Taking Our Own Advice

Between painting and sanding walls, packing up my books and visiting people, I've been reading a Christmas present from my Da, entitled 'On Being a Therapist' by Jeffrey A. Kottler. Kottler makes the point that as a therapist, if we pay attention to the themes that re-surface, over and over again, in our conversations with clients, we'll actually find the key to many of the issues that are most core to our own psychopathologies. Some of the one-liners that he's corralled sound much like me, in some of my most exhortative moments:

- If you do not take care of yourself, no one else will.
- We will be dead for a very long time.
- Symptoms are useful for getting your attention.
- Symptoms will not go away until they are no longer needed.
- We are all afraid to be alone.
- If you do not expect anything, you'll never be disappointed.
- One hundred years from now, nobody will care what you did with your life.
- The material world is seductive.
- Feeling powerless is a state of mind.
- We spend our lives trying to control our hormones.
- No matter what you do or say, half the world will like it and half will not.
- You will never have your parents approval.
- You have a lot less to lose than you think.
- We will never be content for very long.
- It's hard to love without vulnerability.
- Change does not occur without taking risks.
- We are all afraid of being wrong.
- We do not like the responsibility of being right.
- Everything worth doing is difficult. (pg 56)

Further on, because I have a (strong, oh yeah) tendency to practice transference and countertransference as a mechanism for avoiding intimacy, there are some useful questions Kottler suggests confronting when you realise that someone has, erm, 'got your goat':

- What is it that first brought the strong feelings to your attention?
- How are you overreacting to what is going on between you?
- How might you be attempting to disown the problem by blaming the client for being resistant?
- What might you be expecting the client to do that he or she is either unable or unwilling to do?
- how could you alter or reframe your working diagnosis in such a way that you feel less frustration or futility?
- Who does this person remind you of? (I LIKE this one - TN)
- How might you be distorting the way the client appears to you based on your own projected feelings?
- What needs of yours are not being met in this relationship?
- How is your competence being challenged by this person?
- Which buttons of yours are being constantly pushed by the client?
- What is the conflict between you really about? (pg 128 - 129)

And some self review questions in times of burnout, that to me are useful in any role of responsibility, be it managerial, pedagogical, pastoral or medical:

- What haunts you?
- In what ways are you not fully functioning?
- What are some aspects of your lifestyle that are unhealthy?
- What about your dysfunctional relationships?
- Where is your pain lodged?
- How do you medicate yourself?
- What are the lies that you are telling yourself?
- What are you hiding from?
- How is your narcissism showing?
- Who gets to you and why?
- What do your fantasies during session reveal?
- What is it about your secret self that remains hidden?
- What are your doubts and insecurities?
- What are you denying or disowning?
- How does all of this affect your work with clients?
- What is it about these questions that you find most threatening? (pg 173 - 174)

And there's great suggestions for planning a Transformative Trip that doesn't have to go beyond your own backyard - when we get bogged, stuck, burnt, and need some tools for regeneration:

* (Note that the comments on these points are my own - TN)

- Start before we leave - tell people what we're going to do - read a novel, dig the garden, do a sudoku puzzle everyday, paint a wall;
- Go native - get outside of our comfort zone and adopt some of the local customs that we've rarely, or never, tried before;
- Be a snoop - develop the habit of curious questioning in regards to what is going on in the world around us;
- Watch and listen carefully - on the premise that 'it's all new' take an alerted stance in our new activities, breathe them in deep;
- Suspend judgments - we're in unfamiliar territory. It's important to remain open to it rather than closing down with habituated evaluations;
- Get lost - the best bits of life can be the ones we don't plan for.
- Plan for relapses - to maintain the benefits of our 'holiday', what maintenance program can we put in place? (based on pg 238)

Somewhere between altruism and voyeurism, are the challenges, risks and rewards of being a therapist. This is a book with a strong sense of the personal story that lives in the heart of the practicing therapist, and the ongoing dialogue in our own selves that predicates our relationships with clients.