbols shape the meaning of what we see. This picture on the left of two Asian men with pink robes--they must be gay, right? 

The pink robes worn by the two men in this picture read to many bloggers as something that constitutes gayness. It's not necessarily a signifier of sexual orientation or attraction. Beyond the pinkness, I can't fathom why people listing this image on blogs and Tumbler would see this picture as one that depicts a vintage gay relationship.

The thousands of observations we make about people in our silent and mostly unconscious process of categorizing and stereotyping people into easily understood categories aren't any more accurate that are assumptions about the color pink in this photograph. Our categories and stereotypes are useful heuristics--but they need to be constantly evaluated and checked with actual data.

In all probability, thes
e men are not gay. It's unclear whether or not they even have any sort of relationship (intimate or not). 

Perhaps a reader with knowledge about 19th century Chinese history might come upon this blog and share some thoughts (anyone read Mandarin? The text in the background might say something interesting). 

The men in the image, the story about why they were captured on film, and who the photographer was are currently unknown. It's fairly easy, however, to find out a lot about some basic identifying information about the image. 

This albumen silver print from a glass negative, produced sometime in the 1870s, is owned by the Metropolitan Museum of Art. The image, not currently on display in the museum, is one of 8,500 photographs from the Gilman Paper Company Collection. If you want to do some very deep research on the people who collected this photographs, check out these two articles about the rise and fall of the Gilman family fortune: here and here

Beware of what you think you see when you look at photographs. We easily see what we want to see in vintage photographs. It's much more difficult to stand back and let the image tell us the story it has to tell.

This goes for viewing people in your day-to-day life, too. It's always more challenging--and rewarding--to stand back and let a person tell their own story rather than to hear the story we think they should tell.

For more images of vintage men and their relationships (some gay, some straight) visit: Two Men and Their DogAdam and Steve in the Garden of Eden: On Intimacy Between MenA Man and His DogThe Beasts of West PointVintage Men: Innocence Lost | The Photography of William GedneyIt's Only a Paper Moon;Vintage Gay America: Crawford BartonThese Men Are Not Gay | This Is Not A Farmer | DisfarmerDesire and Difference: Hidden in Plain SightCome Make Eyes With Me Under the Anheuser BushHugh Mangum: Itinerant PhotographerTwo men, Two PosesPhotos are Not Always What They Seem,Vintage Sailors: An Awkward RealizationThree Men on a HorseWelkom Bar: Vintage Same Sex MarriagePretty in Pink: Two Vintage Chinese MenMemorial Day Surprise: Vintage Sailor LoveMemorial Day: Vintage Dancing SailorsThe Curious Case of Two Men EmbracingThey'll Never Know How Close We WereVintage Love: Roger Miller Pegram,Manly Affections: Robert GantHomo Bride and Groom Restored to DignityThe Men in the TreesThe Girl in the OuthouseTommy and Buzz: All My Love,Men in Photo Booths, and Invisible: Philadelphia Gay Wedding c. 1957. You can also follow me on Tumblr.

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Confessions from a Reparative Therapist

I admit it. I am a reparative therapist (also called conversation therapy)--just not the kind you think. As a psychologist I have worked with people who have sought to be relieved of unwanted same sex attractions since the dawn of my practice in 1997. Shocked? Expecting some sort of twist here? Of course there is a twist. Before we get to the twist, let's take a look at what the pseudo-scientific organisation called the National Association for Research and Therapy on Homosexuality, commonly called NARTH, has to say. This organization, by the way, has been called a hate group by the Southern Poverty Law Center.

NARTH writes:
Reorientation therapy is simply psychological care aimed at helping clients achieve their goals regarding their sexual attractions, sexual orientations and/or sexual identities. Reorientation is not decidedly different from other therapies. There are many psychological approaches to helping clients with unwanted homosexual attractions. All approaches supported by NARTH are mainstream approaches to psychotherapy. The term "Reparative Therapy" refers to one specific approach which is psychodynamic in nature, but not all who offer therapy aimed at orientation change practice Reparative Therapy.  
The Irreverent Psychologist (that's me!) wonders just what mainstream approaches to psychotherapy NARTH is speaking about. As you may have noted in another blog post of mine, not a single mainstream professional association endorses "reorientation" therapy.

