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Therapy. What is therapy? What the heck is this thing called therapy all about?

Well—let’s take some of the obvious: therapy can be a vent session, therapy can be about advice giving and taking, therapy can be a place where you, the client, can unashamedly hog the show; indeed, you are supposed to hog the show. Hence some of the negative clichés about therapy as well, particularly the vision of a client being a navel-gazer of enormous proportions, someone who actually pays someone else simply to listen to him/her go on and on and on…and the therapist, in this scenario, is a sly fox, feeding such folk sympathetic attention to keep him/her coming back, week after week, so that with payment, the therapist—oh, I dunno, builds a pool in the back yard or something.

In other, plain words, it is a relationship of users: the client uses the therapist to be a pair of ears one does not have to spend one minute thinking about as anything other than a receptacle, and the therapist uses the client as a continual source of money so its in the therapist’s best interest to limit growth and favor dependence.

Hells bells!

No wonder that there are a whole host of folks out there who are downright suspicious of therapy, contemptuous of those who make use of it, and those who practice it.

But for those who have had the good luck to stumble on a really good therapist—not just those, of which there are literally hundreds of thousands, who are merely adequate—and for the therapist who stumbles upon a really good client—not just those who do simply want to vent unencumbered by insight—magic happens.

Magic.

Magic as a guided, intentional source of energy, exchanged between two people, for the benefit—yes, it must be said—for both.

As a therapist, I have had the great good fortune to meet many, many people who enriched my life. The ways in which they do so are too numerous to list fully. So I will content myself with just a few. One woman, whom I miss today, was a person I watched die. She did so with such positive vigor, a woman who said and meant it, “I am so lucky” during her last months. She felt ‘lucky’ because the disease that was killing her had also made her life meaningful. Without it, she felt she would have continued living in such an unaware way as to render life’s lessons barren; rather, she welcomed the lessons she was being made aware of now.

Now was this woman some sort of freakish Maria of The Sound of Music, determined to take the phrase, ‘lemonade out of lemons’ to a garish degree? I have cancer, whahoo! Oh well—let’s have fun with it, shall we? C’mon kids, gather round—it’s time for a song!

Not a bit of it. She came to me depressed and scared. Life had shrunk down to the dimensions of her living room: wake up, have some coffee, take a gazillion pills (for the cancer), eat a little—and watch TV. Watch a lot of TV. Stare dully at the TV for hours between naps because maybe the TV will drown out the thoughts, the fears, the terrible fears, the realizations, my god, I am dying, I am really dying, my life is literally coming to an end.

But, like all of us, there was also a deep, old, wise part of her that knew that now was the time to wake up. There were lessons to be learned, happiness to savor, old loves

and new loves to nurture, that, even when dying, there is still much living to do, perhaps the most intense living of her life.

And so that is what we together worked on: how to live the best way possible right now, here today because, for her, it literally was one day at a time.

Yes, I helped her. I helped her in the deepest way possible that therapy is capable. But she also helped me. I could not have done such effective therapy without her. This woman had to be willing to go to the depths we did, and, indeed, she had to have such depths in the first place—which she did.

What an experience! I came to love her. I say that without reservation. My love for her did not cross the boundaries of therapy; we did not use sessions like two friends having coffee together. I did not socialize with her outside the therapy office, and though I did come to her home on two occasions, they were because she was too ill to come see me. I kept to these boundaries because, first, foremost, and only, I was her therapist. As her therapist, she had freedom with me, which she sorely needed, the freedom to express—anything at all. She needed a sanctum where any thought, idea, emotion was allowed full access, full exploration in front of a person without judgment. Further, I was a person without some sort of responsibility—other than payment—for her. She did not have to worry about my feelings, for one, the way she clearly did with her daughters, with whom she lived, with her mother and sisters, with her friends…

Saying that she did not have to worry about my feelings does not mean she did not care about me or for me; indeed, she came to love me also. With her, more than most clients, I told her some about my life; she was curious, she was interested, and she needed, more than most clients, to forge a connection with me where she felt she knew me, as I knew her, in ways that deepened that connection.

So she, as a client, and me, as a therapist, had a three year experience together in which both of us were made better, stronger, more loving people than before we had the pleasure of each other’s company.

Magic.

Can magic happen when payment is involved? I realize that is the sticking point for many people—the idea of paying someone to be in a relationship with you because, yes, therapy is a relationship. It feels demeaning, perhaps, a commentary on one’s life. For example, when I went to therapy, I was in a bad marriage, I had bad ‘friends’ and my relationship with my family was so-so. But, to use the same example, this woman had loads of friends! She had loving, loving family. She had compassionate doctors; she had done the cancer support group thang the first go-around with the disease. She was not, as I had been, mired in a barren group of difficult relationships. She had an unusually large group of people (because she was that sort of person), ready to be there with her at a phone’s notice. She had no shortage of relationships..

