Why I do what I do

The good, the bad, and the ugly.

Achievement motivation

Psychologists put forth significant effort to earn a graduate degree, and we tend to value competency, mastery, respectability, upward mobility, and financial achievement.

Connection with others

Therapists may experience a form of depth and authencity in the therapeutic process we do not necessarily experience in other familial or social relationships.

Empathy or identification with vulnerability

Our own personal life experiences may have provided us with a strong sense of empathy, or even identification, with others who feel vulnerable, hurt, wounded, pained, and undervalued.

Voyeurism or vicarious living

“My life is kind of boring, if you want to know the truth. I don’t really do that much other than hang out with friends and watch television. But I love listening to the crazy, wacky stories my clients tell. I love being able to ask them personal questions without them getting offended, things I could never ask people in any other setting. “So what’s your sex life like? “What possessed you to ever do anything like that?” “What is your deepest, darkest secret that you’ve never told anyone before?” I just really enjoy being able to peer inside the windows of people’s minds and hearts. Everything else in my life pales in comparison.”

Prestige and respect

” I don’t make nearly as much money as my sisters do. I don’t have the fancy office or the sports car. But people do look up to me. When they find out I’m a therapist, they treat me like I’m important, like what I do matters to people. I get respect and I like that a lot. It’s worth all the money in the world. And you know what? I respect myself. My sisters and my friends might be successful in business, raking in the bucks, but I know what I do really matters. And at night, I sleep like a baby because I know I’m doing my part to make the world a better place.”

And perhaps most relevant of all, and something I feel I must set aside in a category of its own:

Rescue dynamics

“I grew up not feeling very important or very good about myself. I didn’t feel useful to anyone, least of all myself. But now I get to save people. I know I’m not supposed to believe that or say that, but that’s the way I feel. Every time someone comes in miserable and leaves better off, it’s because I did something that helped – or that’s what I’d prefer to think. I thrive on being able to save people like this, and it makes me feel important.“

Motives acknowledged by clinicans according to Baker, 1992; Disclosures by clinicans by Kottler, 2003.

His-story

So there has been a topic I’ve been breaching for weeks. Actually, about 8. But yesterday, as I was gushing to D yet again about another information-loaded day at school, an idea sparked and this is me attempting to give it form and figure. I was lamenting about the fact that as riveting as the material presented in lectures, seminars and workshops have been, it’s been a tad overwhelming. An onslaught of information so fast, so furious, and yet so terribly fascinating, that integrating it all and making sense of what I’m being taught has proven to be quite the challenge.

And then I forgot my old friends – pen and paper, and words. So here are the beginnings of my first clinical notes, I suppose. The exercise of scribbling down short snippets of observations and points-to-note, now to document what I’m learning, and later on about my patients, certainly appeals strongly to the annotator in me.

I want to just start by saying what an enormous privilege it is to be where I am, at this stage of my education. I will unabashedly exclaim that I’m one of those people who have been blessed with the opportunity to potentially make a living out of what I love, simply, to put passion into practice – and I hope that this is a gift that I will never squander, nor take for granted.

So perhaps I should start with the first lesson that I feel compelled to write about since beginning my clinical training. It was an epiphany of sorts in one of the early workshops on history-taking. It’s a really simple one, in fact. At risk of stating the obvious,

Everyone has a story to tell.

And if you dig deep enough, implore hard enough, are daring enough to let curiosity ask the difficult questions… there are no boring bits either. No matter how bland you think you are, or how dull you think the person next to you is.

So on that particular day, I had to share one of my own. One very close to home. I was strangely at ease with it. Although, I’ve often noted this (slightly worrying) comfort derived from my open book policy – but perhaps this is a conversation for another day. In any case, I put my hands up to play client, and found myself slipping on Dad’s shoes. They were black, but had lost their shine, and were worn at the edges. And clunky, oh so very heavy. And as the flurry of questions came, his many worries and troubles pervaded my mind, his thoughts of hopelessness and worthlessness took turns to batter at my esteem, his words spelling defeat and impending doom became my own.

And I daresay, almost like it was the first time, I really listened, and understood.

The afternoon saw us doing another activity. We were asked to get into pairs, draw our family tree and share with our partner about our histories in whatever propensity we were ready to.

So my partner was one of those people in the cohort whom I would simply label ‘colleague’. Those that you don’t talk to beyond ‘Hey, how’re you going?’, unless there is work to be done collaboratively. Sometimes, I catch myself staring at her traditional garb, covering her from top to toe and find myself wondering (perhaps rather condescendingly) – How could I  begin to understand her world? What could we possibly have in common? How could we ever relate to each other?

Well, my partner surprised me.

Without going into too much detail, she shared in vulnerability and honesty.  She explained her genogram, all the boxes and squares, intersecting lines and crosses painting a rich, vivid history of the drama and dysfunction that marks every family. That she was so forthcoming with her issues, took me aback. But I relaxed a little in my chair when I realized – We’re all psychologists in this room, after all.

No wait, we’re all human.

And it is our pain that knits us together, and our weaknesses on which we build strengths upon.

I think I conclude, at this very early stage of my career, that one of the most fundamental qualities of a good clinician is an inherent interest in other people’s stories.

I hope I’ll never tire of them. I hope that I will always respect the sanctity of each one. I hope that I will never cease to appreciate the beauty of the complex, multi-faceted, and highly individualized nature of every story I come across.

So much more to say, lots of lessons past that I need to recount and catch up on, lots of skills that I need to process more deeply and make second nature. Stay tuned.

GAD

I question with a nervous, sheepish laugh, that I don’t know why I do these things to myself.

I woke up this morning, transfixed in a semi-state of panic, washed by a wave of feverish anxiety almost, at the abrupt realization that I forgot that a possible bias in thinking and reasoning of Generalized Anxiety Disorder is:

The over-estimation of threat/danger of the situation at hand, and an under-estimation of the ability to cope.

Sigh, talk about over-catastrophizing.

And they say, that it is a thin, fine line between sanity and insanity, normalcy and abnormality.

I can say I believe it now.