….AND….

This blog entry is intentionally brief. It contains a simple concrete suggestion that is very symbolic in its purpose and potentially multi-layered in its impact. Hopefully, as a reader, you do not find it simplistic.
Whenever my patients use the word "but" in the narrative that describes their thoughts and feelings I encourage them to substitute the word "and". "But" is a word that tens to negate or diminish what preceded it, whereas "and" connotes inclusiveness and coexistence. My intention is to help my clients develop an inner landscape wherein conflictual, sometimes polar opposite, thoughts and feelings can be contained with less tension and more respectful coexistence.
Some examples. Often my patients say,"I feel like I did a good job, but …." and then give a list of reasons why it was not perfect. The positive feeling gets negated or diminished by whatever follows after "but". Other clients describing a spouse/lover/friend say "I love/like ___ but …." and then tell about some annoying or hated characteristics or opposite feelings. Again the love/like gets lost or weakened by the litany of complaints.
Usually I will encourage my patients to substitute "and" for "but" by saying to themselves "I did a good job and I could also have …." as away of counteracting the inner notion That I can't feel good about what I've done unless it lives up to perfectionistic standards. I recommend to other patients to say to themselves "I love my lover/spouse/friend and I hate when he …." as a way of acknowledging and honoring the coexistence of opposite feelings about the same person.
Gradually the use of this simple substitution - in conjunction with our deeper work -becomes a useful tool to expand their capacity to have many complex feelings coexisting within their consciousness.

BE GENTLE WITH YOURSELF

"Be gentle with yourself" is the phrase that I most frequently say to my patients. It is my intention to counteract what, decades ago, Karen Horney called the "tyranny of the shoulds." They are those inner self-critical and judgmental voices that are so deeply engrained in so many of us that we think that they are simply aspects of human nature.
One of the initial steps of the psychotherapy process is to help our clients become more consciously aware how pervasive and insidious these inner critical voices are. And then begin to explore what are their roots. If you observe young children - in recent years I've had more opportunity to this by interacting with my grandchildren - you will witness that this criticalness is not present. How, then, did our clients inner critical "measuring stick" get internalized?
What life experiences with parents, teachers, coaches, and other significant adults in his/her early life contributed to the formation of this "measuring stick"? Answering this questions common background material that most psychotherapists and counsellors explore. It is also important to consider what are the cultural and sub-cultural influences that have contributed to the inner criticalness? The American culture is a very judgmental one and our clients, often without awareness, have internalized its standards. For example, one of the axioms of American culture is that,"You can do anything that you want to do as long as you put your mind to it and work hard." That notion is absurd nonsense, and is a source of feelings of failure and inferiority for many people. The truth is that we all are profoundly limited by our genetics. One small personal example - it exploring its sources how can we as psychotherapists and counselorswould have been impossible for me with very minimal musical ability to have become a cellist in a classical orchestra. No matter how much I practiced. It is then important for all of us to be gentle with ourselves and to come to a place of loving acceptance of our limitations. This will also help us to be more accepting of the limitations of others.
Some of our clients have inner standards that are idiosyncratic. One of my patients has an internalized image of being a generous person. Whenever he fails to live up to that image he chastises himself as "selfish." I often say to him,"Be gentle with yourself" as I gradually get him to look at the impossibility of living up to that standard. No human being could do it - not even the saints.
Within the limitations of a brief blog it is not possible to discuss in depth all the contributors to this "tyranny of the shoulds."
In addition to exploring its sources how can we as psychotherapists and counselors help our clients to counteract this self-criticalness? One pathway is for us to say,"Be gentle with yourself" whenever this voice shows up in sessions. Initially our clients will struggle with being able to take that in. Gradually what happens ,though, is a kind of 'transmission" wherein they internalize that phrase accompanied by the energy of our compassionate presence.
I also write on an index card,"Be gentle with yourself" and encourage my patients to put that in some place where they will see it often. I recommend that they periodically look at it saying the phrase either out loud or to themselves coupled with some relaxational breathing, imagining with the out breath that they are releasing some of the inner judgment or criticalness.
In addition, I suggest that they consider that the source of their own inner voice saying,Be gentle with yourself" is their own Higher Self or personal Higher Power. For some patients that notion does not fit with their worldview. for them I say,"Imagine that the source is some benevolent relative, or teacher. It may either be someone you personally know or some historical figure. Trust whoever comes into your consciousness at this time. Also the image may change over time." Gradually the potency of the inner critical,judgmental voices diminishes and my patients become more compassionate and loving towards themselves.

