Hi everyone, in the middle of the COVID-19 Pandemic, I turn to writing and thought I'd share my thoughts as a fellow human, capable wounded healer, mom, writer, and human.
Letters to new therapists - Being Brave.
It’s less about what you say and more about what people feel when they are with you.
Go into waters that may be scary. I’m not suggesting you operate out of your scope of practice. For example, you don’t want to try EMDR when you’re not certified and comfortable with a treatment approach. However, you can get into the Seeking Safety curriculum and modify it to something you can teach and discuss as an alternative. There's more than one way to approach something or a problem. It’s important that you don’t create more damage to a person – go with your intuition and gut and know your limits. However, pushing yourself and trying new things is what learning and growing means. You’ll fail, you’ll succeed, you’ll walk away feeling like you learned something new regardless. Hopefully your clients will see this in you as well. You want them to be brave, right? You've got to be brave yourself.
I remember being thrown into a DBT group and imploding in my head when the therapist wanted me to teach a chapter to the clients. I had to memorize the material - every little bit of it when getting 50% of it would have been more than what my clients came in with. I put more pressure on myself than what my clients were expecting out of me. Our clients don’t expect us to be perfect and are generally more accepting of our mistakes than we are. It’s also empowering to acknowledge the mistake, name it, ask for forgiveness. They will likely forgive you because they ultimately know you're doing your best and trying to help them. There is grace on both sides but carefully analyze if you’re doing harm.
Whatever you’re trying for the first time will be uncomfortable. Any new skill or strategy is going to feel awkward and this is what we are most often asking our clients to do. Throwing yourself in and moving forward while holding your head high and laughing when you make a wrong move is ok. You’ll make wrong moves. You’ll apologize to your clients when necessary and this will be healing and modeling to them about what being a human being really means. We don’t know all of the answers, we know how to “be” and “think” about oppression and that’s a great starting place.
Find things that interest you. Be curious. Ask other therapists what they have found helpful. You may not feel like you have the time with the stress of work and you’ll also probably think you’re tired after work and can’t take anymore “psychology stuff”. I promise it will be worth it and energizes you, even if you read 10 pages before bed.
My list of most helpful books:
Be you. You're good enough, you're talented and you have the right spirit. For those I supervise, you have it in you and your compass is strong.
A few years ago I was introduced to Dialectical Behavior Therapy. DBT is not just a set of skills or terms but rather, a way of thinking about the world and how people can be assisted by the therapist using both skills and structure of sessions to promote a life worth living.
Resolving trauma while learning a few real-life skills can make a huge impact for those that suffering with emotional intensity problems. The cool thing is -- the skills and learning a new thinking behind them can help those with a variety of problems, not just Borderline Personality Disorder. I have seen the similarities with DBT to various models treating anxiety, addiction, and depression (to name a few). The specific skills taught can help just about anyone wanting to live a better life.
Dialectical (to me anyway) really means that nothing is right, wrong, good, or bad. Usually ALL things have some truth to them and have served purposes in our lives just for survival. We have to learn to think in these terms and find a greater meaning to them. There's a higher "synthesis" with a situation and meaning behind all things. When we can withhold judgement and truly accept what is and validate all sides of the equation we are afforded the opportunity to find meaning.
The founder of DBT posted an article a few years ago outlining why she created the model and how she actually suffered herself from the same things the client she was working with were facing. Read that article here:
Expert on Mental Illness Reveals Her Own Fight
This was totally inspiring to me - here is this brilliant, strong woman who is a leader in the field exposing the rational underneath her model. No wonder why it's so powerful. Dr. Linehan's courage to write her own narrative, at her own pace, and in her own words is a powerful lesson. To be strong doesn't mean you can't be vulnerable. To be courageous doesn't mean having all the answers. To be brave is not without struggle.
I'll be posting a few different blogs on some of the DBT skills that have produced a great impact on their lives in the next few weeks. Some philosophy behind the model in addition to the skills will be discussed as well.
Click here to see Linehan's company/practice.
One of the things I try to be careful about in my work with people and other clinicians is paying attention to the language we use. Language is powerful - it's loaded with meaning. When we work with people, are we referring to "addicts", "alcoholics", "schizophrenics", or "clean/dirty" both inside and outside of sessions? Why would it matter?
It matters because it influences how we think about things. I was called out early in my career by a loving colleague who discussed the ramifications of my noting in reference to a "dirty ua". Does this imply people are dirty? That use is dirty? Does it imply a judgment? You bet it does and I wasn't even aware of the implication. How we think and communicate recovery and our perspectives matters. If you are precisely defining a behavior without judgment, you can feel a lot more hopeful when discussing a situation. For example, if someone is struggling with use and we use "they continue to be dirty for their urinalysis" vs. "they are testing positive for _____" - it takes the emotional and negative perception of a behavior right out of the equation.
In addition, when we label someone as in "denial" we are judging a very real stage of change that is needed for anybody considering a change in their lives... We make it something ugly when we've all been there. Denial is just feedback, feedback a person isn't at a point they are ready to make changes or aware of the need to make changes and respond accordingly with our clinical intervention. Respecting autonomy and stage while having open/honest discussions without judgments can get a person a lot further in your work with them.
When people say "that's so gay" - what does that really mean? It means it's bad, ugly, stupid, and results in hurt and perpetuation of stigma. People who say things like this usually aren't even aware they are doing it because it's ingrained in our culture - until we stop it.
I challenge both helping professionals and those we are serving to avoid labeling yourself or others. Be specific. There's a lot more to a person with alcohol dependence than being labeled an "alcoholic."
They are often fathers, Veterans, artists, children, and someone for whom it is worth defining things differently.
Communication can make or break a relationship. Be aware.
Read more about this: http://www.unleashthenoise.com/2013-summit-findings
Jill Lehmann, LISW, ACSW
Clinical Social Worker. Photographer. Enneagram studier.