But for one hour per week, and, for a while, two hours per week, she needed what I could give her as a therapist, not a friend, a sister, a daughter. I have specific skills with which I draw people out, help them be more comfortable with all sorts of thoughts and emotions, and I am an attentive and purposeful listener: I listen differently. Most of us, with those we like and with those we love, listen for similarities. When we hear them, we seize upon them. We exclaim, “Oh, I know just what you mean! When I…” and we’re off and running onto ourselves. Although some people are talk-hogs (we’ve all had experience with those unashamed hams), most don’t intend to silence the original talker; rather, they intend to bond through shared experience. And, of course, a ‘regular’ conversation is one where the talking ball gets bantered back and forth: the ‘talk-listen ratio’ is fifty-fifty.

But a therapist knows when to stay quiet. We note body language, we see the face twisting even while someone is saying brightly, “and that didn’t bother me at all!” We try not to join with our own experience too much because our stuff will shade the speaker’s stuff; it will alter what he/she was about to say before we spoke up. Although people parody the therapist’s response, “so what do you think?” the reason for that response, and others like it, is to draw the person out without influence. We are social animals, we respond to social cues all the time, often even unconsciously so that, while you may not consciously note a person shifting in his chair, you find yourself thinking a minute later, “oh, shoot, I’ve been going on too long,” and now you throw out a polite question. You stop yourself.

So when a person asks a therapist “what do you think?” about a subject matter, it really means “what do you think about me?” and what I want to get to is why this subject matter brings up some fear about what I might think about you. Hence the other parodied response, “why do you want to know what I think?” Since that has become such a cliché, I try other ways to say it, and assure the person I am not being deliberately obtuse or conducting a power play via withholding: “I’m happy to tell you what I think, and I will, but first, I am curious about any emotions you have right now while telling me X, X, and X.” or “what is happening for you right now that has you stopping yourself? You were in the middle of your story.” “Hey—I want to know what you think because this is your life, not mine!” (with humor)

And I will ask more questions too, questions that note and then build up patterns that are emerging, phrases that are repeated, sometimes unconsciously by the speaker, opinions and beliefs and patter in the head (as we all have patter in our heads) that support and/or limit the speaker. I listen with all my attention.

So back to this client who was dying of cancer. Indeed, she paid me. Indeed, I billed her insurance company for those two home visits as well as those to my office. Am I cold, then? Am I merely in it for the money? I visited a dying woman—and charged for it?

Well—for those visits, no, I did not ask her daughters for this woman’s co-pay. Nor did she pay her portion for the second visit for the many months she came twice a week for the simple reason that she could not afford it. I gave her extra, see because this was an extraordinary situation. I had to make judgment calls, just as I need to with other clients, and those are on a case by case basis.

But I am clear in my heart and mind on the matter of payment. I provide a service and it is a unique service. I received rigorous schooling and satisfied the state of California’s many hoops to jump through in order to be licensed for this service. I continue that education which, in any case, I am legally obligated to do to keep that license current. When I meet with my clients, I conduct sessions with their best benefit forefront in my mind. I use the knowledge and training I have received and continue to receive to make use of time in an energized and directed way.

If we ‘chat,’ say, for ten minutes about someone’s pet, that is directed ‘chat.’ I know this client loves the pet; I know that talking about the animal fires up many positive aspects of this client’s best part of his/her personality: love, caring, responsibility, pleasure. It is important to spend some time with those reserves for the client who is usually in some sort of pain. It is a reminder: you are also happy at times, you are also free of your pain at times, there is something or someone in your life who loves you and whom you love. Love—the most healing force of all. So I remind the client of this healing force through seemingly casual talk of a pet. I do so with deliberation.

I know that such ‘chat’ relaxes the client as well, allows the person to make the transition from ‘out there’ to ‘in here.’ Some clients jump right into ‘in here’ and with such people, I go right along with their flow. Others need a little urging to begin opening up about whatever it is that brought them here, or whatever it is that now, months into therapy, is coming up. Talk of a beloved animal, say, usually stirs up feelings, feelings that are deep, and so is a safe, positive transition into that realm—the realm of emotion. Some dive into emotion; others have to do in, like a staircase down, step by step. I know we need to make that journey, go down that staircase, and my job is to create an environment where someone can do so in this therapeutic space, a different place from any other ‘out there.’

One man, with whom I worked for a number of years, needed to gently debate the usefulness of therapy every other session or so. This conversation, always at the beginning of the session, went on for at least three months until it gradually subsided and died away. Why did he keep coming those three months and, after that period, years if he was so doubtful of therapy? Well, for one, there was the matter of gender and, for another, a matter of culture. Some men—by no means all, but some—have trouble accepting a view of themselves as both ‘masculine’ in all the traditional ways we as a society associate with men and as a feeling, thinking human being who is not only angry (since anger is acceptable to men and for men), but who also gets scared, hurt, vulnerable, and lonely. And some cultures foster the more traditional male role models.