I DON'T NEED ANYONE, I'M STRONG

So many of our clients have difficulty asking others for help and/or are unable to receive help, even when someone who genuinely cares about them offers it. Why is this? In this brief blog entry I will discuss just two underlying dynamics that I have witnessed in my 40 years of private practice as a psychotherapist. One is a survivor mentality developed because of childhood experiences; the other is the underlying "measuring stick" of masculinity that is prevalent in american culture.

SURVIVORS

By not being able to ask for help or not receiving help when it is offered we block ourselves from a powerful source of love -even when we most need it. To understand how this pattern gets established it is essential to look at the childhood experiences of our clients. What children need the most - a sense of safety, affection, warmth, kindness, valuing of their uniqueness - was is short supply for many of our clients. For some, in addition to neglect, they experienced physical/psychological/sexual abuse wherein their bodies and souls were under attack. They were living in a psychological war zone and often feeling emotionally alone.When they recall these childhood experiences our clients remember thinking,"How do I get out of here? How do I get through this?" at some point they realize that their main task is to survive,to somehow keep their bodies and souls alive until they can leave. So, because they feel that others cannot be trusted to take care of their needs, they become emotionally reliant only on themselves. They develop a strong self-protective inner wall. They don't ask for help feeling,"I'm strong. I can handle it myself, I don't need anyone's help." They are unable to receive help when it is offered feeling,"If I open myself to help from someone I'm putting myself in their hands and they are either unreliable or they will hurt me."
Working with this block is a profound therapeutic challenge. With these clients it is especially important to provide a warm and welcoming environment wherein they can begin to feel safe and know that they can rely on our compassionate caring presence.Simple acts of loving kindness are important. For example, having a welcoming attitude,personally offering them a tissue when they are tearful, offering water/tea/coffee as a symbol of nurturance, praising them for some small act of growth etc. Of course ,these clients often have trouble receiving these acts of kindness. These are very important moments in the therapeutic relationship. It provides us with an opportunity to explore more deeply why they have so much difficulty in receiving these simple acts. More of the childhood history will be uncovered. These moments also lead to another aspect of their relationships that these clients don't usually consider - how their rejection of human kindness affects the person who offers the help. These exchanges within the therapeutic relationship often are the turning points. As they gradually learn to accept help from us, our clients become more open to receiving help from others who genuinely care for them.

INNER MEASURING STICK

Most of the men that I've worked with struggle with this difficulty in being able to ask for help and/or receive it when it's offered. At some level of consciousness they have internalized as a "measuring stick" of their feelings about themselves as a man the archetypal American image of a "real man". A "real man" is someone who can do everything, who accomplishes everything on his own and needs no one. Even though in recent decades this definition of what a man should be is changing, at an unconscious level this old ideal still holds psychological power. What happens for most of my male patients is that whenever they are unable to live up to this totally unrealistic "measuring stick" they feel inferior, smaller than other men. That internal "measuring stick" makes it very difficult to ask for help and/or receive it when offered.
I spend a lot of time in sessions continually bringing this cultural implant into conscious awareness. In addition, I help my patients to look at what aspects of their personal story have contributed to this internal image of what a man should be. I suggest to them is not that they are inferior, but rather that they are using the wrong "measuring stick." the one that has been implanted does not fit who they are. They need to develop a different "measuring stick."
I have written extensively(the "Men" chapter in "Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy") about how,within the therapeutic relationship, we can further help our male clients with this issue.

