Dear Young Therapist:
Love is a word you've probably not heard in your training. It's probably not appeared in your textbooks, been a topic in seminars, or come up in conversations with your clinical supervisors.
If you've talked about
love at all, you've probably talked about avoiding it. You might have even been taught that
love is a hinderance to therapy.
The messages about
love that I've learned in the past twenty-one years of clinical practice are clear.
Love is something that must not be discussed between patient and psychotherapist. It certainly is not something to be experienced--and if it is--it should be concealed and unspoken.
Love is too dangerous. It is too confusing. The risks are too great. Patients get confused in therapeutic relationships and mistake care for
love. Some patients, traumatized by violence, are too fragile to understand that
love does not have to be
sexual.
Perhaps you've been taught to be neutral, objective, relatively non-emotional, and essentially impersonal. Perhaps you've even been taught that it's useful to deprive your patients of the emotional connection they want in order to foster growth and achievement of therapeutic goals.
I was admonished by a supervisor once for gratifying a
terminally ill patient's needs by expressing care for him. She was concerned that I wasn't giving him the opportunity to work through his infantile
infintile (thanks CS for finding my parapraxis) dependency needs.
Later, as a postdoctoral fellow, I was taught to never tell a patient that I was proud of them. It was explained that it was too complex of a feeling and patients would get easily confused. I must not ever express
love or
pride. Patients need to learn to accept the limitations of the therapeutic relationship so they can learn to tolerate not getting their needs met in their other relationships.
I've also
learned some other things along the way.
- I wasn't even 20 years old when I had an internship at a rape crisis center. I was left alone in a room to be supportive and helpful for people who endured unimaginable traumas. I had no skills, no words of advice, and certainly no therapeutic interventions. I did the only thing I knew how to do: I cared deeply for my patients and loved them. I never said a word of this, of course. I had already absorbed the notion that love is an unmentionable word in clinical contexts. Still, this was the first time I became aware that expressing care and concern (and genuinely caring and being concerned) for people--in and of itself--can be healing.
- Two years later I was living in Ithaca, New York. It was my last day working at a supervised apartment program for adults who had developmental disabilities and mental illness. The residents threw a surprise party for me. I walked into one of the apartments to do my last check and I was surprised with a song. After a rousing chorus of "For He's a Jolly Good Fellow" each one of the residents and staff gave me a hug. Most of the residents whispered in my ear that they loved me. I whispered quietly into each of their ears "I love you too." I worried what people would think but said it anyway. It was true.
- Two years after that I sat on the back stoop of a shelter for runaway and throwaway teens. A male resident had ran away from the runaway shelter. As he was thinking of returning, I sat with him while he raged against the world and how poorly he had been treated. I looked at him with all the love in my heart. I remained silent fearing what would happen if he heard those words.
- Three years later I sat with an gentleman in his late 50s. He'd been diagnosed with HIV before the virus even had a name. He was having a bad day--filled with pain from the side effects of his medications. He was afraid of dying alone. I sat next to him on the couch and held his hand. I loved him and wished I had the courage to tell him that.
- Three years later, I met two women that forever changed the course of my career. My supervisors and teachers, Robin Cook-Nobles and Judy Jordan, regularly--and fearlessly--talked, taught, and told me that it was okay (and powerful) to love my patients in appropriate ways. I vividly remember the rainy afternoon Robin said that it was okay to love patients, and okay to talk about it. I've never heard a psychologist say that aloud before. I've never heard a psychologist say it again since leaving the Stone Center.
- Later that year I drove to do the oral section of the second part of my comprehensive examinations. My intervention, though concealed with flashy prose and the relational cultural model of the Stone Center, rested in my love of my patient and this song. I almost failed. My intervention was not seen as a strong one. I was not doing things like I was supposed to--I failed to conform to accepted protocols. My stubbornness and belief in the inherent worth of my patient carried the day. I passed.
