I haven't written a blog in over a year and a half and I have no idea if I'll be writing again regularly - blogs that is. One thing that the pandemic did for me was to help me slip into partial retirement.
Although I miss the work I used to do, I very much enjoy my life now. I primarily focus my time on writing, creating workshops, doing individual and group consultation and serving as president of the board for EDIN (non-profit focused on education and insight on eating disorders).
So now back to the idea of mistakes.
After having presented a workshop on Common Therapist Mistakes and gotten such positive feedback, I thought I'd write about some of mine.
In this session, I started out really well, but blew it in the end.
Amanda was sexually abused as a child and grew up in a family that was not very emotionally available. As is often the case with children who don't feel like they can tell anyone what is happening, she felt tremendous shame and doubt. Since in her childhood, she thought no one would believe her, she carried this doubt into adulthood. Although on one level, she knew it had happened, another part of her needed to relive the memories in order to convince herself that the abuse had truly occurred.
She was re-traumatizing herself in an attempt to reassure herself.
What a dilemma!
After trying for months to help her see that she was caught in a loop that continued to cause her trauma, I realized that I was in a subtle power struggle with the part of her that needed to replay the memories. Anytime I suggested a different way of thinking about it, the part of her that needed to replay would dig her heels in and experience shame which took the form of defensiveness. That was my first mistake but not even the mistake that I'm focusing on in this blog. I realized that I needed to step out of the dilemma and help Amanda access her own wisdom about what could happen. I observed to her that one part of her knew that the abuse had occurred but another part needed continued proof by reliving it. When she acknowledged that, I asked her
"what does the part that wants reassurance need from the
part that knows your truth?"
There was a very long pause.
A quick aside here. I think whenever you feel stuck or experience a client being defensive, it may be that you are working too hard. It's okay to try offering a cognitive shift but if it doesn't "take" right away, then step out of the dilemma. Asking what does one part need from another part, empowers the client to access their own wisdom and power and you, as the therapist, can get out of it. Your brilliance as a therapist shows up not when you've made an astute interpretation or given spot on advice, but rather when a client is empowered by your intervention.
But now back to the mistake. Yes, I followed up this helpful intervention with what could have been a fatal mistake. After her long pause, she said "I need some kind of a mantra." I was so excited that she seemed to have made a shift. So without skipping a beat and with great eagerness I said "What might the mantra be?" Then she raised her head and with some anger, said
"Give me a minute!"
Can you see the many mistakes I made here? I was focusing on my own agenda and focusing on an outcome rather than the very important experience that she had just had. I said "Sorry, take all the time you want." It actually took her three weeks to come up with the mantra that she believed would calm the part of her that doubted her story. Fortunately, she didn't allow my blunder to slow her down. As she used the mantra, the replays diminished and her peace and contentment grew simultaneously.
I've developed a workshop titled Common Therapist Mistakes and the Ethics of Owning Them. If you're interested in more on this topic, you can order this workshop on demand through The Knowledge Tree. I've also summarized 10 of those mistakes in this blog. Finally, my book A Clinician’s Guide to Pathological Ambivalence: How to Be on Your Client’s Side Without Taking a Side can teach you how to avoid these and other common therapeutic mistakes by developing skills to work directly on helping clients resolve ambivalence and rewrite old narratives. I would love to hear from you. Please scroll down to the bottom of this page to leave a comment.