WISEHEART; A PERSONAL RELATIONSHIP WITH MY HIGHER SELF

Many years ago - as a way of developing a more intimate relationship with that aspect of my consciousness - I named my Higher Self. I call him Wiseheart. By giving him a name that transcendent aspect of my consciousness moved from being an abstract notion (which might have many possible labels: Higher Self, personal Higher Power, Buddha Nature, Christ Consciousness …) to something more concrete and deeply personal. The visual image I have of him is that of a bearded old man who emanates deep loving compassion and wisdom. In a corner of my office, behind the chairs where patients sit, I have placed a totem of Wiseheart - the face of a bearded old man carved from second growth redwood. On a tree across the brook that runs behind my home I have hung a similar concrete image of my old friend. Both of these iconic images are daily reminders of the ongoing presence in my life of Wiseheart.
My life and work have been deeply enriched by this relationship with Wiseheart. The purpose of this brief essay is to encourage other psychotherapists and counsellors, in whatever way works for you, to develop a more intimate relationship with your Higher Self. Hour after hour, day after day we are in the psychological field of the suffering and struggles of our clients. We are exposed to so much sadness, fear, confusion, doubt. To be a compassionate open-hearted presence wherein our minds and our hearts are fully engaged with the struggles of our clients is -if we really allow ourselves to think about it - too daunting a task for our small selves, our small hearts. By connecting to something larger within ourselves, something that has a much larger Heart capable of great compassion and love, and something that is capable of more transcendent perspectives on the issues of our patients, it is very possible to be compassionately present with them for hours without becoming overwhelmed, numb or depleted. Our Higher Self is that source within our own consciousness. The good news is that He/She is always with us. Our task is to become more aware that this aspect of our consciousness exists, to engage more fully in an ongoing intimate relationship with it and to develop ways of connecting with our Higher Self during sessions.
Five minutes before starting my early morning or late afternoon sessions I look at my carving of Wiseheart, take some meditational breaths, and ask Him for assistance. "Help me to be a vehicle of compassion, of loving kindness and the wisdom of the heart with my patients today. Help me to tap into the healing knowledge within me and from other sources of wisdom outside of myself." Then I open the door and welcome my first person.
Invariably as the daily work unfolds I am in the psychological energy field of some big sadness/fearfulness/confusion/anger that my patients are experiencing. I think that the ordinary human reaction at these moments would be to pull back or shut down -probably without conscious awareness -our hearts as a way of protecting ourselves from being overwhelmed by the bigness of the feelings. What I have learned to do as soon as I become aware that my patient is experiencing one of these big emotional states is to look over at Wiseheart and start doing some meditational breathing. With the in-breath I imagine that I am connecting to this Big Heart, that aspect of my Higher Self that is easily able to be present in a deeply compassionate way. I also imagine that I am accessing wisdom perspectives that transcend ordinary consciousness. With the out-breath I imagine that I am letting go of any anxiety about being overwhelmed, that I am releasing any of my patient's big feelings that may have entered the psychological; energy field of my personal consciousness.
I continue to be grateful for and awed by how doing this enables me to be present in an open-hearted loving way in the face of huge patient feelings. For hours. And not feel emotionally drained, numb or detached. Having done this way of connecting to Wiseheart for many years I never cease to be amazed by His capacity to be deeply compassionate in the presence of some horrific stories and to be a source of what some ancient sages referred to as "the peace that underlies all things."
As I end this essay I again want to encourage psychotherapists and counsellors to develop some daily practice of connecting to your personal Higher Self.Before I begin my contemplative walks in local nature settings I say to myself that one of my intentions is to use this time to deepen my connection to Wiseheart. After my meditations I pray that I become more open and receptive to Wiseheart,s love and guidance. I am profoundly grateful that He provides me with loving companionship and wise guidance both in my everyday life and in my work as a psychotherapist. I hope that your Higher Self does the same for you.