He was among those men; thus, choosing therapy—therapy!—disturbed his idea of himself as a man. In these preludes, he was always respectful; in fact, ‘respect’ was a verb he used often: “I respect you and what you do here,” he would say, “but I don’t know if this is for me, really.” So he was not debating me, as some clients do, testing me to see what I will take from them, what I will tolerate. Rather, his inner debate was with himself: is it o.k. for me to need therapy? Aren’t I supposed to ‘be a man’ about this situation I have created, a situation that is not going the way I expected and, thus, I am in pain, pain, pain…

I am getting to the point where I can’t manage the pain. As for the situation, I can’t find a way to leave it, nor can I find a way to make its current status acceptable for me.

He was stuck. Stuck solid. As is said in twelve step circles, “his best thinking had gotten him here,” ‘here’ being a painful trap of his own creation.

At first, he came for three months Then, after saying he wished to continue, he stopped coming though he sent me an occasional, “I’m still here!” communiqué. Four months later, he resumed and now, four years total as I write this, he has reached the occasional visit status. In between, there was around a two year intense period where I saw him, at the least, once a week, often two, sometimes with phone calls and emails in between.

That period was when the situation began to crack open. I’m afraid there was more pain for this man, more even, than when he started therapy because, at that time, he was merely tapping around the problem, beginning to question it, his role, if he could stand being in this role for much longer. Thus, the status quo remained because he was fearful of the possible consequences of dislodging it. So at first we worked with possibility in an intellectual way. “What would happen,” I would wonder, “if you were not so readily available for her?” or “What would it mean if you took steps to create a more meaningful life without her?”

“I can’t do that.”

“I understand that,” I would answer. “We’re just talking here, playing around with what if(s). I want you to consider these ideas; you do not have to put them in action.”

You do not have to act unless—and until—you are ready.

‘Talk’ therapy—the part that is, for a necessary period, simply talk—can be derided as a waste of time and money. From the outside looking in, it appears that a person you know is going to therapy—and continues to do the same thing. She continues to smoke pot every day. He continues his go-nowhere job. They continue to argue. The family continues to blame the wild kid, and the wild kid continues to be wild.

It is not only that it is hard, hard, hard to change, really change, and furthermore, make that change into a habitual mode of living—I believe that people accept that concept as true; they experience it all too often with themselves—it is also that we have to accept, and then enact, a change that often we are fearful of and, the hardest of all, for good reason.

Give up pot? Get sober? Live sober, every day? It is not possible! I can’t do it.

The couple who argues? Who wouldn’t want to give up arguing? But, see, if they stop arguing, then they have to start actually communicating. They have to let each other in. ‘Communication’ and ‘letting one in’ aint so easy when the person with whom you are trying to do those two things is someone, maybe, you don’t trust, you’ve come to dislike in some areas, someone who, most importantly has hurt you.

For the person who is drugging herself every day, that drug is experienced as a good thing. While it may aid pleasure in various ways, its real importance is as a neutralizer: it muffles all emotions unpleasant: fear, anger, sorrow. And this woman usually has very good reason to need that neutralizer. Give it up? Please! And then that dismissive ‘please!” turns into a whispered plea: please don’t take this weapon away from me, this method of keeping my pain manageable. I need it, you see?

Only now the weapon—as drugs and alcohol invariably do—has turned on her.

So for a long period, she uses therapy as a way to begin imagining life without marijuana and all that implies. She practices ‘in here’ what she cannot yet enact ‘out there.’ Together we explore all the many layers that drug addiction carries with it and, sometimes covertly, sometimes overtly, gently or with more force, I present my own plea: please summon your courage. You can do it. And you don’t have to do it alone. Along with me, ‘in here,’ there are groups ‘out there’ who can help you.

Life lived sober is a life worth living—an argument, you see, she is not going to believe for quite some time because usually pot smokers are in only o.k. jobs, have only o.k. friends, if they have friends, and a partner, if they have a partner, with whom they must deaden feelings in order to engage at all. So ‘just’ stopping the smoking really means making vast changes—the kind of changes that are like deciding to remodel and finally realizing the whole structure has to go—and so my argument about courage also means finding the courage to face changes that will have enormous consequences.

Similar stuff for the argumentative couple, see? Maybe they will end up in divorce. Or maybe—sometimes even scarier—they will end up in an entirely different relationship, one that demands a deeper emotional connection and all the behavioral ways that go along with that.

This is why the old Nike challenge—Just Do It!—is so hard for most of us. Just Doing It means taking one important step but a step that we know in our hearts, even when it is good for us, will call into question all these other layers of living.

As I always say, it takes real guts to go to therapy.

