If Everything Is An Opportunity

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.

Out of the Box

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.

Those who Suffer

I often wonder what makes a client more likely to have a positive and enthused perspective on life.  I have come to find, through 10 years of consistent exposure and work with communities that are low-income and immigrate due to violence and unstable environments, that these are the clients that actually tend to have these characteristics.  Reading their stories on paper, it would seem that they have all the reason in the world to think negatively based on past life experiences, yet they tend to have more loving relationships, appreciation for the little material possessions they have, and consistently come to their therapy sessions able to more easily access joy in their lives than others.

It has been a source of inspiration in my work to listen to these individuals able to have gratitude for the good in their lives.  Many have experienced the death of loved ones because of war in their country, an inability to find jobs that can support a standard United States lifestyle, or have had severe childhood trauma such as physical and sexual abuse, yet they still possess an ability to see the positive in their circumstances.  Those who suffer the most severe trauma often, in my professional experience, have the most positive perspectives on life.  One of the most rewarding parts of working with these individuals is that they come to be aware of the resources they possess to overcome trauma and then are able to achieve their treatment goals with greater velocity.

People don’t choose trauma but they can choose how to react to trauma.  Individuals that seek out therapy are looking to improve their lives and not be victims of their traumas.  When these individuals are given the tools to overcome their traumas and their positive perspectives are used as their greatest resource, they are likely to create a healthy realization of themselves and feel the freedom that they are seeking.  They then have access to create further healing for their communities.   

The importance of liking your clients

I remember my first session with a client like it was yesterday.  The walls of my graduate school counseling center therapy room were stark white and the chairs were very hard.  My palms were sweaty and I was highly aware that there was a two way mirror where my instructors could see what I believed was likely to be a train wreck.  The client came in, a young woman not much younger than myself, and sat across from me.  I searched my memory frantically for every intervention, skill, anything I could think of to share with this client.  Before I knew it 50 minutes had passed. I have no recollection of a word I said to this young woman, but I was so happy to have survived.

After the session I met with my professors to debrief what had happened in the first session.  I was terrified yet again and was sure that they were going to give me a long list of suggestions of what I could do with this client in the future and maybe suggest a different career path, obviously I was a bit nervous about feedback.  When I was given the feedback there was only one question posed, do you like your client?  My instant reaction was, what does that matter?  Then, when probed to look deeper, I realized that this was one of the most fundamental aspects to being an effective therapist.

When I thought about this client more, I realized that I had not cared about getting to know her well enough to even make a decision on whether I liked her or not.  I had made some preliminary judgements about her. I was more just relieved that she showed up.  When I shifted the focus to how I was relating to her as a human I realized that not only was this the key to her trusting me, but that I now had access to helping her in a genuine manner instead of worrying about my performance or, now that I have my own practice, making a sustainable living through my work.   Clients know how you feel about them therefore this area is essential to helping anyone achieve mental wellness.

“Nobody listens to me, EVER!”

Working with human beings, some believe, is a very complicated task.  They are “complicated,” they are “selfish,” and they “never listen.”  There is one particular group of human beings that is often considered to be especially challenged in these ways: THE TEENAGER.  Yes, there certainly is a fair amount of proof from parents and other adults that the raging hormones and the constant pushing of boundaries makes communicating with a teenager difficult.  As a result I have become curious, why is this one of my favorite groups of individuals to see in the therapy office?

There are a predictable set of circumstances that occur when a teen sits in my office.  They will look at me suspiciously, as if I have some very insincere reason for meeting with them.  Sometimes they will not talk to me.  Occasionally I will get one word sentences.  Then there are the outliers that talk to me like they have not spoken with anyone in weeks!  I have sat for 50 painstaking minutes in total silence with a teen because they were not “in the mood” to talk. I like a good challenge but my main goal was to help them have mental wellness and since talk therapy is my training talking is a crucial piece of the process.

Finally, I just started asking them why they had such unconventional communication styles and resoundingly the answer was some form of “Reina, nobody listens to me, ever.”   A whole group of people, at the threshold of adulthood with so much potential, and they are tuned out by those that have the power to mentor them into the exciting next phase of life.  When I realized this I saw that I could make an important difference in the lives of these humans if I did one simple thing: listen.  These non-verbal, one word, anxious-talking individuals started to talk about the areas of life that were causing their suffering and, by listening to them, we were able to reach goals that previously had not been attainable because of mental health challenges.

I met some of my greatest teachers in these teens because they have so much bottled up wisdom that they were so happy to share once they knew that somebody was actually listening and collaborating instead of making demands and giving commands without considering what will most help them. Bear in mind, they do not trust many adults because they have had a lot of experiences of not being listened to.  So, it will take some time for them to share but, with some patience and persistence, they will share and your relationship will strengthen and they’ll be able to heal from their traumas in a supportive setting.  Everyone deserves to be heard and supported, this is a crucial part of achieving mental wellness.

The Depression Epidemic

In the United States in the year 2015 there is something that is infecting all age groups, ethnicities, socio-economic classes, and regions.  According to the National Institute of Mental Health (NIMH) and the Center for Disease Control (CDC) depression is a disease that continues to kill, spread rapidly, and infect indiscriminately.  Depression is an outbreak that is causing people to have a significantly lower quality of life and that contributes to major family stress and separation.  There is a treatment: go to therapy and take medication.  However, most do not access these avenues and thus the epidemic spreads.

Why do people not seek out the help that they need?  If they had another life threatening disease, would they not go to the doctor, get medication, or at least be able to take some time off of work?  A likely scenario is this: A human is infected by depression and then they tell someone if they are desperate enough because it feels that bad.  The other human may tell them “snap out of it,” “go for a walk,” “think positively,” or “maybe you should go talk to someone,” as if they were not already talking to someone.  Let’s face it, mental illness is an uncomfortable subject to talk about for many and so people usually avoid such conversations.

Let’s compare this to another disease, the spread of a flu virus.  The flu shares many of the same characteristics as depression (it kills, can spread rapidly, and infects indiscriminately), yet think of what someone is likely to say to you if you tell them you have the flu.  Maybe, “take some time off,” “go see the doctor,” and “what can I do to help?”  The response has shifted from fear and deflection to a focus on self care, advice to seek professional assistance, and others offering support.   Thus, people can just “get over” the flu because they have supportive resources that help them to overcome the disease rather then perpetuate it.

So what can we do to change the depression epidemic into the depression eradication.  A crazy notion that is held in many professional circles is that depression is not seen as something that can be removed from the world but rather simply treated.  I disagree with this mentality.  Unlike an epidemic that is spread by an organism, we can not kill off or isolate those spreading the epidemic.  However, we can access and eliminate the vector that is causing the depression epidemic to spread.  From the paradigm I hold, the family systems paradigm, the vector, or transmitter of the disease, is the degeneration of the family system.  The source of the degeneration is a shift of priority from taking care of each other to taking care of only ourselves and only using other human beings as a means to take care of ourselves. 

I assert that if we took care of others as a priority then depression would no longer exist.  If we stop perpetuating the social norm of looking after only oneself by rewarding those who do so with more money, accolades, and respect, we would be able to eliminate the vector of depression.  We are feeding the vector and thus the cycle of depression continues.  The epidemic will continue to spread and the quality of life will decrease.  Myself and other mental health professionals will continue to treat the disease but the outbreak, with it’s rapid spread, is unmanageable and, I for one, will work to eradicate it rather than perpetuate it.