This blog entry is based on work in the Small Heart,Big Heart chapter of "Working From the Heart: A Psychotherapist's Guide to Heart-Centered Psychotherapy"

MOVING FROM SURVIVING TO THRIVING

It's so hard to change the patterns of a lifetime. It requires hard, conscious work. And compassion towards ourselves. Our patterns of behaving are deeply rooted. Because these behaviors have been repeated and reinforced so many times during our lives they are so well engrained neurochemically that we are brain-wired to repeat them.
We are also afraid to change our ways of acting and thinking because they serve a self-protective function. They helped us to survive when we were younger. Some of us come from backgrounds of significant physical, sexual or psychological abuse or profound emotional neglect. For many of us the impact of our earlier environment was more subtle. Without an awareness of the impact upon us our parents,teachers et al were critical or judgmental of our sensitive Selves. Or there was a familiar atmosphere of fearfulness, tension, anger or sadness. This felt, at some level of consciousness, unsafe. So our Selves went into a self-protective hiding place and developed outward ways of behaving in order to survive. Although the use of the word survive may,in some instances, seem exaggerated or unnecessarily melodramatic, for the sensitive Self the stakes feel very high and the notion of surviving in a hostile or neglectful environment is very fitting.
For most of our patients - although this is not true for those who are currently in abusive situations - the need to be in a survival mode no longer exists. However,before they are able to put in the very hard work of changing, our patients need to understand how their patterns initially developed. Also, they need to perceive that unwittingly they are continuing now to act as if the same degree of physical or psychological threat still exists. After that initial therapeutic work is done I tell my patients,"It is time to move from surviving to thriving." In order for their Self to develop more fully - to thrive - they will have to do some hard work. While this is happening I encourage them to say to themselves the phrase/mantra, "I'm moving from surviving to thriving." Simple aphorisms - because in a few words they embody a simple and profound truth - like that can be very helpful and potent in this deep inner work.
As therapists it is very important for us to embody and express compassion for how difficult it is to change these patterns. Patients usually become judgmental and angry toward themselves because they are having such a difficult time changing. It seems to them that it should be simple. I often say,"Be gentle with yourself. Be compassionate towards yourself. It is very hard to change the patterns of a lifetime." I remind them that our brains are wired to respond in these ways, that the patterns are deeply engrained neurochemically and that, at some level of consciousness, they serve a self-protective function. Gradually, through my repeating."Be gentle with yourself" my patients internalize this phrase and become more compassionate toward themselves during the difficult process of changing.

