Friday, January 25, 2008

More on my therapeutic approach

The past few days have been a light work load. As I result, I’ve had time to read and reflect. I am currently reading a book by Irvin Yalom, The Gift of Therapy: a letter to a new generation of therapists which serves as the catalyst for this post. (In my studies, Irv Yalom is considered a “classic.” His work on group theory and therapy was a must read.)

The three values that shape my life and work are healing, courage and freedom. If you review the first page of the sexualhealthinsittute.org website, these three words are integrated into a mission statement. I try to use these values that shape all my relationships in my personal life as well. I thought it might be helpful to expand on these values as they relate to my work with clients.

Healing.

Nearly every client I work with struggles with a sense of brokenness, impairment in their ability to relate to others, struggle to get by in life, and otherwise simply connect with their own internal power. In some clients, the pain and brokenness is palpable: you see it in their face, the way they walk, talk, and the way they look at others in the world. My goal is to provide a space where they can experience as sense of relief from their pain and brokenness, if even for one hour. While the sources of the pain are varied, the amazing consistent struggle is that every client is struggling to experience a sense of healing. Healing might be mean relief, or awareness, or even insight as to why pain might be there. While I’d like to believe that the pain and brokenness will go away, in some cases the pain and brokenness might be permanent. Such might be the case of a loss, illness, or death; or as some theorists hold, experiencing pain and brokenness is simply a part of being human. When the pain cannot be erased, I’m committed to walking part of the journey together. Sometimes simply walking with another person is enough to ameliorate the feeling of separateness and isolation that accompanies the pain and brokenness. Sometimes the shared experience can transform the pain and brokenness into an awakening that is startling.

Courage.

Too often people minimize their own courageous behaviors. Our culture, through the movies and media, has reduced courage to acts of bravery on the battlefield. Unless you are facing a life or death situation, courage does not exist. This portrayal minimizes the infinite expressions of courage that I see in my work. For me, courage is the commitment to act in the face of fear. Courage is expressed by simply showing up in my office. Courage is expressed by disclosing to your partner the sexual compulsive behavior. Courage is expressed when a sex offender sits before his victim apologizing for his crime and asking for forgiveness. Courage is in the victim of a sex offender who confronts their abuser determined not to let the offender’s behavior destroy their life. Courage is in the individual who profoundly accepts an insight into reality; whether it is accepting the thought “I’m gay,” I’m positive,” or the addict who says “I have a problem.” Courage is when a client takes a moment where he or she is confronted and says “your right.” Courage is when a client accepts an awareness of how a particularly thinking error has shaped his/her life. In the many years I’ve been doing this work, I’m amazed at the number and types of courageous expression. And, in my own personal life, courage is when I confront a client out of a commitment to healing, even if I’m fearful the client will bolt and terminate therapy. As therapists, were taught that we’re supposed to help our clients feel better. I know I’ve created temporary pain for a client by uncovering and reflecting a painful reality. My commitment in my work is to be as open, honest, loving and courageous as possible to facilitate healing. And yes, that may mean sharing things with you that you don’t want to hear. Courage is when we struggle through the pain. That is when healing occurs.

Freedom.

Our society often equates freedom with free will. We often take a narcissistic view that freedom allows me to do what I want; and more often than not, freedom is framed as “You can’t tell me what to do.” In essence, unless I get my way, or what I want, I’m not experiencing freedom. The current rhetoric in American Politics is based on this approach. Instead, in my work, I emphasize freedom as a profound acceptance of what is. With this acceptance there is the ability to generate new possibilities to act. Hence, truth is the prerequisite for freedom. (This perhaps helps the reader understand the emphasis on confronting thinking errors.) From the profound acceptance of truth/reality, the client is better able to make choices that reflect a positive goal in their life. Two examples come to mind. First, profoundly accepting that you are manipulating others around your chemical or sexual behavior allows you to stop manipulating others. If you aren’t accepting this reality, your denial prevents you from being free. A second example is a person who profoundly accepts their same-sex sexual attraction. Avoiding this reality creates shame, depression, avoidance, and a diminished sense of self. Acceptance allows the opportunity for the individual to make free choices about what to do next. Why the emphasis of a profound acceptance? Too many times, both in my personal life and in my professional work, I see situations where someone says they accept “what is” only for the thinking errors to change to type of avoidance. Hence, for me a profound acceptance is acceptance that creates a transformation. And honestly, this type of acceptance is incremental and a process rather than an off/off switch. Therapy is the process of radical acceptance of “what is” and therefore allowing freedom. When this experience occurs, the experience is transforming, both for the individual and for me as a witness to their courage and freedom.

The three values shape my work. It is the therapeutic relationship that I commit to living these values with integrity. Now, I’m human, and I know I make mistakes. I welcome opportunities for my own growth in this process as well. While it may be your therapy hour, I know I’m touched by your transformation.

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