on being a therapist

Therapy is a mysterious process. Something unique happens when two souls meet in a circumscribed safe space. They affect each other in ways that are hard to describe to the outside world. Many people wonder what makes therapy special and what exactly produces results. When people hear about my training, they start asking me questions, or they make comments about therapy that are wrought with their own assumptions. Usually it's people who haven't experienced therapy for themselves.

I've been thinking about my answers to some of these common questions or comments, so here are my attempts to clear up some misconceptions:

Therapists get paid to be supportive and automatically like the people they work with.
Ethical therapists don't lie to their clients, ever. Sure, we receive some training on how to evade certain questions we feel would be harmful to answer, and we don't disclose too much personal information. But other than that, everything we say is truly what we think and how we feel. We are genuinely amazed by people, their survival and their abilities. We don't love our clients blindly and automatically, without any consideration of who they are, just because it's our job. We don't even necessarily love all aspects of our clients all the time. There are usually things we don't like as well, and when the time is right and the relationship is strong enough, your therapist will probably point those out. But therapy wouldn't be what it is if we didn't find beauty in all of our clients' souls. People, in their struggles, in their vulnerabilities, in pain, in perseverance, are pretty amazing. And this includes every person I have worked with up to now and will work with in the future.

What's the point of therapy; can't you just complain to your friends?
Therapy and friendship are similar and different. Both therapists and friends see people during painful and vulnerable points in their lives, and both like those people despite their faults and mistakes. However, therapists are trained to listen with a different ear. They open up a door in their hearts and take on pieces of people's struggles. Therapists listen to their clients, and they listen to themselves. Therapists listen to the tone in the room. Therapists listen for patterns, for significant motifs, for contexts. Therapists don't even really have any stakes in what you say; they just care about what it means to you. They care about how you're feeling now, and how you felt then. They care about your process through tough times, and they rejoice with you in happy times. So the next time you have an issue that you can't talk to your friends about or a feeling so unbearable it keeps you up at night – great! Talk to a therapist; that's what we're here for.

All people do in therapy is complain in the presence of another person, who just gets paid to listen.
Many people tell me that therapy is just about people whining. They ask me how I can choose to sit and listen to people's endless complaining. What they should be asking me is how I chose a profession that is actually one emotional mind-twist. We function on a completely different level than simply "tolerating whininess" and nodding our heads in automatic agreement. Through tuning in to people's emotions, we actually alter their experiences. Consider this hypothetical scenario: a man comes to therapy after growing up with an aggressive father and an absent mother. He has a general disposition of feeling angry, hurt, helpless, ineffectual, undermined, unappreciated. The female therapist, in her position of caretaking and authority, triggers those feelings, and he is usually angry at her in their sessions. But she, unlike his parents, recognizes those feelings, absorbs his anger without retaliating, and also appreciates and empowers him. Over time, he becomes less self-depricating and explosive, and gains a clearer and healthier sense of self. In other words, the process of therapy actually changes his internal experience. So the whining and the complaining is only the tip of the iceberg of everything that is bound to happen in therapy.

Life sucks, get over it. Everyone has issues, move on.
Occasionally I get the "what's the point of therapy; people just need to learn to suck it up" comment. Incidentally, this is a philosophical question that I (and I assure you, many other therapists) have asked myself as well: if therapy is a relatively new field and people have gone on living in tough circumstances and with painful emotions, then why change it all now and advocate that people get help and feel better? The answer is complex, but for me it boils down to these points: a) people have always sought the help of various healers, for emotional, relationship, sexual, existential, etc. issues; b) our knowledge of ourselves continues to grow, how can we not use it to help ourselves (see: medicine); and c) just because people "sucked it up" before, doesn't mean that they didn't suffer all their lives from emotional ailments that we now know are very preventable and healable. Who knows what was getting people through life before (wizards, tight communities, shorter lifespans, rigid social roles, religions?), now we have this tool that anyone can use to find healing and purpose. And I think everyone should give it a try.

Have anything else to add to how therapy works? Anything else left you curious about therapy?

on being an immigrant part 5.2

What I've worked out for myself so far stems in part from (drum roll please for how therapist of me this will sound) Freud's essay, Mourning and Melancholia. Therein he ponders the sources of sadness and effects of loss on people's beings. Reading every sentence of this essay has been like getting hit by a train of realization.