HELP ME TO FORGIVE MYSELF

At some point in their therapy every client tells us something for which they need to forgive themselves. Yet for most of us our training did not teach us how to help our clients to forgive themselves. I learned how about twenty years ago from a very painful personal experience.
From that experience I was able to discern four important aspects of a process. First, while there are certain steps that we can take to facilitate the work, self-forgiveness unfolds with each person according to its own timetable. The other three aspects have to do with using petitionary prayer, the healing power of spending time in nature and the importance of using some guided imagery as a way of tapping into other realms of consciousness.
Self-forgiveness is not a rational process. It cannot effectively be attained through analytic reasoning,some form of intellectual understanding or some other primarily cognitive process. Because forgiveness occurs in the territory of the heart and spirit it can only be accessed in those realms. As psychotherapists and counselors we need to find ways of tapping into those other realms of consciousness that transcend our everyday ego processes.
I encourage my patients to use certain prayers/mantras. Sometimes these prayers are a kind of petition that is reaching out to some external source of forgiveness outside of ourselves. What patients call this source depends on their particular spiritual path. These prayers also attempt to connect us to some internal source of forgiveness. I tell my patients that they are calling on some aspect of their personal consciousness that transcends their everyday mind, a source of deep inner wisdom that knows what is in their best interests. I use the terms Higher Self, Deep Self or Personal Higher Power to give a name to this inner source. When one of those names does not resonate with a particular patient, we find something else.
I write on three separate index cards:
Help Me To Forgive Myself
Please Forgive Me
Help Me To Feel Forgiven
and give them to my patients suggesting that they put them in a shirt/blouse pocket next to their heart, in their car or in some other place where they will see it often. I encourage them to take the cards out and say these prayers/mantras often between sessions. In the first session after I hand them those cards I ask my patients about their experience in using the cards. Most commonly they have used them only a few times often guiltily reporting,"I didn't do my homework". I respond warmly with a smile,"That's what happens with most patients. That's how guilt works - it will undermine our work by getting you not to do what will help you to feel better." And then I encourage them to do more. They usually do.
I also suggest taking the prayers with them on solitary walks to some local nature setting that is special to them. Contemplating the words while walking in the woods, by the ocean, along a brook or on the top of a hill deepens the efficacy of the prayer. I explain to my patients that in many ancient spiritual traditions it was common for people, whenever they needed some deep psychospiritual healing, to go away from the distractions of everyday life and go into the natural world. This form of retreat into some place in nature fostered greater access to other non-rational realms of consciousness both within and outside of themselves.
After several weeks of saying the prayers and visiting their nature place between sessions I begin to use guided imagery. I ask my patient to close their eyes and have them do several minutes of meditational breathing. Then I say," Imagine that you are taking a solitary walk in your nature setting. Remember that this is a safe place where no harm can come to you." For some patients who prefer forest settings I will guide them to a clearing in the woods with an ancient deeply rooted tree in the center; for others it will be a long walk along the edge of the ocean listening to the gentle waves; for others it will be a walk through the woods to their brook or river where there will be a stone to sit on. After a while I will say,"Stop walking. Now begin to imagine coming towards you at a distance that feels safe to you, some image of forgiveness. It is important to trust whatever image shows up at this time, even if it makes no sense to you. Spend some time just witnessing this image. Now begin to imagine opening up your heart and letting in the forgiveness that the image in some way is offering."
In the twenty years that I've been doing this self-forgiveness work I've witnessed a wide spectrum of images. Sometimes what emerges is very personal to that patient - some loved one or beloved pet. Sometimes it will be an image from their spiritual or religious tradition. Sometimes it will be an archetypal image. Sometimes a "presence". Sometimes a warm light or enveloping fog. Sometimes... Since a lot of what happens in this work is mysterious and idiosyncratic to that person, it is important for us to respect whatever image shows up and to quiet down our need to analyze or interpret. Sometimes a patient spontaneously tells why he/she thinks that a particular image occurred. I've learned over these many years that my need to analyze and understand can interfere with a sacred process. So nowadays I rarely inquire - unless I can't contain my curiosity.
Usually there will be a number of these imagery sessions, sometimes in back to back sessions, more commonly interspersed over several months. For some clients the forgiveness image remains the same each time. Often it changes. It is essential to trust how the process unfolds with each patient and to remember that forgiveness does not occur in linear time. You may do this imagery work for weeks and at some point it feels finished. Then for many patients the need for more work becomes clear six months later. In these instances forgiveness needs over time to penetrate through many layers of consciousness.

Of course it is not possible within the limitations of a blog entry to discuss all the ways of working with self-forgiveness in great depth. For a deeper discussion including several examples of particular patients and a description of my personal experience that led to this work take a look at "Wisdom of the Heart: A Therapist's Guide to Heart-Centered Psychotherapy.

