Friday, April 17, 2009

Common Mistakes Made by Therapists

1. Too Much Advice Giving/Not Enough Listening: This is a common mistake made by many therapists, regardless of how long they have worked in the field. We know that people need to gather feelings from the limbic system and send them to the frontal cortex for processing. Essentially, they need to feel their feelings, talk about it. Feel a little, talk about it, feel it, talk about it. This process of feel then talk is what we call processing and, ultimately, healing. When we jump in too quickly and interrupt that process with advice, the client is not given the opportunity to engage in the processing, and a giant piece of work is left undone.

2. Impatience: This is usually the mistake that leads to mistake #1. Good therapists can quickly assess a client and often have a fairly accurate reading as to why a client is in therapy, what is contributing to their problems, and what they need to do to change-- all within the first 2-3 sessions. The impatient therapist recognizes all of this and wants to jump straight to the healing! As therapists, we have to relax and allow clients to walk through their own process of change at their own pace. We have to accept that this process can sometimes takes months or even years. We may not even be around to see the entire process, and we need to accept that we are here for a time to assist this person in this phase of their growth. It is our role to guide, challenge, listen, and support along the way. This is often one of my own biggest mistakes, and what has helped me the most is learning to find the wonder in the client's process. I may have their ultimate goal in mind, but I have learned to find peace and gratitude in every little step they take to get there. It is much like parenting. We want our babies to grow up to be healthy adults, but this doesn't happen overnight! We celebrate every small accomplishment along the way.

3. Taking Clients out of Their Feelings: Because most therapists are naturally and intensely compassionate people, it is often difficult for them to sit with a client who is experiencing pain. We know we want clients to discuss their hurts, and when they do they will cry or rage. This is difficult to watch and be with, particularly when you are connected with the client. We do not enjoy seeing people hurt and we want to rescue them from this. This is especially hard with child clients, so children's therapists need to be particularly mindful of this trap. As therapists, we should remind ourselves-- it is good for clients to feel; it is good for all people to feel; this client needs to experience this deferred grief or anger; these stored feelings have become toxic and are poisoning this person, we have to clean it out.

The field of psychotherapy naturally draws to it hurting people with deep wounds of their own. This is true for many "caretaking" fields such as social work and nursing. This is not to say that every therapist and nurse is a hopeless codependent. It is just very important for those of us in this field to know why we came to it, be aware of it, and how it affects us when we step into the room with clients. Many therapists have deep wounds or "original pain" as John Bradshaw described it. If a therapist has not worked through their own "original pain," he/she will be unable to allow a client to go there. This leads to mistake #4.

4. Denial of Personal Make-up/Triggers: I have seen countless therapists who present with giant steel barriers around their own pasts and hurts. A good therapist has to acknowledge their own humanness. That is, they have to admit, I am a person capable of the same hurts and behaviors that my clients come to treatment with. I am capable because I am human too and I have my own weaknesses and issues that I work through daily. If you are a human being, then you are imperfect and have flaws. Therapists have to be comfortable with their flaws, which may be a tendency to control others, defensive, overly sensitive, or procrastinating, etc. It's ok to admit weaknesses to yourself! Therapists who are in denial that they have any personal issues of their own often come across as judgemental with clients. Their attitude is "Why can't you just do the right thing, get better, and be a great person like me?" If you believe for one second that this attitude does not come across with your clients, allow me to correct you-- IT DOES. A good therapist should believe from their very core, "But for the grace of God, there go I."

5. Poor Self-Care: Every day when we, as therapists, step into sessions with clients we bring our tools into treatment. Carpenters use hammers, nails, saws, etc. Doctors use their scalpels, x-ray machines, and whatnot. Therapists, well, we bring ourselves. We bring our minds, our bodies, and our emotions. When I come into the therapy room I want to bring healthy, sharpened, up-to-date tools. Would you want your doctor doing surgery on you with an outdated rusty tool? Would you want someone building your home with half the tools missing or without any blueprint? In the same vein, we should bring a healthy self into treatment. We should take good care of our feelings. This means we ACKNOWLEDGE that we have them, especially feelings brought up in therapy with this client. We get our own good therapy to keep our emotions and mind sharp and healthy. We stay connected with peers and supervisors to remain cleaned out. We get good sleep, exercise, eat well. We manage our time, delegate, speak up for ourselves, and know when to remain quiet. We nurture ourselves spiritually, physically, and mentally. We TAKE VACATIONS AS NEEDED without guilt. If you care about your field and your clients, then start with caring about you!!

6. Stagnation: Ok, therapists, here is a real shocker for you. Did you know that when you graduate from school that you really know very little in the way of providing good therapy?! Did you know that you will hone your skills in the moment with clients and in your supervisions and consultations? Good therapists are not born from textbooks alone and the textbook you learned from in 2006 may already be made obsolete by new research? Many well-intentioned therapists graduate and believe they are now finished with learning. They may feel "I know all about Psychology, I have a degree, " and never care to crack another book on the subject or seek out good guidance. Getting a degree in Psychology does not make you a therapist, it's just a good start. After that you have to stay updated in what is going on in your field. There are so many wonderful new treatments available. Every day we are learning about the brain's involvement and impact on behavior. Again, would you want a doctor operating on you who is operating using techniques from a 1920's textbook? This is not to say that some of our great foundational teachings in psychology are to be forgotten... they are not. Just stay current and open-minded.