Let's look at one more bit of what NARTH says before I get to my practice of reorientation therapy:
We respect the right of all individuals to choose their own destiny. NARTH is a professional, scientific organization that offers hope to those who struggle with unwanted homosexuality. As an organization, we disseminate educational information, conduct and collect scientific research, promote effective therapeutic treatment, and provide referrals to those who seek our assistance. NARTH upholds the rights of individuals with unwanted homosexual attraction to receive effective psychological care and the right of professionals to offer that care. We welcome the participation of all individuals who will join us in the pursuit of these goals.
It all sounds good, doesn't it? This business about achieving one's goals pertaining to their sexual orientation makes for a lovely thought, right? Remember the part about choosing their own destiny. This will be important.

Let's talk about the work I do, shall we?

I'd like to introduce you to four patients. They are all representative of real people. I've changed biographical details to protect their identities and privacy. I've asked for their permission to include them in this way: they have all agreed. I am thankful for the people who are behind these stories for allowing me to share a small portion of their experience. 
  • A sixteen year old male teenager coming to therapy because he's worried he might be gay.
  • A Mexican-American woman with elderly parents, struggling between staying with her same-sex partner or caring for her aging parents who believe homosexuality is a sin.
  • A businessman in his 50s who stayed closeted out of fear of his business would suffer. Facing the second half of his life, he struggles between satisfying his desire for companionship with men and maintaining strong business relationships in his conservative line of business.
  • A hipster 20 something woman, raised by a father who was a Baptist minister who sexually abused her. "I'm not even sure I'm gay, I think it might just be something that happened because of my father."
In each of these clinical situations, a person grapples with important concerns. A teen grapples with schoolyard bullies, his Catholic upbringing, parental expectations, and the confusing desires of an adolescent.  A Mexican American woman struggles with a conflict between her heart and a cultural expectation to, as the youngest daughter, stay close to home and care for her parents. A businessman struggles with strong feelings that same-sex attraction is negative, a strong attraction to men, and making a choice to risk loosing life-long friends who might reject him for his sexual orientation. A hipster struggles with separating out desire, love, and attraction from trauma and abuse.

Four very different people, with very different life situations, clinical presentations, and developmental issues. Each of them, however, questioned their same-sex attraction at one point or another in their treatment with me. Among the things they wanted to explore and work on was furthering their understanding of their same-sex attraction.

Each of these four patients, at one point or another, had the goal to remove unwanted same sex attraction. Here's where it gets complicated. Who gets too decide what the goal is? Who is deciding whom's destiny?

I have a quiz for you. Don't worry, it's painless and will be over before you know it. Who decides whom's destiny in a psychotherapist-patient relationship? Circle one: (and grammar people, is it who, whom, whose, or whom's -- I'm sure someone will tell me.)
  1. The patient
  2. The psychologist
  3. The intersubjective self
Many of you might circle number one. I like that choice. Almost without exception, I accept my patients exactly where they are at. It is not for me to decide what makes for a life worth living. Rather, it is for me to ask really good questions that help open and explore new ways of looking at their life and provide tools for my patients to be more effective agents in their life (thus making for a life that they make happen, rather than a life that happens to them). 

Choice number one, however, doesn't always make sense. Sometimes it is choice number two. For a large portion of my career, I've worked with patients who self-injure and are highly suicidal. Patients have starved themselves to near death, injected themselves with poisons, broken their own bones, and have tried to (or actually did) kill themselves. It would be disingenuous of me to say that I don't have a say in what the goals of therapy are.

There are, based on laws, ethics, and my own sense of decency, places where I need to exert power over a patient's decision making. I must intercede and protect children, senior citizens, and disabled people from abuse. I must intercede and protect my patients from killing themselves or killing another person (though from what I have gathered, if a patient kills someone and then tells me I cannot violate their confidentiality). Lastly, if I believe someone's decision making is impaired because of a mental illness I can have them involuntarily hospitalized. Those are the four ways in which the law and my ethical code dictate me to intercede and take over the life of my patient. I loathe to do this, and try to take every step I can so that my patients remain active agents in their life--not me.  

