Rumination is a primary symptom of mental illness. This occurs when an individual has cycling thoughts of negativity that cause them to feel that their present, past, and future will be and was a failure. When working with clients it is interesting how often they are not aware that they are engaging in ruminating about what is happening in their lives and making negative meaning out of it. With the awareness that this is occurring, change in this pattern is possible.
An example of this occurrence is as follows:
A client is late for an appointment. This brings about a cycle of thinking about all of the bad things they have done to cause themselves to be late. The difference between rumination and normal thinking patterns is that the person is likely to become immobilized by the thinking pattern and not able to problem solve. The experience is of being stuck in the thoughts about what they did wrong versus being constructive in the moment such as contacting the person to let them know you are late, finding ways that may in the future allow you to be on time, or moving on from the event by not thinking about what occurred for too long.
The most tragic feature of rumination is that it steals any possibility of having joy or appreciating that moment. It is like a happiness assassin, killing off all joyful aspects of the time spent in this cycle. It is not possible to have more than one thought at a time so the ruminating moments deprive you of the opportunity for positivity that is always on the other side of suffering.
Domestic violence has an impact on the whole family system. Children of domestic violence especially suffer because of the confusion they experience seeing people that they love treat each other in ways that are not loving. The victim in a domestic violence relationship experiences a strong sense of hopelessness and loss of self esteem. The aggressor lives a life filled with rage and lack of true intimacy.
Working with victims of domestic violence there are clear symptoms present. They are dealing with guilt that they have allowed themselves to be treated badly by someone they love. They are often disappointed that the person they thought they would have mutual love and respect from did not give them these things they needed. The most common symptom I have witnessed is a complete loss of identity and self worth, they no longer trust anyone to love them or give them respect, especially in a romantic relationship.
The children often become the protector of the victim or the justifier of the aggressor. Children have an amazing ability to love their parents no matter how awful their circumstances may be. The resilience of children is remarkable. However, later in life, they often become the victim or perpetrator of violence. There parents their primary teachers, and the cycle continues….
In developing my model of working with clients, which is a constantly evolving process, there is one principle that comes up again and again: Everything is an opportunity. I see this as mostly an exciting prospect, although this also creates a lot of responsibility and hard choices at times. For the purpose of this article, I am going to assert that everything is an opportunity for growth. What is possible when this is the perspective I take as a clinician working with clients and if the clients can also embody this as well?
I will suggest a scenario, a client is struggling with a depressed mood most days. I am working with them on observing their thought patterns and I give them the homework to see everything that happens for one week as an opportunity to grow. When they speak with their partner, children, teacher, employer, and therapist this colors every conversation. When one of these individuals tells them that they are not listening, this could evoke anger. From the perspective of growth, what a great opportunity to be able to see an area to improve their relationship. A client or employee tells you that you are being bossy or controlling, what a great growth opportunity for you to see how you can improve your contribution to the morale of your workplace!
Let’s take a look at the other side, if you take these same scenarios and see them as obstacles to your growth. You are told you are not listening and it becomes another thing you are not doing right in the relationship and you become angry and distant or stop communicating. Then you are informed that you are being controlling and this becomes an obstacle for you to be able to complete your work effectively and give instructions in the workplace or help your client meet their goals. The same scenario, opposite outcomes.
Looking at my work with clients, when I can come from a place of opportunity to grow, I find that clients reach their goals more efficiently and are able to have better and more fulfilling relationships. There is nothing more gratifying in my work then to see clients achieve the goals that bring them a sense of purpose in their lives. They are able to continue to grow far beyond treatment given this tool and teaching them to apply it in their everyday experiences.
Working with clients is a privilege. They inspire, they challenge, and, to be effective with some, they make you think completely out of the box. The therapy box, or room, had long felt constricting to me, especially when working with kids. They often want to be out exploring the world. I have yet to meet one that wants to do a traditional 50 minute talk therapy session. It is sad when I think of how we become socialized to ignore that desire. As has been for many of my main lessons learned while practicing therapy, kids can be an adult’s greatest teacher.
I have seen change occur and goals met by doing whatever it takes, with confidentiality respected, to connect with a client. Some of my most transformed clients were able to deal with their trauma through seeing the ocean for the first time, going on a walk around the block, or in their living room. There are some clients that did not have the resources to come to an office or had a disability that prevented them from easily accessing transportation. Being willing to think outside the box can drastically shift client success in treatment. I believe that mental wellness is for everyone and no one should be excluded from treatment or limited in the way that they can receive it.