Wednesday, January 24, 2018

EVOLVING AS A PSYCHOTHERAPIST

As I reflect upon my over 40 years as a psychotherapist I can now see there were stages in my evolution. I have also witnessed similar patterns in the therapists I have supervised and in colleagues that I've known for many years.The evolution has not been completely linear. There were certainly moments of creativity during my imitation period and there continue to be moments of imitation during the this later more authentic epoch.
IMITATION AND IMMERSION
In my earliest years as a psychotherapist I usually simply imitated what my therapist had done with me.At times it was pure mimicry - using the same words, gestures and tone of voice. My first therapist was a psychoanalyst. When I realized that I needed more training and supervision I went for four years of point-doctoral study to the same institute where he had trained. For those four years I read extensively and almost exclusively the writings of Freud, his followers and the neo-Freudians of the next generations of psychoanalysts. I immersed myself in that tradition.
If Freud witnessed how I worked now he would probably turn over in his grave or more likely excommunicate me for betraying him, the psychoanalytic tradition and my teachers. Yet I strongly feel that period of imitation and immersion was essential for the foundation of my lifework as a psychotherapist. I also acknowledge that I still use some of those concepts and techniques - they are now expressed through the unique synthesis that is my more authentic self.
Imitating our therapist or supervisor or favorite author was not a negative, it was necessary. We read extensively or entered a training program and assimilated ideas and techniques within a particular theoretical framework that we were initially drawn to or exposed to. It was important to immerse ourselves so that a solid foundation got built through practicing certain techniques and internalizing ideas within that paradigm.
Perhaps it might be fitting to describe that initial stage as an apprenticeship.
During this early period of our development some of our initial expressions of creativity and movement toward a more authentic self often show up as acts of rebellion or subversion. My second therapist was the head of this analytic institute. In therapy with him I refused to lie on the couch. In the atmosphere of that psychoanalytic institute that was a very rebellious act - an early signal that I was going to follow my own path.
With some of my early patients who were adult children of alcoholics I went against what was then a cardinal rule of psychoanalysis - to remain neutral and not disclose yourself. I revealed that my father too was an alcoholic. My patients deeply appreciated that empathic linkage. I took a further step and submitted an article describing my unorthodox ways of working with that population of patients. Somewhat to my surprise it was accepted by a respected psychoanalytic journal.
MASTERING THE CRAFT
As we practice the techniques that we have assimilated we learn: what works for some clients and not others; what ideas explain issues that our clients are struggling with and what does not; what ways of working are a good fit for our personality and what feels inauthentic.
In order to further evolve in the craft of psychotherapist it then becomes essential to intentionally expose ourselves to other theoretical perspectives and to expand our repertoire of techniques and strategies. This stretches us in that we are not rigidly adhering to a particular framework and broadens what we can offer our clients. As we explore and incorporate these other pathways what occurs - often unconsciously - is an internal reorganization of theoretical perspectives and a synthesis into a new therapeutic self. I explored Jungian,humanistic, cognitive-behavioral, psychosynthesis and many other perspectives. Increasingly we then find it hard to answer the frequently asked question,"Are you a Jungian, cognitive-behaviorist, Freudian...? What would you call yourself?"
BECOMING MORE AUTHENTIC
Many therapists over a number of years are able to develop a high level of mastery of the craft of psychotherapist. They expand what they can offer their clients by synthesizing the ideas and techniques of these other approaches. Yet they tend to stay within the boundaries of the known and familiar rarely breaking out to try something radically new, something that is their own unique insight or technique.
From my perspective it is important in the later stage of our evolution as a psychotherapists to consistently take more risks - to say or do more things with our clients that are authentically our own, that we have not consciously heard or read about others doing. To be more creative. This is not to say that we haven't been creative before or that these ideas are not influenced by others.
Sometimes these creative movements emerge from a personal life experience. For example, my ideas and strategies for helping my patients with self-forgiveness evolved from an identity crisis precipitated by my initiating a divorce. Nothing in my professional experience provided a clue how to forgive myself for the overwhelming guilt I felt for causing so much pain to people that I loved. I then developed ways of helping my patients to forgive themselves that were inspired by my personal journey.
Another, the technique of The Council, emerged from a weekend retreat in an isolated cabin that I took when I was turning 60. I had decided to imagine that the different parts of my personality were on this retreat and were addressing the question,"What is happening in my inner life as I enter my 60's?" I took a yellow legal pad - the same kind that I am writing on now to compose this blog - and unexpectedly I wrote pages and pages of thoughts and feelings. That led to the concept of The Council - a very effective tool that I now utilize when patients are facing a major life decision or entering a transitional moment in their lives.
Two medical crises, one was a very aggressive cancer in my mid-60's and the other seven months ago shortly after my 75th birthday, wherein I almost died liberated me to be more self-disclosing in unexpected ways. My patients dealing with their own medical crises or issues of aging and dying have been profoundly grateful for these moments of empathic connecting.
At other times these creative moments just spontaneously arise during a session where we suddenly find ourselves saying something to or doing something with a client that we've never thought of or done before. And its on the mark! It's exactly right for that person and that moment. Afterwards we find ourselves wondering,"What just happened? Where did that come from?" It is our creative and courageous - going beyond the boundaries of what is familiar and known - response to that moment.
These moments off letting go and being receptive to "something" flowing through me have increased since about ten years ago I started to more actively cultivate my relationship with my own personal Higher Self.In addition to my conscious efforts to engage my Higher Self during my contemplative walks in nature I started a practice of meditational preparation before starting work. Before I begin seeing my first patient I spend at least five minutes in meditational breathing and asking my Higher Self, "Please help me to be a vehicle of compassion and heart wisdom." Also, "Help me to connect to other sources of wisdom and healing beyond myself. Help me to be open to the assistance of the Higher Self of my patients." During sessions, particularly at moments when I feel uncertain what to say or confused by what is happening or overwhelmed by the amount of emotion that my patient is expressing, I ask my Higher Self for help. These "prayers" have helped to create a receptive space in my ordinary consciousness so that these creative moments of inspiration from multiple sources of consciousness can occur. At these times I feel more fully alive and authentically present to the moment.

Many of the ideas expressed in this blog have been influenced and inspired by writings about creativity in Oliver Sacks recent posthumous book,"The River Of Consciousness."