Members of SPLC Hate Groups Need Party Hats
Beyond ethics, there are myriad ways my personal beliefs directly and indirectly exert power over the the decisions I make in my consultation room. My job, as a seasoned and reflective psychologist, is to constantly work to become more and more aware of the ways in which I am using power to influence patients--and to use that power wisely, thoughtfully and transparently as possible.

Now what about therapy to rid oneself of unwanted same sex attraction? That's when we get to circle number three, the intersubjective self. What's that? That's where psychologist and patient get to have fun exploring an idea together. The patient and psychologist join together and explore many different ways of thinking. Our selves merge in a way, become one for a moment, and can see much further and deeper into any given issue. 

Choice number three isn't for the novice therapist or the weak at heart. It's painful, difficult, and challenging to be open enough to connect with another in this way. It's also dangerous if a psychologist isn't self aware enough to recognize their power and all the different ways they can use it to demand rather than guide.

What issues might one contemplate in regards to sexual orientation? Religion, morals, culture, spirituality, oppression desire, wishes, family, needs, homonegativity, heteronormativity, relevant scientific literature, scripture, and, well, it's endless really.

Do I have an opinion about people who are gay, lesbian, bisexual, queer, transgender, or questioning? Yes. I think they are people to be loved and people who are to be cared very deeply about. It's not really for me to decide whether people should or should not be LGBTQ--it is for them to decide. It's for me to help them explore, to separate fact from fiction, and to hold a picture bigger than they can hold on their own.

Some of the patients I've worked with over the years have decided (a) they are indeed an LGBTQ person. Other's have decided that (b) while they are likely an LGBTQ person, they would prefer to contain that part of their self because of a variety of reasons (family, culture, religion, etc.). Others have decided that (c) they aren't actually and LGBTQ person at all.

Options (a) and (c) are easy. I've yet to have a patient select option (b) as a way to lead their life. They have explored the notion for a long time, and in the end, opted for for either being LGBTQ and having loving fulfilling relationships with same sex partners, or choosing to LBGTQ and be celibate for religious reasons, family reasons, etc. A small handful have selected option (c)--they aren't gay, or not yet ready to decide if they are gay.

This is how therapy is done. Thoughtful. Reflective. Taking into account multiple perspectives, multiple ideas, and multiple positions. Let's return again to the so-called reorientation therapists. 

Julie Hamilton at NARTH--she had a lot to say in response to my questioning of her ethics. In reviewing her official statement on the NARTH website (this link will actually get you there, have fun with the others)

  • Dr. Hamilton demonstrates both an unsophisticated understanding of ethics in her reliance of choosing option one (remember my little quiz!) 
  • Dr. Hamilton appears to be falsely pretending that she isn't exerting any influence on her patients (a likely failure of even knowing there is a choice 3, and it's unclear if she is is able to admit to choice number two). 
  • Dr. Hamilton demonstrates an egregious misuse of science and a total failure of scientific thought. Some day I'll have to review her failings--which in her capacity of president of NARTH become NARTH's failings--in a later blog post.
NARTH states on their website they believe in open scientific dialogue. Strangely they don't invite this dialogue. Note the comments on their blog are closed. Let's be serious here: they aren't interested in dialogue. NARTH is interested in foisting their agenda of propaganda and pseudo-science on a vulnerable population.

It seems likely that Julie really isn't in the market of helping patients. It seems that she is in the market of peddling her agenda of propaganda and personal beliefs under a thinly veiled guise of pseudo-science.

Julie writes:
Ethical therapists do not solicit clients or coerce clients into seeking change. The clients served by NARTH therapists are clients requesting change.  
Ultimately it is the client who must choose with proper informed consent and without therapist-coercion, the most satisfactory life for himself or herself.
Sounds good on paper, doesn't it? It's not good. It's dangerous. Julie's unsophisticated understanding of ethics and clinical practice is dangerous. What her words reveal is a situation in which a therapist, unaware of her own agenda, dangerously foists her world view on another. Therapists who do this are, in my opinion, are engaging in the worst kind of malpractice.