Of course there is no way of telling who I would have become if I hadn't moved away from my home, but I do know that as a kid, pre-immigration, I was happy, imaginative, rambunctious, and a leader of all the other kids in the neighborhood. I had hardships and difficulties, yes, but I also had many people around me for support and I felt a sense of belonging there. Since coming to the U.S., at least, (and it has been close to 15 years now), I have felt a low-grade but ever-present sense of sadness, loneliness, and somewhat emptiness. It's not that I am depressed; I have energy and friends and interests. I have some zest for life. And it's not that I am completely empty either. My life does have purpose; my personal and professional goals give me a sense of meaning. And yet, I go through life feeling sad and lonely, without a heartfelt connection to many things in the world, my existence sometimes seeming futile. Deep down, I'm melancholy.

In his funky and specialized, yet precise and well-thoughtout way, Freud writes this (emphasis is mine):

Mourning is regularly the reaction to the loss of a loved person, or to the loss of some abstraction which has taken the place of one, such as one's country, liberty, an ideal, and so on. In some people the same influences produce melancholia instead of mourning and we consequently suspect them of a pathological disposition. It is also well worth notice that, although mourning involves grave departures from the normal attitude to life, it never occurs to us to regard it as a pathological condition and to refer it to medical treatment. We rely on its being overcome after a certain lapse of time, and we look upon any interference with it as useless or even harmful (p. 243).

The distinguishing mental features of melancholia are a profoundly painful dejection, cessation of interest in the outside world, loss of the capacity to love, inhibition of all activity, and a lowering of the self-regarding feelings to a degree that finds utterance in self-reproaches and self-revilings, and culminates in a delusional expectation of punishment. This picture becomes a little more intelligible when we consider that, with one exception, the same traits are met with in mourning. The disturbance of self-regard is absent in mourning; but otherwise the features are the same. Profound mourning, the reaction to the loss of someone who is loved, contains the same painful frame of mind, the same loss of interest in the outside world—in so far as it does not recall him—the same loss of capacity to adopt any new object of love (which would mean replacing him) and the same turning away from any activity that is not connected with thoughts of him. It is easy to see that this inhibition and circumscription of the ego is the expression of an exclusive devotion to mourning which leaves nothing over for other purposes or other interests (p. 244).

It is evident that melancholia too may be the reaction to the loss of a loved object. The object has not perhaps actually died, but has been lost as an object of love. One feels justified in maintaining the belief that a loss of this kind has occurred, but one cannot see clearly what it is that has been lost, and it is all the more reasonable to suppose that the patient cannot consciously perceive what he has lost either. This, indeed, might be so even if the patient is aware of the loss which has given rise to his melancholia, but only in the sense that he knows whom he has lost but not what he has lost in him. This would suggest that melancholia is in some way related to an object-loss which is withdrawn from consciousness, in contradistinction to mourning, in which there is nothing about the loss that is unconscious (p. 245).

In mourning we found that the inhibition and loss of interest are fully accounted for by the work of mourning in which the ego is absorbed. In melancholia, the unknown loss will result in a similar internal work and will therefore be responsible for the melancholic inhibition. The difference is that the inhibition of the melancholic seems puzzling to us because we cannot see what it is that is absorbing him so entirely. The melancholic displays something else besides which is lacking in mourning—an extraordinary diminution in his self- regard, an impoverishment of his ego on a grand scale. In mourning it is the world which has become poor and empty; in melancholia it is the ego itself (p. 246). 

Even through Freud's jargon, my condition becomes much more clear to me now: I lost a loved object (the country, the city, the home base, the culture, the language, the people, the sense of belonging) and I have not processed the loss in any conscious or tangible way. In a sense, I am stuck in a loop of "pathological" mourning: I am sad and unable to allow myself to love a new object (new country, new language, new culture, new people) that might "replace" the old one. Because I've acculturated well enough--to the outside world, it looks like I fit in with the new environment--the loss is harder to see, and yet, my entire being is in many ways absorbed in this self-depricating confusing loop of pseudo-mourning. When there is nothing outside of myself to put a finger on, it is I, not the world, that becomes empty and dark.

