As many experienced therapists might be able to relate, the ups and downs of therapy are normal. It could be the low or high of the client’s subjective mood or our evaluation of the therapeutic progress.They serve as vignettes of life’s natural ups and downs. Reacting to them in a calm way is one of our primary tasks. That is theoretically this way.
In the first few months of my therapist life, I experience the rhythms of sessions with some predictable pattern. In the beginning, I might have some healthy anxiety about building that rapport. My slight nervousness might show up as speaking a bit more as due to the need to prove my qualifications as a therapist. As I become more aware of my tendencies as the weeks went on, I slowed down. I phrased my questions more carefully with more open-ended questions and allowed more silences. The sessions get easier.
Then as the weeks passed, the familiar anxiety of inadequacy returned. Am I doing enough? Is the client feeling better? Am I using the right techniques. I consulted, I asked and I deployed whatever I found fit in the moment. I felt the movements in some sessions and missed it in others. Then those surprises creeped up on me. A client reported doing something she was not able to do for years, such as shedding a tear or expressing feelings to an intimate partner. My heart felt lighter. Whether it was my doing or not, something was moving in the client’s life. Of course, there was that secret hope or stubborn faith that what I was doing mattered. From the moment to moment mood stabilization, the week to week secure presence, the psychoeducation, the thought-stirring questions, and to the somatic experiences, I held onto the belief I made a difference or at least planted a seed.
After that, a couple of more weeks would pass. The ups and downs of our own life would create emotional waves that have its high and low. During the weeks I was well regulated myself, I would be able to set the proper emotional boundaries for even the most anxious or depressed client. On my less balanced weeks, I would feel it more. I would carry their sadness more, I would feel it in my shoulders, I would be more sensitive to the hyperarousal or hypoarousal state of those in my personal lives. My tolerance window has become wider but I am also carrying more load so the window gets filled more quickly. Perhaps a close friend’s accusation wasn’t so far-fetched. My job has taken most of my emotional reserve. I did not have enough for her. Since I was always the one more emotional regulated between the two of us, she felt the difference when I could no longer tolerate her emotional needs from me. She was used to my responding to them in the past. I was ready to let go of that role before I became aware of it. Once as I listened to my friend expressing distrust over some long established relationship, I become conscious of the fact I no longer wanted to serve that reassuring role in my personal life as I did in my professional life. I became more possessive with my peace. I use the resources within my window of tolerance for my career. It sounds selfish, but I needed that boundary to be able to do this job. I deserve people who can manage their emotional ups and downs better in my life. I will always be there when life’s unpredictability catch up with my friends. However, I will not be the routine crutch they lean on for their emotional regulation. That is a job. Friendship or relationship should not be work.
As weeks go by, I guarded my reserves more jealously, as once advised by a supervisor. However, as the uncertainty of whether I am making a difference in clients’ life mounted week after week, I became more restless during the 10th week or so. I began to set goals, prepare techniques and look for solutions. That was when I felt stuck. Things were not moving as I expected. Then my classmates, supervisors, therapist and peers helped me shift out of that mentality. It is not for me to decide when the clients were ready to move. That was the byproduct of the ego’s desire to be the expert. I might have some theoretic knowledge about healing, but I can never replace the client as the expert of their own life. I was there and still am there as witness and assistant as part of their journey. I am not entitled nor am I responsible for making them change. They themselves have to decide for themselves when that should be. By showing up for therapy, regardless of various amounts of subconscious or conscious resistance, was the first step of their change. To accept them for who they are in their current state was the first offering toward healing I can give them. The symptoms, whether it is depression, anxiety, or family conflict, derive primarily from some lack of acceptance toward their own state. It made sense that my first and foremost job was to accept them wherever they were. If they sensed some anxiety in me for wanting to change them before they themselves were ready, I would only bring additional stress. However, accepting their current condition with unconditional positive regard did not mean I do not have the confidence for improvement. I simply did not feel the urge to push it at any particular moment. That would serve me not the client’s overall sense of empowerment. In addition to the acceptance, I had to stay curious and admire the clients’ process of working toward change in their own way. This was the compassionate wisdom shared in peer supervision. As a result of this ephiphany, I was able to be more present with the client. They led me through our conversations as I held the macro picture of their situation and toolbox of resources ready in my head. I was able to pick up more of the meanings or hidden significance of each of their sentences. This meant the client felt I was more attuned to them. As more emotional safety was built, they are also more open to any reflections or somatic experiences I introduced.
Overall, I felt lighter during the session after that switch in mentally. The movement was more fluid. As repeatedly emphasized for all professional helpers, whether it is physicians or psychoanalysts or social workers, self-care must be the foundational skill for our profession. I had to first ensure my own safety before I can give my clients the oxygen mask, as they say in flight safety protocol. In the end, the biggest payout for this profession is how much it helps us as we are trying to help others. Accepting the present allowed me to stay curious about what exactly is going on for my client. Admiring what they were going through expanded my tolerance window further for the ups and downs of my therapy sessions as well as my own life.
My fellow therapists/coaches, please stay curious with me, for all the life paths you encounters including your own.