The cartoon above is originally found at:

Tuesday, April 14, 2009

Children with Autism: Quote of the Day

"Eeewww, look at that nasty wig," says Caleb while playing with my hair.

age 5
( I don't wear a wig, by the way... just thought I'd add that. :-) )

Saturday, April 11, 2009

Children with Autism: Quote of the Day

After several days of telling the 5 year-old boy that it's "too wet and muddy outside to play," he asks,

"Mom, is it clean outside yet?"

age 5

Thursday, April 9, 2009

Children with Autism: Quote of the Day

"I am prisoning you to Daddy forever, because you have ruined my life!!"

(while in a tantrum)
age 8

Tuesday, April 7, 2009

What in the Hell Are You Thinking?!

Really... I mean, really... come one... you're joking... you're kidding me, right? Surely to all goodness, you are not going back to that worthless loser? You are NOT going to move your entire family into your mother's house! You're getting married... again?! To an alcoholic?! WHY are you having a baby with someone you just wanted to divorce last month!!!

These are situations I face every day, not just as a professional in the field of counseling, but as a professional human. We all have friends, family, or acquaintances that make us ask-- "What the hell are you thinking?!" To speak the truth or to not speak the truth, this is the dilemma. This is a dicey and tricky dilemma and one I delve into with great consideration.

First of all, I think you have to consider the nature of your relationship with the person in question. If this is a co-worker or a not-so-close acquaintance, you should probably keep your mouth shut. Most people are really not all that interested in honest feedback, even those people who go to a therapist and pay money for honest feedback. It is really hard to hear the truth about ourselves sometimes. It is painful and we want to avoid pain and discomfort. Even if this co-worker or not-so-close acquaintance asks you for your opinion, if the situation involves any of the delicate matters referenced in the first paragraph-- really, don't give your opinion. I have found that a response like this works well, "Wow, you are really dealing with a tough situation here. It looks like you're just doing the best that you can right now. I really hope this works out for you." This is an honest statement and keeps you out of it.

If the person in question is a very close friend or dear family member, then there may be reason to share honest feedback. If your closest friends cannot tell you the truth, then who else do you have? Before divulging rigorous truth to even a close friend, ask yourself these questions: Will my honest feedback actually help my friend/family member in this situation? Are other people telling them this same information? If so, how are they receiving it thus far? How can I give this feedback AND insure my friend/family member I love and care for them? Could the consequences of my NOT sharing my opinion create harm to myself or other people? Will my NOT sharing my opinion hinder my relationship with this person or affect the way I feel about myself?

Since we are talking opinions here, it is MY opinion that we should only be completely and bluntly honest with others when we feel the information is vital to the person's health/well-being, the person is at least somewhat likely to receive it, and/or we cannot maintain our own integrity if we say nothing. There have been times when I have been confronted or given honest feedback and initially did not receive it very well. After a few days or weeks of allowing the information to sink in, I began to realize the truth in it and own it as my own truth. I was later able to thank the person for having the courage to be so honest with me.

So, when are the times to just remain silent? Perhaps you have already shared your honest opinion multiple times and it is not being heard. Perhaps others have also confronted or asked the person in question, "What the hell are you thinking?!" If this person continues on their own path toward destruction despite the repeated warnings and offered assistance from others, you just have to let go. You have the right to limit your relationship with the person (if the friend/family member's behavior is affecting you). There are also those people who are strong-willed and just need to experience mistakes... again and again... before they finally get it. Those are tough people to love, especially if they are your children, for example! Sometimes we remain silent because we love the other person enough to let them have their own mistakes. We care enough to let them walk through their own process of change and see the mistakes for themselves. This is so hard to do.

So, the next time you have one of these "What the hell are you thinking?!" kind of moments, pause before posing this question. It's a loaded one and can bring with it big consequences.

Above picture found at:

Saturday, April 4, 2009

Surviving Withdrawal

It seems that one of the biggest predictors for achieving sobriety (from any type of addiction-- drug, alcohol, love, gambling, etc.) is the person's ability to endure withdrawal. Certainly there are people who endure the pain of withdrawal and, in a matter of days or weeks, return to the drug. There are even those who have survived withdrawal multiple times. I think the largest group, however, are those who never enter withdrawal EVER.

I have come to believe that enduring withdrawal is nearly impossible when attempted alone. It's just too hard and an addict needs accountability, someone there holding them to the sober line. Addicts turn to the drug/activity of choice to avoid emotional pain of some sort. The use of addictive relationships and substances helps stave off pain from the past that, at the time, we did not have the tools to experience. A neglected or abused child with no parental support is not equipped to emotionally cope. The pain of this remains frozen and forever delayed through addictions. When this person, at age 35, decides to stop the addictions, the pain of that event, and perhaps many other events, shows up presenting a bill. Withdrawal pain includes experiencing delayed hurts... thus, why so many people fear they cannot endure it.

If someone feels they are ready to endure the darkness and pain of withdrawal, then I encourage you to surround yourself with loving and supportive people beforehand. Cut back on other responsibilities and be prepared to show immense kindness and compassion to yourself. Be prepared to cry, rage, and talk, talk, talk. You may want to write about what you are feeling. You may want to exercise or read about what you are going through. Reading about the process is a helpful reminder that the pain of withdrawal is productive and useful. Be patient with the process and know this is only a season of hurt and will yield great rewards when endured.

You have essentially been dropped into the ocean with oxygen, a flashlight, and a compass and told where to go. If you freak out and continually come to the surface, you will never be able to complete this mission. At some point you have to accept that you have all the tools you need to get where you are going. Stay calm, stay in the water, use your tools, and keep swimming.

Photo above found here: