Friday, December 14, 2012

It's Important for Psychotherapists and Counselors to Share Aspects of Our Personal Stories

   There are many situations in which our clients benefit from us sharing relevant aspects of our personal stories.Yet for some psychotherapists and counselors revealing any aspects of their lives feels unprofessional. As an elder with over 38 years experience in private practice I am advocating that - for the sake of our clients - we slog through those personal and professional issues that might prevent us from disclosing.
   Certainly there are good reasons why there are cautions or, in some schools of thought, prohibitions regarding talking about ourselves. There are instances where some psychotherapists/counselors are allowing their own personal neediness, narcissism or countertransference issues to intrude into the therapy. In those instances it would be very important for the psychotherapist/counselor to reflect,"Why am I doing so much sharing?" or "Why am I talking about myself so much with this client?" And to bring that question into their own therapy.
   There are traditions of psychotherapy theory that stipulate that the therapist should not share their personal narratives because that will interfere with the transference. In those theoretical perspectives the working through of the transference is the core wherein real change occurs and self-disclosure potentially could contaminate the work. As someone who was trained in the traditional psychoanalytic model my experience suggests otherwise - that transference remains a potent force that still occurs even after I share relevant aspects of my life.
         My Experiences 
   Early in my work I had quite a few adult patients who came from family backgrounds with an alcoholic parent. Often the therapy seemed to stagnate. I decided to take the risk and share that my father was an alcoholic. My patients were grateful for the heartfelt empathic connection. They opened up more and felt more hopeful. Their therapist not only knew what it felt like to be the child of an alcoholic, but also had recovered from the traumas of that experience. For those patients, the professionally distant,non-revealing therapeutic stance of the psychoanalytic method was too reminiscent of their depriving and often emotionally unavailable parents.
   Twice in my life - in my early thirties and at the age of fifty - I experienced periods of suicidal ideation. I never acted upon these thoughts, but I experienced the toxic mixture of despair and self-hatred that leads to the thoughts that death is the only way out. When I have patients who are suicidal, at some point I usually share with them that I too have experienced that state. This helps them to know that I am not judging them and I feel compassionate towards them. I am also offering myself as a beacon of hope in the darkness. I often say, "There is no pressure on you to be hopeful. I will carry the hope until it reawakens in you"
   Seven years ago I had a very aggressive form of lymphoma. A friend of mine, another psychologist in his early sixties, who was being treated for another form of lymphoma, died during the time I was receiving chemo. That sent me a very cogent message about what the disease could do. Although my recovery has gone very well, I live with the possibility that the cancer could return at any time and this time it may take me. As a result, death is my daily companion and informs my decisions every day. My sharing of this experience has deepened my empathic connection to patients who are struggling with serious illness and their own mortality. It makes them feel that their therapist is both a professional and a human being who has a genuine heartfelt sense of what they are going through.
   For those of us who do this healing work these difficult times in our lives expand our hearts and increase our capacity for compassionate caring. When we open our hearts and disclose these aspects of our journey that are relevant to their suffering our patients feel that compassion more palpably and more deeply. They feel us connecting to them as both professionals and fellow human beings.
   From my perspective there is one caveat to our talking about our own lives. I am initially quite cautious about talking about myself with clients who had narcissistic parents. because this can evoke such a strong transference reaction that might cause them to terminate the work, I usually share only after they have internalized a sense that I genuinely care about them  