So I say this: I know you are out there--survivors of damaging reparative therapy--lost, forgotten, hurting, and silenced by alienation. Come find me and let's use this place to tell your stories, to find connection, and come back into community. Come take a critical look at ex-gay propaganda with me. Come tell your story (anonymously if you're scared).

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The Heart of the Story Part I: Yoda Meets Cognitive Behavioral Therapy

My mother recently sent me a rather long e-mail. That's not a particularly uncommon experience. Answering it here on my blog, however, is very unusual.
You talk a lot about life as the stories we tell ourselves.  I've been thinking about that a lot lately. Do you have a good resource for me to read about this?  Have you written anything about it on your blog that you could perhaps share with me?
Actually, I don't think I have written much here on my blog about stories--and how those stories are the way in which I've come to see as the way we create our own humanity. Since she asked, and since I've been looking for a good topic to write about, why not have you all join in on my response to my mother?
I just finished a book entitled, You Don't Look Like Anyone I Know.  It's a true story about a woman who came from a chaotic, dysfunctional family, as in her mother was a paranoid schizophrenic & her father, a cross dressing alcoholic who was also crazy.  She had been face blind all of her life, but didn't really realize it until she was in her early 40's...  I took some rather extensive notes citing the more interesting parts. 
For those of you who wonder how the Irreverent Psychologist got to be the Irreverent Psychologist: you might find some clues in the above paragraph. The Mother of the Irreverent Psychologist (MIP) notes that she has taken "extensive notes citing the more interesting parts" of the book. As regular followers on Twitter may have noticed, a small portion of the voluminous notes I take while reading appear on my Tumblr page. 

The nut doesn't fall far from the tree. 

...but I digress. The MIP started her email with a question about stories but manage to ask two questions. The first question--about stories--will come a little later. First I'll tackle the MIP's question about cognitive behavioral therapy.

The person in the book visited a cognitive behavioral therapist to treatment of claustrophobia. It seems that the individual in question had a panic attack while having an MRI. MIP wanted to know what I thought of the intervention. 
"Are you ready to kill the monster?"  There was no reason to be afraid.  This fear was just an old remnant signal from the brain stem.  The brain is very dumb! the therapist said.  We can learn to override it.  There is no fear, only fear of fear. There is no such thing as claustrophobia. 
I personally don't see much utility in telling someone they aren't experiencing what they are experiencing. If someone is having a hallucination it does not good to tell someone they aren't having a hallucination. While you and I might not see, hear, or smell what the other person is hallucinating, they are. The better response is to validate the experience of the other while also validating my own. For example, "It must be so scary to be smelling burning flesh. That however, is not my experience of what I smell in the room right now."

And there is no fear, only fear of fear? Who is this guy, Yoda? Fear is a physiological response in our body. We are, of course, capable of interpreting it in a variety of different ways. Nonetheless, fear is still fear. It is certainly true that most anxiety disorders become less about the fear response and more about fearing frighting situations. At the heart of most anxiety disorders is avoidance--we begin to limit our life because we avoid situations that we fear might cause fear. Perhaps this is what Yoda--I mean the therapist--means.