- A few years after that, as a post-doctoral fellow, I worked with a rather ornery teenager. Rather than talk with me and tell me how much he disliked me and the rest of the world, he sprawled himself out on the couch and pretended to sleep. Every so often one eye would peep open to see if I was still paying attention. I sat for the entire hour focused on him, loving him, and imaging how his parents might have (or might not have) just sat gazing at him with love when he was a tiny baby. My supervisor, Louise Ryder, seemed moved to tears when I told her this story. I was too.
I've developed a good deal of technical brilliance in the last twenty-one years of working with people. I can create masterful interventions in a variety of modalities and nimbly conceptualize people and problems from a variety of theoretical orientations. You'll need to learn how to do this too, young therapist. It's a necessary part of learning to be a good at what we do.
Technique and skill, however, are not enough. Don't let yourself dwell too much thinking you are something special. Most
trained monkeys can develop technical brilliance with the number of hours we spend in supervision and class.
There are more important things that cannot be taught. They must be discovered.
You'll need to learn to
love.
Loving patients is a dangerous method. Yet in the end, I think you'll learn that it is the only method that you'll keep by your side--day in and day out--for your entire career.
Love is the only method and theory that I have. It is the place from which every action I take as a psychologist originates from--at least on days in which I am not cranky. I suspect many other therapists, of all training and orientations, would discover the same after wading through years of injunctions against and
fear about
love.
When I graduated from high school my mother gave me the book her mother gave to her when she graduated from high school. In some ways, this passage started my development as a psychologist. Vicktor Frankl writes in his book
Man's Search for Meaning:
Love is the only way to grasp another human being in the innermost core of his personality. No one can become fully aware of the very essence of another human being unless he loves him. By his love he is enabled to see the essential traits and features in the beloved person; and even more, he sees that which is potential in him, which is not yet actualized but yet ought to be actualized. Furthermore, by his love, the loving person enables the beloved person to actualize these potentialities. By making him aware of what he can be and of what he should become, he makes these potentialities come true.
More recently, reading Gail Hornstein's book
To Redeem on Person is to Redeem the World: The Life of Frieda Fromm-Reichmann, I came across this passage from Erich Fromm's book
The Anatomy of Human Destructiveness:
To have faith means to dare, to think the unthinkable, yet to act within the limits of the realistically possible; it is the paradoxical hope to expect the Messiah every day, yet not to lose heart when he has not come at the appointed hour. This hope is not passive and it is not patient; on the contrary, it is impatient and active, looking for every possibility of action within the realm of the real possibilities.
So there you have it.
Love and
Faith. The two bookends of my professional practice as a psychologist. Deceptively simple. Incredibly powerful. Often scorned by the professional community.
I'm old enough to no longer care how my fellow psychologists evaluate me. I'm skilled enough to know how to wield these twin tools of relational growth and change within the safe boundaries of a therapeutic relationship.
I'm thankful that I've never met a patient that I couldn't
love or couldn't learn to
love. It's from that space that I begin to see the seeds of where a person might be able to go, grow, and let go. It's from that space that I can find the confidence to let go of wanting a patient to be something I need them to be (or society needs them to be) and let them go about finding what they need themselves to be.
Still, young therapist, I don't frequently tell my patients that I
love them. It
is often dangerous and disruptive to use the word. Patients
can become incredibly confused and conflicted. Too many therapists also become confused and conflicted.
Just because
love is dangerous, doesn't mean it shouldn't be thought about.
I am not afraid to
love and to say that I do when a moment of genuine honesty is the best intervention. Don't forget this, young therapist. Don't forget that our work is built on a foundation of faith in humanity and
love of the person who sits across from you.
The flashy (or boring) masterful interventions and protocols you learn are necessary. Caring and
loving and believing in humanity is necessary. Neither, on their own, is enough to accomplish much of anything. Joined together you have the possibility for movement and growth.
You need to both become a master at your craft and a master at loving a fellow human being--being with a patient,
loving them, caring for them, and having faith in them--in combination with masterful interventions--that allows another person to find themselves.
We wither and die alone.
We grow
in connection with others. We grow in being
loved by another. We grow in finding that after all we've experienced,
you've got the love inside--it's been there all along.
