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How do you do it?
Mar. 14th, 2002 07:26 pmA while back, someone asked me how I manage to do the work of a therapist. Not as in "how do you know what to say?" but as in "how do you listen to such horrible things and survive?" And I told her: it's not some special quality that I have, I'm just using a set of learned skills and routines. Some of them were taught to me by my clinical supervisors, and some I developed on my own.
Today, for the first time in a long while, I found myself needing to consciously run myself through my protective routines upon leaving the clinic. I thought I'd write about them here.
These are specific techniques for unwrapping myself from what's happened in an intense client session. I don't want to detach myself from my clients' emotions and experiences while a session is happening, because I think of empathy as essential to therapy - but I don't want to take their emotions and experiences home, either. (That won't help the client, and it certainly won't help me.) Then there are my own emotions about the session - frustration, maybe, or uncertainty, or just the sheer weight of being the competent, responsible person. I don't really want them to linger past the end of the clinic day either. Here's what I do:
1. Breathe. Not just any breathing, because the fast shallow breaths I tend toward when I'm tense will just make me tenser. I breathe like a singer, from the diaphragm. I breathe in slow and easy, and breathe out with a little more force. As I exhale, I visualize a bubble expanding outward, big enough to contain me, growing a bit larger with each breath. Everything inside the bubble is Rivka. It's my center of calm. The feelings that came from the client aren't part of me, so they get pushed further away as the bubble expands. At first, the bubble collapses back against me, but eventually it gets big enough to keep the center of calm. Then I find the places in my body that are holding the experience of the session: is my stomach fluttering? am I gritting my teeth? The next few times I exhale, I visualize pushing the warm strong air through the part that's holding tension, letting the tension eddy away until it's outside the bubble of my center of calm.
2. Separate that time from this time. That time is when I was doing the work of listening and feeling and responding. This time is not for that work. Here are some of the things that create a separation: Writing my notes. Filing my charts. Putting my coat on and leaving the clinic. Taking off my ID and pager. Driving home. Changing out of my work clothes. Running a mundane sort of errand. Or, if I need to clear my mind quickly before the next client, walking down the hall for a drink of water, or eating a strong-tasting mint.
3. Do something else. If I leave my mind to its own devices, it's far too inclined to slip back to where it's just been. It's better not to let my mind pick the topic, so I'll deliberately set myself something absorbing. Singing along to the car stereo at the top of my lungs, say. Calling a friend to chat about something non-work-related. Shopping for dinner, and focusing my attention on the textures and colors and qualities of the ingredients. Going target shooting. Expect to see a post soon about my trip to the Keys, because that's today's designated something else.
It's taken practice, but it works pretty well. I felt like hell when I left the clinic, and now I feel... tired, but fine. Skills worth having.
Today, for the first time in a long while, I found myself needing to consciously run myself through my protective routines upon leaving the clinic. I thought I'd write about them here.
These are specific techniques for unwrapping myself from what's happened in an intense client session. I don't want to detach myself from my clients' emotions and experiences while a session is happening, because I think of empathy as essential to therapy - but I don't want to take their emotions and experiences home, either. (That won't help the client, and it certainly won't help me.) Then there are my own emotions about the session - frustration, maybe, or uncertainty, or just the sheer weight of being the competent, responsible person. I don't really want them to linger past the end of the clinic day either. Here's what I do:
1. Breathe. Not just any breathing, because the fast shallow breaths I tend toward when I'm tense will just make me tenser. I breathe like a singer, from the diaphragm. I breathe in slow and easy, and breathe out with a little more force. As I exhale, I visualize a bubble expanding outward, big enough to contain me, growing a bit larger with each breath. Everything inside the bubble is Rivka. It's my center of calm. The feelings that came from the client aren't part of me, so they get pushed further away as the bubble expands. At first, the bubble collapses back against me, but eventually it gets big enough to keep the center of calm. Then I find the places in my body that are holding the experience of the session: is my stomach fluttering? am I gritting my teeth? The next few times I exhale, I visualize pushing the warm strong air through the part that's holding tension, letting the tension eddy away until it's outside the bubble of my center of calm.
2. Separate that time from this time. That time is when I was doing the work of listening and feeling and responding. This time is not for that work. Here are some of the things that create a separation: Writing my notes. Filing my charts. Putting my coat on and leaving the clinic. Taking off my ID and pager. Driving home. Changing out of my work clothes. Running a mundane sort of errand. Or, if I need to clear my mind quickly before the next client, walking down the hall for a drink of water, or eating a strong-tasting mint.
3. Do something else. If I leave my mind to its own devices, it's far too inclined to slip back to where it's just been. It's better not to let my mind pick the topic, so I'll deliberately set myself something absorbing. Singing along to the car stereo at the top of my lungs, say. Calling a friend to chat about something non-work-related. Shopping for dinner, and focusing my attention on the textures and colors and qualities of the ingredients. Going target shooting. Expect to see a post soon about my trip to the Keys, because that's today's designated something else.
It's taken practice, but it works pretty well. I felt like hell when I left the clinic, and now I feel... tired, but fine. Skills worth having.