I LOVE MY PATIENTS

I love my patients. When I say this it oftentimes makes others uncomfortable.On one occasion I was being interviewed by a psychiatrist on radio and she said,"I read your book and I really liked what you had to say. However, your using the word love made me uncomfortable. I think that I would have preferred the word nurture - I nurture my patients." I responded,"I am aware that it makes people uncomfortable- sometimes it makes me a little uncomfortable too. We need to ask ourselves why does saying'I love my patients' make us feel that way?" One of the reasons is that in our culture the first associations to the word love are usually to sexual or romantic love. Of course,those expressions of love would probably be harmful to our patients. Yet, in other areas there is a wide spectrum of acceptable expressions of that feeling. We can easily say "I love...my children, my wife,boyfriend,friends,animals,home, community etc. Why not include patients?
Another explanation for the internal struggles is that it feels unprofessional to say,"I love my patients." We tend to define professional as objective and not emotionally attached. Yet, in some other cultures that is not true. Several years ago a dear friend,who is a psychotherapist, was on a trip in Cuba sponsored by a social justice organization. On this two week trip she was among a group of health care professionals who were in Cuba to witness how their health care system worked and to interact with Cuban health care professionals. She was very surprised to witness how often and easily the Cubans said,"I love you" and were openly expressive of their love toward their patients. And how openly they expressed that love of their patients at professional meetings. When she returned we had several interesting conversations. We discussed how our training emphasizes this other notion of "professional" as objective and non-attached - more scientific. It led us to recall how important it was for the early leaders of the fledgling fields of psychotherapy to be accepted by members of the medical and scientific community. They felt that in order to establish the legitimacy of this field among the other sciences that it was essential for them to be viewed as objective and emotionally distant. It seemed to both of us that we were still unnecessarily holding on to that earlier model.
When I am asked during interviews how I express my love I reply that, first of all,it is important to state that I am not talking about sexual or romantic or sentimental love. Those expressions of love towards our patients would be unprofessional and harmful. I am talking about open-hearted expressions of praise,encouragement,compassion,acts of loving kindness,warmth,celebrations of growth,consoling touch,non-judgment,caring challenges etc. A common response from other psychotherapists and counselors is,"I do those things too although probably not as often as I feel them and I don't really talk about it with my colleagues. Also, I don't usually think of those things as an important part of the treatment." Yet,according to the research literature about effective psychotherapy, when clients are asked what was most helpful to you in your therapy most frequently people reply that,"My therapist cared about me as a person." Moreover,there is increasing research on brain patterns indicating that compassionate caring over a period of time changes brain patterns in positive directions.
For most of us psychotherapists, counselors, life coaches, pastoral counselors a significant part of our original intentions in doing this work was our heartfelt desire to help people with their problems - to alleviate human suffering. For many of us our training with its emphasis on theories, techniques and professionalism has caused us to suppress those original heartfelt feelings.
A primary motive for me in writing the book,"Working From the Heart:A Therapist's Guide to Heart-Centered Psychotherapy", doing this monthly blog and Twitter, and making my youtube videos is to advocate that we return to our original heartfelt intention by being more openly expressive of our caring. Then our patients benefit not only from our theories and techniques, but also from our open-hearted expressions of love.

WHAT IS IN MY BEST INTERESTS?

Whenever patients are faced with conflicts I encourage them to ask themselves the question, "What is in my best interests at this time of my life?" Sometimes the conflict is a major life dilemma the resolution of which will probably change their life in significant ways. In these instances I tell them that, "This conflict cannot be resolved at the level of consciousness at which it currently exists. A good resolution that is in the best interests of your total personality can only come from a higher level of consciousness by engaging your Higher Self and your compassionate heart". Then I describe to them the technique of The Council. This process of convening a Council to resolve major life dilemmas is described in detail elsewhere in an earlier blog entry, in my youtube videos and in a chapter in my book, "Working From the Heart:A Therapist's Guide to Heart-Centered Psychotherapy?
The question,"What is in my best interests?" is also helpful in resolving the small conflicts of everyday life. Usually my client experiences the conflict as being between two different ideas, feelings or courses of action. I ask them to consider the possibility that each idea or feeling is emanating from a different part of their personality. Each part needs to be heard with compassion and honored. Most commonly my patients will describe one feeling or idea and then say "but" and describe the opposite/different feeling or idea. I then encourage them to substitute the word "and" for "but". I explain that that when "but" is used in these circumstances it tends to negate,diminish or devalue what preceded it. By substituting "and" I am valuing both and helping my patient to find a pathway of allowing the two to coexist in their consciousness with compassion. By using the word "and" my patient learns to respect both parts of their personality and begins to have a tool for containing the tension between them. The longer they contain with compassion the tension between the parts the more they create the possibility of a middle path resolution emerging. It may be a creative synthesis of the two ideas or courses of action. Or it may be a totally different third resolution that serves the needs of both parts of the personality. Or it may be that one part of the personality - after having its voice respected and treated with compassion - will realize that the other viewpoint is better for it too.
By encouraging my patients to more frequently ask themselves,"What is in my best interests at this time?" I am helping them to access their higher consciousness with ever increasing frequency. From my perspective the source of this question is their Higher Self. Someone else might say their personal Higher Power or their Inner Wise Elder. Whenever I use this perspective I hold up my right hand - symbolically indicating higher consciousness - as holding the big question, "What is in my best interests?" In my forty years of doing this therapeutic work it has been quite rare that any of my clients were taught about their higher self or shown any ways of accessing it in their everyday lives.
It is a very rewarding feeling for me to hear how my patients gradually internalize this notion and more frequently ask themselves, "What is in my best interests?"