And speaking of guts, how about talking to a stranger, eh? Here is a person whom you don’t know at all—and you are here to tell this person your innermost secrets, troubles, concerns? And, further, you pay this person for the privilege?

Hells bells!

But let’s take, say, the intensely private person. I have a client, for example, who only gives out a cell phone number, has a P.O. Box as her mailing address, pays to have her information not displayed on the Internet, and also pays for a service that alerts her to the general location of anyone doing a search on her name.

If you met her, not a friendlier, more charming person would you hope to meet. You would have no idea of the caution, the many layers of that caution, with which you are being observed, and the decisions made based on that observation.

. Her friends, whether or not they know it, are kept firmly at arm’s length. Her rare lovers (and not a more beautiful woman would you hope to meet), are also carefully chosen. They may be allowed into her bed, but they are never going to get a love letter, an angry letter, even a Dear John lover. Letters are words forever in print now in someone’s possession—much too risky.

Such a person is not about to carelessly confide in friends or lovers. For her, my role as an official keeper of secrets, punished by law should I ever disclose them without her permission, is one that allows her to talk freely—well, as freely as she could manage for months until I, too, passed those inner tests. For her and others like her, the word ‘confidential’ is one most prized in the language. And I’ll say this about her, she would be the best person with whom to confide where the body is buried. She would never betray a person’s confidences. Except, well—to me. But she knows that not only do I not know you ‘out there,’ I wouldn’t and couldn’t tell if I did.

Well—for one, there is the matter of honesty. How honest are we with our friends, our partners, our colleagues? And are we honest with ourselves? Do we have enough true insight into ourselves; is it possible to explore ourselves with just ourselves?

I myself tried that for decades. I am a writer in journals, an out loud talker to empty rooms, a reader of books inspirational and philosophical, a debater with others on the Meaning of Life…I knew myself, sure. I knew that, for one, my marriage had soured and, sadly, soured within the first weeks of marriage—yes, you heard me, that was indeed weeks—and there I was, year twenty-two of this relationship (twelve married) when I first went to therapy.

So if I knew myself so bloody well, what the heck was I doing in this relationship for over two decades, eh?

It was like this: because of certain truly awful and scarring events in early childhood, I did not believe I was worthy of anything better. Men were a foreign species to me, scary and untrustworthy. So I had married a weak man I thought I could control. But like many of that ilk, his ‘strengths’ proved to be ironclad: persistent drug use; persistent and angry entitlement; persistent attempts to stay plunged into an alternate reality of his making and to his liking—he was a big participator in Grateful Dead shows, Burning Man festivals, desert ‘happenings.’

Not only did I suspect all of this when I married him at the age of twenty-five because, after all, by then we had been together for ten years, these problems immediately intensified within weeks of marriage. He had campaigned to marry me but, once the deed was done, reality—never a strong point—was now in his face vis-à-vis me. Suddenly I was the symbol of Adult Life. I was now his wife, not just the cool girlfriend, and as his wife, I became the Mother in residence: a female figure from which to rebel, but one to depend upon creating a nice, safe haven when needed. Like all men—all men—he liked having food in the fridge, clothes laundered, a clean house, and available sex. But he also needed to believe he was Wild and Free…blah, blah, blah.

This dilemma was acted out in month three of the marriage and I remember, in all my talks with myself and writings in my journal, that I saw this quite clearly. I wanted out, I did not love him all that much, as he did not love me all that much, but, man, my parents had spent so much on that wedding! We had an elaborate wedding with all the fixins—something that in of itself had taken on a life of its own.

And what about me? I too had only lackluster, part-time employment, I too engaged in persistent drug use (mine was alcohol), I too had trouble with reality—my idea of a retirement plan was that big blockbuster book I was going to write—and so taking action, definitive action, was beyond my slender capabilities at that time.

Was I able, at that time, to be that honest with myself?

Indeed I was not!

So stuck I stayed. I saw his problems, sure, but mine? If I were a therapist to that girl of twenty-five (because she was no woman), I would quietly advocate for strengthening of the self, addressing the childhood damage, cutting out the means of addiction, getting real about supporting oneself in this world, and, finally, cutting loose from a damaging marriage.

And while all of the above might take time, maybe a lot of time, it sure wouldn’t take twenty-two years.

Therapy is something hard to define, a reason why I find myself turning to aspects of it, illustrations of it, and my own experience with it, both as someone whose whole life turned around because of it, and as a therapist now. I find that it can’t really be summed up all nice and neat. Perhaps that is because therapy is neither ‘nice,’ nor ‘neat.’ In contrast, it can be painful and messy. It is like a successful love—it has layers of experience, it inspires many emotions from the gamut of love to hate, it reminds me of Shakespeare’s marvelous musings about women, “… in all her infinite variety.”

So why not try it out for yourself?

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