He asked me what I was afraid of in the MRI tube and I told him:  suffocating, not being able to get out. 
He said I could get out. No, I said.  I have to squeeze the ball and wait for the technician.  But would happen to you while you wait? he asked.  What is the danger you fear? 
I wanted to go to bed.  I didn't want to get in the tube again.  I didn't need to cure my claustrophobia; it was the least of my problems. "Well, I'm afraid I'll die. I feel like--" 
The therapist replied, "It is a feeling state.  You see?  You won't really die.  You can't.  There's no deadly spiders or deadly toxins...nothing in the tube is really dangerous.  You just want to get out.  You don't need to though.  Nothing bad can happen in the tube.  You just lie there.  Right?  In a tube.  It's a tube." he said. 
Well yes, Yoda/Therapist is right in correcting a cognitive distortion. It isn't likely that a person would die from deadly toxins, spider bites, or anything else while having an MRI. However is this person hallucinating? Are they actively seeing, feeling, hearing, or smelling things that other people do not? I would argue that the experience of the hallucination first needs to be validated before correcting a the cognitive distortion. Poisonous spiders that both you and I see can kill you. Poisonous spiders that only you see, that are a product of a hallucination, are not lethal.
The more he talked, waving his hands, pleading, the better it sounded.  When we were babies, ten thousand years ago, we were afraid if we were in a small space, in a crevice, and with reason:  if a baby was wedged in a tight space, it was dependent on someone else to get it out.  Our heart rate went up.  Our fear response increased our chance of survival.  Not anymore.  Not for a long time.  But the limbic brain, the oldest part of the brain still thinks all tight spaces are equally dangerous.  
I think Yoda/Therapist is being a little simplistic here. Not everyone dislikes tight spaces and panics when they get into such predicaments. It is likely very true that our physiological system has evolved in such a way that when we perceive we are in danger our bodies become flush with "fight or flight" hormones. However small a component it might be, we do have some agency in this process. We first have to decide that the information we are taking in through our senses represent a physical threat. While we might only have a split second to make the decision, there is nonetheless a split second in which we made a decision about whether we are in danger or if we are safe. Folks with anxiety disorders often move so fast into fight or flight that they aren't even aware of that moment in which a choice can be made.

That is the whole point of cognitive behavioral therapy for anxiety disorders--to teach people the awareness of that moment in time when a decision can be made and equip them with skills needed to properly evaluate their perceptions.
"It's a monster in your brain.  We kill him!" he announced, grinning like a kid.  He motioned to me to sand.. He put his fists in a fighting position.  "Right now?" I said.  I thought we were just having a talk.  He was nodding, waiting, smiling, rocking on his toes.  "We give it a try." 
We walked toward the room.  At the threshold, he hit the front of his forehead with his palm.  "We must use this." he said, and smacked the back of his head with the same hand, "to overcome this."  In the room he said, "Well, what is scary to you in here, this room?   What would be really scary?" I walked across the room and stood by the small closet.  "I would go in here."  He said to go in.  I did an he closed the door.  "What will freak you out now?" he said through the closed door. 
I could hear and feel his body leaning against the door.  And the monster leaped.  I couldn't believe I was sitting in the dark in a closet with a man leaning on the door.  I had never been further from who I was, and at the same time I suspected somehow I was becoming myself in there.  This I realized was the gap.  It was funny and fascinating.  He jangled the doorknob.  "Do you see the monster?  Is he near?""Yes," I said.  "He is here."  I was smiling.  It was like the monster was on the screen in the MRI tube, and I was clicking at him.  I was scared, but not in the way I thought I would be.  It was so goofy.  I was outside the scare, having it--it wasn't having me.  Maybe for the first time in my life.  
"Are you laughing at him?  That is good!  See!"  He banged on the door, hard.  I shook, startled, and then I was still.  It was quiet.  The monster grew.  I kept watching him.  He didn't take over.  There was a gap.  I was able to see the monster.  I could see just what he was talking about . 
I heard him leave the room.  He came back, running, threw himself against the door, rattling the knob, pounding.  Again and again and again.  He screamed.  Kick the door.  I sat there and stared at the monster, and he was right.  Each time he pounced, the monster grew bigger, but never as big as before.  Whenever I jumped or startled, I turned up the volume on watching, and each time I did this, the fear got smaller, always much smaller than the time before.  Until it was just really hot in that closet, and extremely boring.   I came out of the closet.  "I am cured," I said.
This all sounds like very creative systematic desensitization to me. It's best, of course, to actually first teach people skills at lowering their physiological arousal before stuffing them in the closet and scaring them.

This has gotten so long that we'll have to continue the answer to the question that the MIP really asked later. Check back in the coming days for part two of this post.

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The Safe Emergency of Therapeutic Situations: Fritz Perls and Gloria (and me)

Recently I wrote about Carl Rogers. While putting together that blog post, I rediscovered the "Gloria" tapes that every psychotherapist-in-training has likely had some exposure. The tapes were therapy demonstrations filmed in 1965. "Gloria," a young recently divorced women, volunteered to meet with Carl Rogers, Fritz Perls, and Albert Ellis.

