Member Contributor — Sue Cristol, LMFT

My Client, Myself

The longer I do this work, I am surprised over and over at the benefits it offers. I acknowledge that part of it is the growing number of years I have been on the planet coupled with a long list of “issues” that are alive and well, stubbornly floating to the surface from time to time. Like so many physical ailments, some of our psychological challenges are not cured but rather, managed. How well they are managed depends on a myriad of variables.

When we listen carefully to our clients, we can hear all of them. We help them to understand the impact each factor may have on present and future well-being. It is our mission to uncover, clarify, challenge and continue to be curious. When we, as therapists, continue to evolve, we discover with the client, what variables come into play for us. Together, we uncover what strategies can positively impact functioning, what small behavioral modifications might help and how realistic change is. We and the client are actively involved as partners. When our struggles mirror our client’s, we learn with them and understanding is reinforced for us as well.

We know that for change to be successful, repetition is critical in reinforcing key concepts. We also understand that our client needs to be ready. Sometimes, it is up to us to gently nudge or push things forward. This is a delicate matter. Change is a process many of us resist vehemently. Accepting the resistance and embracing our client with acceptance and patience provides a healthy path forward. “If you can accept and have compassion for me, maybe I can do that for myself someday.” Likewise, as therapist, I am reminded of embracing my trials with an accepting compassionate approach.

When working with clients who struggle with anxiety and depression, guiding the client away from a diet of negative thinking has its challenges. Some therapists who, themselves have been in the pit of depression, intimately know this. They also understand the sense of hopelessness that feels like the pain will continue without end in sight. We can help with introducing a new way of understanding emotional pain. Trying to hide from it, mask it with addictions or living in denial doesn’t effectively move and enable us to start climbing out of the pit. Since many times, we cannot change the circumstances surrounding the offending event, why not change our relationship to the thoughts and feelings instead of racking our brains trying to figure out why we’re having the bad thoughts and feelings.

The self-defeating thoughts are there, try as we might to push them aside or shove them down. Practicing a circumspect acceptance (not approval) with a dose of healthy objectivity sounds impossible at first. However, with practice, I can attest that it is possible. I don’t have to talk specifics with my client because I’m not comfortable with too much self-disclosure. My intimate understanding of depression and anxiety comes across in my way of being and personal attitude. It’s almost an “energy.” I know that a depressive episode has an ending, but I cannot predict when it will come. However, I can hold the hope for my client and enable him to trust that there is an end in sight. At the same time, I am reminded that my state of mind is variable. I cannot alter the contents of the thoughts very much, but with determination and patience I can change my relationship to the thoughts. The shift occurs when the thoughts no longer control me but rather, I am in control of my thoughts.

As explained above, my relationship to the bad thoughts and feelings can shift, especially if I have the intention to change it. An important concept for psychoeducation is metacognition, thinking about thinking! We could talk about the possibility of becoming aware of negative thinking patterns and how shifting focus to an acceptance rather than a withdrawal or denial decreases emotional intensity and opens the door slightly to a healthier outlook.

Working with clients who are going through struggles related to grief and loss can be fraught with countertransference, especially if the feelings represent our unresolved injuries or losses. This is why it is so critical for a therapist to know and understand her own triggers and weaknesses. Even though we may have worked through these issues in our own therapy, they tend to make an appearance when faced with the raw emotions of grief. Here again, I can hold the hope for my client that the pain will lessen with time. I express this with my words and convey an understanding and empathy with my comforting presence.

It was true for me that time lessened the suffering. As we know, the pain does not disappear completely. It does become easier to stay with the grief and then let the feelings pass. When the client and I sit with his almost unbearable feelings of loss, I share in the grief. I am fully present and I believe that the client knows this. We work together to reach a more comfortable place in the grieving process.

Whether it’s about guilt, forgiveness, anger or abandonment, taking the journey with our clients is our mission. Also, encouraging self-determination and empowerment builds self-esteem. Therapy sessions become a safe place where new ways of being are expressed, managing a comfort level with negative feelings are practiced, and my client is not alone in their thoughts. Feeling comfortable to express our authentic selves is a gift for both parties involved.

We know that doing this work is more of a calling than an occupation. It is fulfilling and rewarding. At times, it’s heart-breaking and complicated. The client-therapist relationship is one of the most unique alliances formed by people. What seems, on the surface to be a relationship that is totally one-sided (we know everything about the client and they know little about us), it actually is reciprocal, just in a different way. My client may not know specific details about my life, but he certainly knows my general (core beliefs) view of life. She knows even more when my experiences mirror hers and I can provide an authentic self and grounding presence, even if I do not officially “self-disclose.” It is a fantasy to think that we can have perfect impartiality. And I really don’t know that being totally neutral should be the ideal. After all is said and done, it is the relationship that creates the magic. And that is a wonderful thing.

Susan Cristol, LMFT, is a licensed marriage and family therapist. She works with children, adolescents, couples or adults. Susan stays current on research in the field of special education, as well as research and the many writings in the areas of psychology, sociology and marriage and family therapy. Her specialized training includes (but not limited to) cognitive behavioral therapy, trauma and abuse, domestic violence and play therapy. She may be reached 818.426.5546 or at https://susancristol.com/contact.