I spent a portion of the last six months of my internship traveling around the country interviewing for a job. I came close a few times. One was particularly exciting: a community college in Oregon was hiring an assistant director of their counseling center. As I was for every other job I got an interview for, I was named the runner up. Runner up wasn't going to get me employed.
So my internship was coming to a close and I was become a little concerned. I call a friend, who calls a friend, who calls me back. They told me about this clinic in Cambridge that has a post-doctoral training program. I made a few phone calls and before I know it, I'm on Harvard Square for an interview.
The whole interview experience was a hoot. It was a hot humid day, I was recovering from a minor surgery, and the person I interviewed was interested in giving me a hard-hitting stress interview. It took me nearly a year to forgive the psychologist who interviewed me. In the end, he became one of my favorite mentors. I'll have to leave this story for a future blog post.
In the end I was offered a part-time postdoctoral fellowship that paid just over the poverty level. I made a few other phone calls and arranged for another part time job at a local counseling center. I was busy--and barely made enough money to pay my bills--but I had the pieces I needed to get my post-degree hours in so I could sit for my license.
Apparently I interviewed for a fellowship that involved working with adolescents who were highly suicidal and engaged in self-injurious behavior. Who knew? I remember hearing something about Dialectic Behavioral Therapy (DBT) in my doctoral program. That was my main role in my fellowship: working with adolescents in an intensive day treatment program as well as in an outpatient clinic doing DBT.
Marsha Linehan and her followers can sometime take on the aura of a cult. Sometimes it feels that those "on the inside" think that DBT is the only treatment--the only way--to work with people. They have done some fantastic research. That's for sure. They've done some fantastic research in highly controlled settings with highly controlled patient populations. In real-world practice, DBT provides a useful tool to use in combination with other useful tools. Empirically supported treatments work a bit differently when they are taken out of the lab.
Below is a great clip of Dr. Linehan explaining DBT. She said something early in the clip--something important and worth highlighting (and is the point of this blog post). At 1:04 Linehan says "I love her so much." What? A psychologist loving a patient? That's not supposed to happen, right?
To date I have four examples of psychologists who I have heard talk about loving patients: Marsha Linehan,
Irene Stiver,
Robin Cook-Nobles (a former training supervisor and mentor), and
Judy Jordan (another mentor who deeply influenced my training). Check out the companion blog entry to this one called "
A Few Notes on Love."
I think talking about love is an important dialogue for psychotherapists--and it's something that I'd like to hear Linehan talk more about. As a fellow, and then later as a psychologist in private practice, I've heard scores of psychologists, social workers, psychiatrists, and counselors talk with contempt about their patients. I watch in horror as these folks lose their ability to see the humanity in those that they work with and reduce their patients down to a list of bothersome symptoms.
One of the gifts of what Linehan offers in DBT is acceptance--acceptance of patients--acceptance of feelings--and acceptance that people are doing the best they can. Many get blinded by the tools, language, structure, and research of DBT. They loose the basic humanity--the acceptance and love--of the the patient.
Here is Linehan's entire talk. It's worth watching--especially the parts where you catch her humanity, acceptance, and love.