I haven't watched this tapes in years--the last time was perhaps sometime in the late 1990s. They are fun for me to watch. It is also interesting to see a lot of myself--both my history and my current practice--embedded within the words of these three men.

Let's start off with Fritz Perls. Along with his wife Lara, he founded the school of Gestalt psychotherapy. It's not a theory I think a lot about anymore--that's probably because the theory itself sits deep in my bones and works behind everything I have learned. In the early 90s I started hanging out at the Gestalt Institute of Cleveland, took several workshops, worked individually with a gestalt therapist for several years, and later participated in a gestalt therapy group for several additional years.

I'm indebted to this early teachers--Jody Telfair, Barbara Fields, Karen Fleming, Mary Ward, and Jackie Lowe Stevenson. There have been many teachers since then but none so central as these.

On to the show. Here is part one of the the full Gloria tape with Fritz Perls.

A friendly sort, eh? Before judgement sets it, put Perls in his time. This was 1965. It was a time of great social change and liberatory movements. Confrontation was in, as was, apparently, smoking.

I'll share my reactions about the clip here. I hope you do, too. I'm curious what you think.

I found myself with a bit smile on my face at the 4:20 mark. I remember my first day in my gestalt group. One of the members  confronted me about my smile nearly as soon as I sat down. "I get confused when you talk about sad things and you smile," she said. "It makes it hard for me to connect." This woman was much kinder that Perls, and I learned a lot about myself. I'm wondering if the smile intervention is some sort of standard thing.

Roll the tape forward to the 7:10 mark and you'll hear Perls saying "what are you doing with your feet there?" Forward again to 9:15 and Fritz imitates Gloria's hand gestures and says "what does this mean? Can you develop this meaning?"

Gloria, looking a little vexed, expressed that she is worried that Perls is going to notice everything she does. I've seen that same look in my office. While I'm not nearly as aggressive or confrontational as Perls, the importance of observing the ever changing tableau of the moment is part of what settled into my bones from my early gestalt training.

Gestalt therapy, beyond anything else, is about learning to pay attention to what is figural--that is, what part of the environment (and what parts of my clients' experience) is reaching out, grabbing at me, and wanting to make connection. The mild look of shock that Gloria gives--it's really not so bad to experience. When I'm paying attention and something jumps out at me and grabs my attention--and I fully notice it and share my experience noticing it--the magic of therapy happens. What was unknown becomes known. The hidden becomes viewed. The shame melts in the light.

A non-gestalt teacher of mine, Glenda Russell, talked a lot about the velvet glove.  Paraphrasing her:
"You have to learn how to lovingly hold clients with one hand and gently spank them with the other. Without this balance, you can't do anything."
I don't think Perls understood this balance. Rather than a velvet glove he used something that felt more like nails. I think he was a little too enamoured with the showmanship aspects of therapy. He seemed to be unable to deeply hold a client while sharing his confrontations and observations from a connected place of love and respect.

My favorite part, where I actually laughed out loud, was at 13:52 Fritz says "ahh, you don't have enough courage to come out by yourself. You need someone to pull the little damsel in distress out of her corner."

I wasn't laughing out of a sense of schadenfreude. Okay, maybe just a little. Mostly, though, I was laughing because I was immediately transported back to a moment of my training that is etched deep into my memory. In many ways I was acting like a little damsel in distress. I was a young 20 something taking an intensive gestalt weekend workshop. One of the participants in the group was walking around shaking at his finger at each of us demanding that we all offer him some sort of help.

I was annoyed beyond measure and filled with all kinds of righteous indignation. Who was this guy, anyway? What was up with the group leaders? Why weren't they doing something? I was paying a lot of money to have some strange guy shake his finger at me.

Karen Fleming, one of the leaders,  asked me what I was experiencing.

"Nothing," I said. I was good midwestern boy. I didn't get angry. I was always nice. I held the door open for people too (I still do, in fact). Karen said, "that's strange. Every time [the finger pointing group member] speaks your face and neck turn purple."

Oh crap. Busted!

"I'm a little bothered, that's all. I don't think it's my job to take care of him. I'm wondering why you are letting him shake his finger and yell 'shame' at each of us?"