This entry is based on material discussed in more detail in The Council chapter of "Working From the Heart:A Therapist's Guide to Heart-Centered Psychotherapy"

AN ISLAND OF SANITY

For some of our clients we are an island of sanity amidst the madness of their lives. Sometimes there are so many things happening in their lives that they are completely overwhelmed and on the edge of panic much of the time. Sometimes what is happening is mostly internal. They are feeling so much conflict among different parts of themselves or some unwanted long-repressed feelings are emerging from underneath or there is some deep sense of dread about what is going to happen next. Our clients in these situations are feeling very anxious - near terror - that they are going to "crack up" or totally collapse.
During these very difficult times they look to us to be a reliable source of stability - an island of sanity - when everything around them and within them feels like an unending turbulent storm. Our peaceful and compassionate presence provides a sense of refuge that they do not feel with other people in their lives. Our office space,by how we have furnished it and the objects we've place within it, also helps to create this sense of tranquility. This aspect of psychotherapy is rarely ever talked about in our training with its emphasis on theories, techniques and professional objectivity. Yet, I have experienced the importance of this way of being for our clients especially when their outer world or inner world is coming apart.
Jennifer,an old patient of mine, recently called me. The company where she had worked for twenty years decided to close, her husband was diagnosed with cancer and her daughter - the mother of her beloved granddaughter - had inexplicably become closed off. She was having frequent nightmares, daytime panic attacks and felt like "I'm falling apart and I'm going to crack up." Jennifer felt quite embarrassed that she was in this state after having done so well since we ended her psychotherapy ten years earlier. I let her know that I was not disappointed in her and felt honored that she was seeking me out during this very difficult time. I also said it was not unusual for patients to reconnect with me during these kind of crises.
Jennifer felt so relieved to be in the sanctuary of my office where she could feel the reliable safety and peaceful security of my presence. I helped her to understand that part of the reason for her being so overwhelmed and terrified was that these current events were triggering the chaos and profound neglect of her childhood home. This perspective helped her to feel somewhat more stable. However, increasingly she felt flooded by these memories. Combined with the powerlessness created by the unfolding events of her life she continued to feel very anxious about having a breakdown.
I did with Jennifer what I have done with other patients under these circumstances. I gave her something personal from my office that she could take home. I handed her a carving of a tree that I had brought back from a vacation in the redwood forests of Northern California. Redwoods, of course, are trees that heave survived many storms, fires and attacks from insects. They are an iconic image of strength and stability. I held the carving for a while, rubbing my hands on it and said, "Bring this home with you as a reminder of what it feels like to be with me in this office. When you're feeling overwhelmed pick it up and hold it. Keep it until this storm is over and then bring it back to me." My perspective in doing this is that she will be borrowing my strength for a while until she can reclaim her own.
I also asked Jennifer if she felt like there were any other places where she felt safe and sane. She remembered that throughout her childhood she had always gone into the woods near her home. She felt safe there and not alone - like the big trees were protecting her from the emotional insanity of her home. I encouraged her to spend a lot of time in the woods now to recapture that childhood sense of sanctuary and tranquility. I also asked whether she had any photos of those woods or some similar woodland setting. She recalled that she did have a photo of a wooded place that reminded her of that childhood refuge. I told her "Put that photo up in your home. Whenever you're feeling very anxious look at it, remember what it was like to be there . Then do some meditational breathing. Amidst the powerlessness and panic of what's happening in your life now you can reconnect to that old familiar sense of sanity and peacefulness that at some level of consciousness you still carry inside of you." Jennifer smiled warmly, "I like that idea, I can do that."

These ideas are based on the Sanctuary chapter of my book, "Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy