Tag: therapists

Grief is Love with Nowhere to Go : Therapy

One of the privileges of my therapy practice, quite distinct from many of my colleagues who work in large counseling clinics, is the ability to have long-term relationships with clients. I have several clients with whom I have worked with for over a decade. That longevity is not the norm for most therapy experiences, of course. Most of us access therapy to find help for mind/body problems that can find a great deal of relief and resolution in a few months’ time. My practice is a bit different; while I do see clients for the many common psychological problems humans have, my work is centered on our experiences within our families.

Families are how human beings form loyal connections, raise children, share culture and manage change. No matter what form our nuclear family took, we are each a product of our parents’ genetic lines, and their emotional outlook on the effort of living. The decadeslong development of human children means we are subject to the personalities, resources and behaviors of those we live with. Then in adulthood, most of us form intimate partnerships, creating the next generation of our family. The continuing influence and problems that this large network of relationships creates for each of us is the focus of family systems therapy.

A couple of weeks ago, I came close to another aspect of life families manage, death. One of my wonderful clients — a person of faith, so passionate for her spouse and children, a devoted professional, loving neighbor, co-worker, and friend — lost her life to an aggressive cancer, smack in mid-life. We had talked together about her personal challenges for over 10 years, and when the cancer that had been quiet for a while rose back up with force this spring, I knew that our remaining time would be precious and short.

I know how to walk with those at the end of life as a pastor. I know how to provide spiritual care at this mysterious, liminal passage. But I had yet to grieve a client who had been in current therapy with me. As her last difficult weeks passed, even our brief conversations had to give way to more critical ones with physical medicine providers. One of my client’s final acts of grace toward me was to put her pastor in touch with me, who could share her experience and keep me informed of funeral plans. Then my client died as she had hoped, quietly in her own home. Her pastor as well as her husband lovingly reached out to me later with the funeral plan.

On a hot Friday morning, I drove to her church. Hundreds of us came together to grieve and remember. I was an anonymous mourner, known by sight to only two people in that large sanctuary. And yet, I belonged. It was perhaps one of the best funerals I have ever attended. Gorgeous music she chose; loving, true words spoken about her; and God’s gracious love for us spoken and shared in word and sacrament filled the sanctuary with quiet hope. It was a wrenching, heartachingly joyful service for someone gone too soon from those who needed her and need her still. Need her still.

We live in an increasing isolated culture, each stuck in our pockets of neighborhood, home life, children’s activities, workplace, political concerns and a thousand small but essential obligations. While there may be so many times in your life when you feel unseen, forgotten or left out, I want to remind you of the power of your most essential relationships. Human beings hold one another together, and while it may go unspoken so much of the time, we are the world for one another.

And yet, we don’t often say it. Or believe it could be true that we are that important to others. We have so many hundreds of thoughts and concerns we manage just to get through each day. We have deep cultural belief in the myths of individualism and independence; we may live quiet, solitary lives. But, as this experience of loss has reminded me again, our lives are so unique and irretrievably short. We don’t know the length of our lives, and yet we barrel on as if we can live forever.

Nothing matters more than love. Loving ourselves for our own mental and spiritual health, loving our neighbor for the sake of our shared world, loving our friends for the deep and varied connections they make and loving those who share our daily life in family. What is that beautiful and true saying about grief? Grief is just love with nowhere to go. May you love with breadth and abandon and may you know that deep love in return.

Written for / published in the Savage PACER 9/30/2023

Is a Vaccine at Odds with the Christian Faith?

The Christian faith is all about loving God and neighbor. Get immune, save and love your neighbor and their children. Get the Covid vaccine.

Perhaps it’s never been possible to have agreement on the definition of a faith tradition; ideas about what it means to follow a religion have always been fluid and contentious. I read a news article this week that a settlement was reached in an employment religious discrimination lawsuit, granting a Minnesota man $65,000 in back pay and damages from his former employer over his refusal to be fingerprinted for a required background check. He said it was against his Christian faith to do so.

Henry Harrington claimed that his employer, Ascension Point Recovery Services (APRS), a debt collection company, had failed to make the required accommodation for his belief and fired him. A similar employment case was filed four years ago in Pennsylvania, when a local school bus driver refused fingerprinting as part of her background check, claiming that the process would leave the “mark of the devil” on her, preventing her future entrance to heaven. That’s news to me.

Many more of these religious objection cases have been filed across the country in recent years as social and legal changes have pressed up against long held personal beliefs about social responsibility, employment requirements, privacy rights and our own physical autonomy.

Can a life insurance company, considering you for a new policy, require you to release to them your full physical and mental health record, disclose your family medical history, take your blood pressure and a sample of your blood? Might they also review the public filing of your divorce decree from 10 years back? They have been doing such things legally for decades. Can a federal employer take your photo, driver’s license number, Passport information as well fingerprints to screen you for a job? Will it search for any records of arrest or legal charges brought against you in national data bases? Most certainly it will.

As more information about our individual lives is collected and shared, many of us are pushing back. Where does my right to security of person and property end and legal or social demands begin? And when we must make arguments for protecting those intuitive, personal boundaries, it’s no wonder that issues of faith, meaning and core values come front and center.

These same issues, it seems to me, are at the center of the debate around Covid vaccine mandates. For most of 2020, we prayed and hoped for the miracle of a safe and effective vaccine to be created by our nation’s research scientists, folks who have been steadily working on similar virus strains of influenza, bird flu, and SARS for decades. Because of the previous research, the vaccines came quickly, tentatively released after multiple trials with eager volunteers, giving us hope that it would snuff out the pandemic and its possible mutations with our majority immunity.

The vaccine is free for all. Now anyone over 12 can get immunized! And even after weeks and months of pleading and even cash incentives, 20% of eligible Americans have refused this life-saving medicine.

I have come to understand this refusal by so many as the result of all the loss of privacy many of us feel over the last two generations mentioned earlier. Some people, claiming conflicts with the vaccine and their faith practices, have received exemptions from vaccination in the past few months, risking their own health and the life and wellbeing of those around them.  Even when such exemptions don’t seem to be wise or practical, current law does allow such freedom when it comes to boundaries set by a person’s sincere religious practice.

But people are still dying, children are still not protected, and our medical personnel are traumatized by the continuing demands on their health and stamina. As new mandates are announced, reluctant employees are claiming a religious exemption, requesting letters of support from their Christian clergy. I want to go on the record with this admonition: Don’t ask your pastor for such a letter. Your pastor can’t make a coherent faith argument against receiving an approved vaccination that will save your life and the life of those around you.

Why? Because, quite simply, the Christian faith is centered on the life and ministry of Jesus of Nazareth. And if there is a central theme to his life and teaching, it is love of God and love of neighbor. In this, Jesus taught, is all the Law and the Prophets. It’s not about creating a cover for your distrust of government, or resentment that you are expected to take medicine because someone else says so. It is not so you can live your life exactly on your own terms, shouting “freedom” until you are hoarse. Every day of his life, Jesus spoke and demonstrated his gospel, that as God loves us, so we are called to that same love of one another. To take proven medicine when you can, to save your own life as well as the life of the weak, young or vulnerable, is discipleship work. There is no religious excuse that makes any sense to me. Love Jesus? Love your neighbor. And get your shots.

 

(Written for The Savage Pacer, Spiritual Reflection column; Published Saturday, 9/18/21)

 

 

What is Structural Family Therapy?

I’m grateful to Sal Minuchin for helping us as family therapists understand, conceptualize and maneuver within the dynamic structures of families: the way that the emotional and legal connections of parents to their children over generations create fluid as well as fixed patterns of hierarchies, loyalties, rules, subsystems, coalitions and boundaries. While we may know these experiences instinctively, his theory gives us a vocabulary, structure and system of talking and thinking about these automatic family features.

I’m particularly glad for the way his ideas give us a way to talk about family power. How are marriages formed? How do parents use their power over children? What does it mean to be a grandparent, a sibling, a twin, a youngest or oldest child? Who creates the family rules? Who breaks them? Of critical importance is the way that this theory helps me to conceptualize children’s emotional dysfunction. I don’t have to think simply in individualistic, intrapersonal terms. I’m free to think, speak and intervene with children’s pain interpersonally by helping their parents better manage their own functioning, power, and relational well-being.

Every time I draw a new genogram, and hear about a conflicted marriage, a stressed child, or cut-off grandparents, and think about rules, power and family structure, I draw upon the core ideas of Minuchin and generations of clinicians after him who have helped us all become students of family structure.

1/2021: Here’s a great detailed look at Structural Family Therapy from a new counseling resource, Choosing Therapy: https://www.choosingtherapy.com/structural-family-therapy/

Sometimes it IS About You

As a family therapist and systems thinker, I view the conflicts and discussions in my therapy office as shared events and problems. We are all connected; what I do effects my spouse, my children and other close relationships, just as what they do effects me.

But there are times when one person’s habits, behaviors, attitudes, or choices are the source of a system’s pain. A problem frequently has a source. And it just might be you.

One of the most pained expressions I hear after couples therapy is the complaint that “therapy is always about me” and never focused on their partner. I hear it most frequently from my male clients. This reflects, I believe, the fact that men don’t often start conflict conversations in their relationships, leaving their women partners to do all that heavy emotional lifting. If their troubled patterns have been going on long enough, and the woman, despite how often she requests help or change, is always doing the complaining, the man is inevitably backed into his corner. Of course he feels that therapy is always about him. Because he has to travel so many emotional miles to catch up to where his partner has been.

In other situations, it may be that addiction is stealing away all the relationship and family stability. Or infidelity and secrets have damaged the sense of safety and closeness. Or one partner’s failure to care for their health, or work life, or family of origin problems weighs the entire family down. While all of these issues have system impacts, it just might be true that therapy, at least as we begin to unwind the issues, may truly feel like it’s All About You.

Please Don’t Lie to Me

I know as a person and therapist that Truth with a capital T is often a very subjective target. Your truth about an experience doesn’t have to be anywhere near my version of the truth of that same thing. You may LOVE Taylor Swift as a musician, and me? Well, I’m more Bruce. We went to the same concert perhaps, but did we have the same experience? No.

But when it comes to arriving at some shared version of what is or has happened in your family or marriage, or where you went on a vacation, or what your child said to both of you when she arrived after curfew last weekend, we should be able to agree on a mutual version of facts. We won’t get the details quite straight, but we should be in the same county. Even the same neighborhood. When we can and do, we can begin to talk about what is painful, or good, or what is not working or what you may want to talk about changing.

What sets us all up for failure, however, is when one person in the conversation is lying. Omitting facts or key feelings, covering up important details, scamming the rest of us in the group. I have to tell you, I’m a pretty good judge of people, most of the time. But I get slammed rather regularly by clients who have been lying to their spouse or to their family and friends for so long they are great deceivers. We will go session after session, even month after month, and I will notice that we aren’t getting much traction for emotional or behavior change. I will hear reports from one side of funny feelings or vague worries they have, and I keep working to be optimistic and focused.

And then the phone call, or the teary confession. “I’ve been having an affair.” “I want out.” “I can’t do this anymore.” Hits me up the side of the head every time.

If you are going to spend the money and time and energy to do therapy, please know that I will begin by trusting you to tell me the truth. Maybe not the Whole Truth, and Nothing But, but some version of truth that helps me know what we are all talking about. If you want some help uncovering that secret in the rest of your life, you will need to start by trusting me to hear it. Please don’t lie to me. I can’t help you when you do.

 

What’s So Bad About Excellence?

I had another conversation with my professional mentor last week, and she said something about me and my good friend, K, as we finished the conversation:

… “it’s because you (both) over-function.”

Now, if you have been part of my training in psychotherapy, you would know that over-functioning is not a great thing. It’s not even a good thing. It implies that I regularly do more in my relationships than is necessary or even helpful. I felt the power of her comment today in a session with a couple in which I was working hard, being helpful, resourceful, and empathetic all at once. I was working, but I was working very hard.

But here’s the rub: what’s the difference between doing more than necessary and striving for excellence? Because that’s what I see myself doing. Pursuing professional and personal excellence. My clients count on me to bring a centered self into their time with me, a professional who has done her homework, reflected on their lives with them in session and on my own time, and who is prepared for their questions.

If I don’t bring my best efforts to my sessions, isn’t that the same as me under-performing? In the context of the primary models of family therapy, doing too much in the room doesn’t allow the space or energy for the client to lead their own therapy.  I want my clients to lead their own work. I just find, however, that that is only possible when I model what that means in the context of self reflection and critical thinking.

I know one thing for sure: I don’t want to be an under-functioner just to show how flexible I can be. Like most things in the therapy room, I will be looking for the sweet spot of the middle way, doing my best and then, helping my clients succeed, to get out of their way and walk beside them.