For now, I am thankful for this clarity and new perspective. It doesn't make the pain any easier, yet, but I know that I am moving in a healing direction. All I can do for now is let myself be still, listen to what is going on inside, and be patient with the timing and unfolding of this process.

on being an immigrant 5.1

Everything I write on this topic seems trite. The words in my head fail me miserably. Is there really a way to describe the width and depth of a painful experience?

***

This picture is how I spent my adolescence. And even though I'm an adult now--an adult who doesn't always sit around sulking and who maybe has a better capacity for tolerating emotions--doesn't mean that somewhere inside I don't still look like this.

Source

I often resort to wearing black, and now I know that it's because black actually is the color of my soul. At least for now, because I'm mourning. Turns out, my life has included a lot of unmourned things that require mourning. The best I can promise myself right now is that I will try as best as I can, considering I've had poor examples and little experience truly mourning losses.

***

I roll my eyes at myself and feel sad about meaningful parts of my life all at the same time. 

on being an immigrant 4

My therapist told me that I have to forgive myself for leaving my home country.

I've been thinking about this phrase for a few hours now, letting it sink in. I, forgive myself.

Am I angry at myself? Am I sad, deeply, with myself? I didn't think so; I wasn't the one who decided to immigrate. Yet this phase made so much sense. What chord was it striking?

It's easy for me to be angry and sad about my childhood circumstances. It's easy to blame the people who plucked me away from an environment where I was comfortable, where I felt supported, where I knew a sense of connection and belonging to those around me. Yet, in some twisted way, I'm punishing myself for being here, and for not being there. This punishment is covert and subtle. It exists mostly in the fundamental grief I feel about being whoever I am now.

Forgiveness is part of the grieving process, and the grieving process is part of healing. So here I am, hopefully on the road to becoming less sad about my autobiography and to feeling OK about my self. 

on being an immigrant part 3

For the most part, overall in life, being bi-cultural is cool and advantageous. I guess. I mean, I can speak two languages and intimately understand two separate world views. I can communicate with a substantial portion of the world and I can even connect people through translation and interpretation. Knowing English is a huge advantage in general, of course, and stating that I am fluent in Russian on a CV is also impressive. I feel special for having extra skills and an edge when it comes to navigating our multicultural world. Having a U.S. passport also gives me traveling rights to most places, whereas having a Russian passport means I never have to deal with visa paperwork to visit my home country. Most people stop at these apparent benefits and proceed to tell me how lucky I am to have had such life circumstances.

But being bi-cultural, for me, is an unending identity crisis without a solution. It's as if my self exists in two towers, with just a few dangly bridges connecting them. There is some communication between the two towers; information can pass back and forth over the bridges. But these connections are tenuous, sometimes slow and sometimes dangerous. Some things never even pass from one side to the other.

Source: 20aday

In my mind's eye, I picture the tower on the right to be the Russian one and the left one to be American*. My self momentarily resides in the tower that corresponds to the context in which I find myself, but most often it runs back and forth between the two towers (my soul is fit?) depending on my various thoughts and moods. So if I am talking to my family in Russia on the phone, for example, I speak mostly from within the Russian tower. But most of the other time, I'm forced to function from the American tower, to effectively adapt to U.S. culture and not seem like such a strange stranger.

But then it gets even more complicated. The two towers are separate enough entities, but they can never be fully distinct. The bridges connecting them are permanent and I can never sever a connection with one identity or the other. When I function from within one of the towers, I know the other exists. There are bridges, doors and windows that cannot close. The other tower always casts a shadow on whatever I am doing within the first tower-context. Also, the Russian tower began building from birth, whereas the American one started construction in adolescence, and thus the Russian one is more sturdy and fundamental. I think my self lives there most of the time, even when I am in the U.S. and even when I speak English, although like I said, towers always cast shadows on each other.

Confused yet? I know I am. This bi-cultural chaos is my daily life inside my head. I try to be fully appreciative of the advantages of my situation, but sometimes it's me who considers single-tower people the lucky ones.

*The therapist in me would chuckle here at the fact that my Russian side feels so right and America is just so gauche!