At this point Mary Ward pipes up saying "ooohhhhh, you poor baby. You think it's my job to take care of you?" I think my face turned so purple it nearly exploded right off my skull.

I learned a lot about anger that day.What it signals to me, how to know when I am getting the signal, and how to express it.  I also learned that sometimes confrontation is good in therapy. Mary said the right thing, the right way, at the right time. She landed on just the spot that she needed to to propel me forward. I still think, however, she could have been a little nicer.

Some of the Gestalt types too close to Perls missed a few lessons on kindness, compassion, and a gentle touch. That's okay though. We can learn from them too. And therapy doesn't always have to tickle, right?

Let's look at part two. There used to be a part two. The whole video is in the same clip because the original clips I used were removed from YouTube. There is a lot more smoking that needs to be done.

Fritz is showing a lot of Gestalt theory here about connection and the cycle of experience.

When we get to the 8:55 Gloria and Fritz are in the middle of a piece of work which is really flowering. They are talking about closeness and navigating just what that means. I found myself transported back to the Gestalt Institute of Cleveland. I was maybe 27 or 28 years old at the time.

Months before, during what I thought would be a normal psychotherapy appointment, my therapist said "I'd like to talk to you about my summer schedule." I remember she mentioned something about a vacation coming up, so I figured she was going to tell me about that.

What she ended up telling me was that at the end of the summer she was moving away. I was pretty shocked. In fact, I'm fairly sure that (a) I stopped breathing and (b) she noticed it an mentioned that it might be helpful if I continue to respirate.

I remember our last few appointments vividly. In one of them, she had asked if I minded if she ate an apple. She was hungry and felt she wouldn't be able to focus her attention on me without a little food

Feeling a little sad, I thought about the different ways I could look away from the experience. I could blame my therapist for leaving. It wasn't her fault, though. People move. I knew that. I also knew that she would know I was looking away and she would gently show me that I was. Okay. Blame wouldn't work. Maybe pity? Why didn't she seem upset? Maybe she should be. Right? No. Not really. I already knew she cared. We worked that out before. I knew this was my emotional experience. It was mine to have. It was also mine not to have. I knew I had that choice. I knew if I took that choice she would be there, observing me looking away. She would also be there just the same if I walked into my sadness. She would notice it and me. There would be no expectations other than I show up and be fully present in my experience (avoiding or not).

No where to go. I could see no good reason to avoid where I was. I gave into the moment--and my feelings-- and spent the better part of the hour sobbing in despair. I was filled with so much sadness that day I could barely remain upright. It was about nothing in particular. No romantic upset was happening. No squabbles with friends or family. I was sad at the end of my therapeutic relationship but it really wasn't the cause of my unrelenting loneliness.

I was making contact with the void--the end of the cycle of experience--a tiny death. It's a scary place to hang out. It's a place that most of us avoid at all costs. I distinctly remembering doing nothing to avoid the void. I looked right into it with all its dark despair. I looked and Jody and cried and cried and cried. She looked back silently, eating her apple, fully present as always.

Jody didn't really need to speak. Our prior work and built tightly woven cocoon around us. I knew she paid attention to me--all off me. It was unnerving at times. She noticed my breath and taught me to understand its own unique language. My body language also told her things I didn't know I said. I learned how I spoke through  my physical body. I also knew she would always be there in the room--fully and completely.

We created a place that was safe enough for a therapeutic emergency. While I didn't plan on having one on our last session, it ended up being the perfect occasion for me to create one. Having found a safe enough cocoon to be in, I was able to push (and be pushed) into looking at experiences I would have rather avoided. I looked into that scary dark void of nothingness.

She said a handful of words to me that day. The only ones I remember were her first, about being hungry and eating the apple, and her final words, about my experience. They were all I needed to hear. they were the right words, at the right time, said in the right way:
"Thank you for sharing this with me and choosing to be so present. We have to end now."
I fully inhabited one moment in time, connected with another, with no agenda and little distortion.  Nothing to be afraid of. Nothing to avoid.

Beginning, middle, and end. The cycle of experience.

That is the gift of Gestalt (with or without the velvet gloves).

...and you know what, that void isn't so bad after all. Something always comes next. We just don't always know what it is.
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