Monday, November 12, 2012

Psychotherpists,Counselors,Life Coaches Can Be Soul Friends to Our Clients

   In the early stages of my evolution as a psychotherapist periodically patients would say that it felt like I was their "friend." Yet it didn't feel to them like any kind of friendship they had ever known. Some patients,as they were leaving my office, would say"See you next week my friend." Although I didn't express it to my patients, internally something about being their friend made me feel uncomfortable. I didn't quite know how to respond. Nothing in my training prepared me for it. Initially I thought that I had done something wrong- perhaps I had overstepped some boundary and done something unprofessional. Perhaps I had evoked some transference issue or was acting out some personal need for friendship. I was struggling because this notion of friend didn't fit into any category of friendship that I had ever experienced. In the beginning I pathologized it.
   Then I read a book by John O'Donohue entitled Anam Cara. It described the Celtic tradition of anam cara - soul friend. In Gaelic the word anam means soul and cara means friend. Since both of my grandparents were Irish immigrants the phrase had a strong resonance. His description of soul friend gave me a framework to understand what kind of unique friendship some of my patients were attempting to describe. It also added an additional layer of sacredness to how I viewed our work. My patients were entrusting their souls to me. For me this insight increased my sense of reverence for our roles as healers and a deeper sense of responsibility.
   It is not my intention to engage in an ontological discussion of the notion of soul. That conversation is well beyond the scope of this blog and my book. Suffice it to say that what I mean in this context is the essential nature of the person.
   The souls of most of my patients have been neglected, abused or wooded, treated with apathy or disrespect. Many of them have lived in soul-killing environments. I have felt that I need,by my presence and the ambience of my office, to provide the opposite - a sense of sanctuary, a safe refuge for their souls. When we initially meet our patients for the most part their souls are in hiding. From my perspective a primary goal of a more heart-centered approach is to invite the souls of our patients to come out again. From my experience the souls of our patients respond not to rational insights or cognitive techniques, but to welcoming warmth, compassionate presence and acts of loving kindness.
   I am advocating that psychotherapists, counselors and life coaches consider the notion that one of our cardinal roles is to be a soul friend to our clients. Being a soul friend is a particular kind of friendship that goes well beyond the ordinary definition of friend. He/she is the kind of friend who honors our essential nature, who wants to know our "deep within" and treats our souls with respectful reverence. He/she invites our soul to come out of hiding through nurturance, affection, celebration of growth and loving challenge. In myriad ways the soul friend says"You are valued. I am here to help you to become more fully the unique being who you can be."

   This is based on the Anam Cara chapter of my book Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy (Jason Aronson Publishing 2011). Take a look at my website ( for more information.

Monday, October 8, 2012

Love Blocks: A Heart-Centered Approach to Psychotherapy and Counseling

   One of the primary goals of psychotherapy is to help our clients to let go of their barriers - love blocks - to easily receiving and giving love. My focus is upon the struggles we have in simply taking in love when it is offered. My over 38 years of private practice has taught me that when our clients become more receptive to love they naturally become more giving. Of course, it does not make rational sense that people block love. Yet we all do. Here are some everyday examples: many of us have trouble receiving praise; we struggle with letting people help us or asking for help; it's hard for many of us to easily accept physical affection or let someone in when they are trying to be emotionally close; how often do we internally say "If you really knew me you wouldn't say such nice things"; how frequently do we expect our partners to "read our minds' and know what our needs are- if we tell people what we want then what we get back is "not real love". All of these everyday instances, and more, are forms of blocking the love that is available to us. Notice that I am addressing the wide spectrum of ways that love is expressed, not just romantic or sexual love. Notice how pervasive and insidious these blocks are. We need to learn why we erect these barriers - often unconsciously - to letting love in.
   We need to take sufficient time with our clients to explore a central question, what are the wounds that block their receptivity to love? For most of us our patterns of blocking love were formed in childhood. If we observe infants and young children we are reminded that there exists a natural state of simply giving and receiving love. Within the limits of temperament(some children are slow to warm up,others are introverted), some genetic difficulties(autism, Aspergers syndrome) and considering the developmental stage(infants are more receptive to others when they are in their mother's arms), generally young children receive and take in love easily. By the time we are adults, most of us have experienced some significant degree of loss of the receptive self.
   Our primary therapeutic task is to uncover the reasons for that loss and to work through the blocks to receptivity. In that process often the initial most transformative moments are when our clients are able to take in our love. In the limited space of this blog I am unable to discuss in depth a number of blocks and how they get worked through. However, I will try to give a glimpse into the work using the example of three blocks.
                     I Don't Deserve Love  
   This is the most insidious block. For some people it is the core barrier; for others it is often present in addition to another block.The most common way it shows up in therapy is when I praise one of my patients. People with this block are usually unable to take in the compliment. This difficulty in receiving providrs an opportunity to explore how did this pattern develop. When this occurs I usually begin the exploration by saying in a warm non-judgmental tone,"Young children usually easily take in compliments and are not critical of themselves. What happened in your family that contributed to this moment when it was hard for you to take in my sincere praise? What has happened to make you feel so undeserving and critical of yourself?" This difficulty in receiving my praise repeatedly recurs. Often it leads to moments when my patient says,"My parents really knew me. If you really knew what I'm really like, you wouldn't think that I'm a good person". Then I inquire,"What do you mean if I really knew you?" The work with this block usually progresses slowly because it is so deeply rooted. The most transformative moments are when patients begin to take in my genuine caring for them as we get to know each other.
                   I Don't Need Anyone, I'm Strong  
   This is the block of those clients who are unable to ask for help from others or to take in help when it is offered. Therapy is difficult for them and filled with ambivalence because they are in the uncomfortable position of needing our help. Their childhood history is usually one of feeling emotionally alone, of psychological abuse - a toxic soul-killing environment.Their childhood experience is one of being in survival mode. "I'm on my own,how do I protect myself and get through this. I have to be strong." Their childhood homes were psychologically unsafe so they need to feel a sense of safety with us. Their sessions with us, our office space, becomes a refuge for their hearts and souls. The initial transformative moments occur when they are able to receive our simple acts of loving kindness such as my handing them a tissue when they are tearful instead of them taking one from a purse or my offering a cup of tea when they are in the waiting room or consoling touch after a tear-filled session.
                  Love Is Not in the Cards For Me  
   These patients feel like pariahs - perpetual outsiders - feeling that others find them repulsive and don't want them around. At the deepest level they feel like defective human beings. Love is available to others, but not to them because there is something wrong with them. Often their history is one of being unwanted by parents, their arrival on the planet being experienced as a burden, an unwelcome responsibility. As most sensitive children do, these clients interpreted their mother and fathers inability to nurture them to mean there's something wrong with me.
   One of the most healing aspects of their therapy is my welcoming attitude - I continually let them know that I am glad to see them. Of course, initially they don't believe that this is genuine saying/thinking, "It's your job to say those things, you don't really mean it." I remember one patient revealing with hesitation,"When you go into the bathroom after our sessions you probably throw up because you are so repulsed by me." The transformative moments of working through this block
usually occurred when my patients were able to take in my welcoming warmth and began to believe that I was glad to see them because I genuinely appreciated who they are.
   Our insights and clinical skills in uncovering these patterns are vital. However, it is our warm and compassionate presence and our acts of loving kindness that are essential in inviting the wounded receptive self out of hiding. Our clients begin to trust that, if they allow themselves to be open and receptive again, the outcome will be different this time. That process begins with our relationship with them.  

   This blog is based on the Love Blocks chapter in my book, Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy. My story of working through my love block and several patient stories are included in that chapter.

Monday, September 10, 2012

Working From the Heart:A Therapist's Guide to Heart-Centered Psychotherapy

    I love my patients. I know that some people will criticize me for being unprofessional in saying that. I know that others will encourage me to use some word or phrase other than love such as "non-judgmental" or "compassionate" or "unconditional positive regard". These are aspects of what I am describing, but insufficient. What I am discussing more is a way of being with clients - a kind of presence that can be integrated into any theoretical perspective of psychotherapy or counseling. I think that a big part of the problem is in our culture using the word love evokes images of sexual, romantic, or sentimental love. That's not what I am talking about. Indeed those forms of love would be harmful to my patients. what I am referring to is a broad spectrum of expressions of love that include: acts of kindness, compassion, encouragement, welcoming, open-hearted warmth, consoling touch,valuing,and celebrations of growth. I would wager that most readers do at least some of those things. And would probably do more if they didn't feel it was unprofessional, harmful or unnecessary.
   Most of the psychotherapists,counselors, pastoral counselors and life coaches that I have met originally entered this work because of a heartfelt desire to help people. Yet their training focused on theories,techniques and maintaining professional distance. Developing a compassionate presence. increasing our capacity for empathy, being a kind and caring person or a carrier of hope were infrequently or rarely mentioned. The message inherent in the focus upon theories and techniques is that genuine heartfelt expressions of love are unnecessary, unprofessional,perhaps even harmful.
   Here is the paradox and dilemma. Throughout the literature exploring what is effective in psychotherapy, consistently the most common response from clients is"My therapist cared about me as a person". Increasingly brain imaging research reports that a consistent and sustained loving presence can produce positive shifts in brain patterns. Apparently those moments when we genuinely move beyond the strictures of a professional role are healing and very meaningful to our clients.
   I am not saying that all our clients need is love. They need our minds and our hearts. The most effective psychotherapy and counseling occurs when we are both professionals using our theories and techniques and loving human beings. What I am advocating in a heart-centered approach is for us to return to our original intentions and bring our compassionate caring more into the foreground of our work.
   Opening our hearts makes us more vulnerable. How we respond will depend on what has happened to our hearts in the past when we allowed ourselves to be open and also in our current lives what are our possible unmet emotional needs. In the Wisdom of the Heart chapter I describe the personal issues that I had to work through as I evolved from a traditionally trained psychoanalyst to a more expressively open-hearted therapist. For our patients their primary issue will be of being receptive - how able are they to take in love when it is offered to them. This is the area of "love blocks" that I will discuss in a future blog and is discussed thoroughly in the Love Blocks chapter.

 The ideas discussed here are based on the Wisdom of the Heart chapter of my book: Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy