by
Psychologist:Phyliss Shanken, M.A.
Here are the words of a former patient (who gave me permission to publish his thoughts about his experience in therapy): Thank you for all that you have done in my "awakening" from a very long dream of nightmare proportions. I feel as though you were my guide with the bright light and I simply followed you till clarity and light, health and better weather made it possible for me to carry on by my self - at least for now. It also feels good to be awake! I like the analogy of awakening but I also like the vision of you standing in the fog holding a lantern of light for me to see in the fog. I always thought that psychotherapy was supposed to unravel your confusion and tell you what to do. In that analogy you would have been standing by the fork in the road pointing which road to take but you never did. You simply lit up the road and forced me to choose which way was right for me. True in order to do that accurately you need to see pretty far down that dark highway and so you need a pretty bright light and that bright light was you Phyliss Shanken!! Thank you again for what you did for me and continue to do.
Many people ask me: What's it like to be in therapy? If you were my patient, as we got to know each other, you could expect me to present you with various forms of feedback, observations, affirmations or questions to help you dig down into your gut for explanations of your pain. Our goal is to reach some understanding about why you react to your personal distress in a characteristic way and we try to see how your typical reaction effects your present day functioning. To attain this comprehension, we must look at your past as well as your present day life.
One of my favorite quotes is from Maya Angelou's poem, On the Pulse of the Morning, read at President Clinton's inauguration:
History, despite its wrenching pain, cannot be unlived, but if faced with courage, need not be lived again.
Because I immerse myself in people's emotional pain, I am particularly in touch with the impact of early hurts on people's lives. Many times, as people share their personal stories, I relive with them their fears of being abused by a parent; their terror over watching their parents quarrel; their scary trips to the doctor; their reluctant temper tantrums that only brought them grief; their loss of a loved one through death; their agony over being teased as a young child; or their disappointment over not being chosen for sorority.
None of these recollections is trivial. To those of you who experienced the "crush" of these never-to-be-forgotten traumas, the memory of these nightmarish scenes assumes an indelible place in your mind.
With the people who come to see me, I try to help them face their past hurts, appreciate how these have shaped them and then make use of the strengths they have acquired because of and in spite of their deprivation. In chorus with this acceptance of their early life anguish, I encourage them to move on. As their personal plots unfold, my hope is always that I can open myself up like a flower and allow them in. They are the experts in their own records. My patients are artists who brush their emotions onto scenic canvases.
Together, we not only explore your past; we look at you’re here-and-now life for it’s own sake. Even though your current coping mechanisms are designed to help you circumvent your suffering, what you do to avoid discomfort might cause you even more strife.
For example, suppose you come to see me because you worry all the time and this is affecting your relationship with your spouse, family and friends but you can't stop yourself from ruminating. As we talk about your present day life, we ascertain that you are upset about your child’s going off to college. You want to allow her to grow up and away, but with all that could go wrong in the world, you know full well you could lose her forever.
You are exquisitely aware you have absolutely no control over what will happen to her, but even so, to insure her safety, you wish you could be in charge of her every move.
It may take you and me a little while, but eventually we figure out that all your worrying is an attempt on your part to act as if you really do have control. If you just worry enough and never let up, nothing could possibly happen. It’s only if you stop worrying that disaster will hit. So, what you developed as a way of controlling (or worrying about) an uncontrollable situation, has now taken you over and you can’t stop fretting lest you cause the bad thing to happen. You come to my office because your incessant worrying is out of control. You had been attempting to worry enough so you could stop the pain over possibly losing your daughter but what you actually did to stop your discontent caused you more pain.
In my role as psychologist, what do I actually do? Normally, believe it or not (most people don't) I'm not actually analyzing people. I merely sit with them and see what happens. Yep, it's as simple as that. I don't say Dick has a problem expressing his anger toward his wife so today we’ll work on helping him with that. Instead, in essence, I say: Hello, Dick, glad we have this time to spend together. I look forward to absorbing your anxiety, confusion, conflict, whatever comes my way as I open myself up to experience what it must feel like to be you.
Okay, I don't actually say this out loud but it's essentially what is going on inside of me. We're having a conversation. That’s all there is to it. Imagine you and I are in your living room by the fireplace having a nice chat. It’s similar to what my patient and I are doing. In my kind of therapy, the only difference is that one of us has a trained way of looking at things. The one who is called the therapist is good at active listening, researching, analyzing, and synthesizing. One of us has a diverse set of experiences, has traveled the road not taken and can give back a unique perspective to the other traveler on the journey to personal transformation.
Since we're on this journey together, I work hard to understand exactly what my patient is experiencing. I might have to "try on" or synchronize with him or her. This process has many advantages: First, for my patient, the mere overt expression of what ails him and what in his past haunts him is a cathartic process in and of itself. I've had people come to me for maybe two or three sessions, just long enough for us to imprint their histories on an imaginary tabloid equidistant between us, after which, they say something like, I’m feeling so much better. Do you think I need to come anymore?
Imagine it this way: How many of you have anyone in your lives who really listens to you without being bowled over by your twisted stomach-wrenching tales of woe or who says, "Sure, sure. Now let me tell you what happened to me".
Then there are those who in disgust or fear turn their heads away like a doll with a twisty rubber head. It's as if your words and feelings made them avert their eyes, as if you had just struck them. But sitting with an authentic listener, her act of listening, or merely sitting with you as you release your distress, is a known antidote to solitary suffering.
Second, the idea is to help people go where they want to go and not to impose my own goals on them. The internal places I want to go for my personal growth are often much too deep for the preference of others. Consequently, I work hard to help us clarify the specific therapeutic goals of my patients.
How do I feel about working with my patients? The memories of many people's lives resonate inside me. They reside in the sanctuary I fashioned for their souls and buried under layers of my time and experience. I remember every single person I’ve ever treated. They've imprinted themselves in my mind's visual field. I have registered their pain in a special place deep within my heart. I can still hear their silent screams of terror. I have relived with them the early traumas they've suffered at the hands of the adults who had control over their survival. I have loved them with my whole being. I carry their spirit within me. I am changed because of them.
The people who visit with me are pilgrims in a voyage to the land of self-acceptance, personal integration and peace of mind.
I am always energized when I'm about to meet a new person in my waiting room. A fresh challenge confronts me and I don't know with whom I’ll be working, how his or her life will unfold, what troublesome issues will be presented and how I can help.
How do you get to know and help a perfect stranger? You embark on an adventure with him or her. What questions do you ask? And then how do you put it all together?
At the same time, my patient is going through a process: "Who is this woman to whom I'll be telling my secrets? Will I ever feel better? How can I do a good job of telling her about myself and my problem? Is she trustworthy? Suppose I cry. It will be so embarrassing. Whatever I do, I mustn't tell her about." What do I say first?
Many people ask me how I feel about listening to people all day.Rather than enduring the process as some have suggested, I feel invigorated. Instead of putting up a wall to protect myself as is popularly believed, I choose to immerse myself into their inner world. I feel privileged that people allow me into their lives. I wouldn't have it any other way.
I am a vessel into which my patients pour their liquid secrets. Over time, I gradually replay what they have built up in me and give them back these confidences couched in an illuminating way so they can be enlightened by what they see. Together, we are making poetry in therapy. Within my core, I am a romantic. Without design, over and over, I somehow end up in a love place, finding ways to extrude a metaphor of heart. If my patients don’t produce poetry then I perform the deed by reflecting on their singular words and phrases with a literary spirit.
People often wonder: "Don't psychologists have to put up a wall so you're not affected by your patients?" Here are some of my responses:
The most important ingredient in my training was that I entered into my own personal analysis with a doctor who specializes not only in treatment, but also in training others to conduct psychotherapy. Yep. I was what you call psychoanalyzed: four times a week, lying on a couch.
My own therapy helped me to understand what it feels like to be a patient, to examine my conflicts and motivation, and to receive difficult and unwanted feedback, which, of course, I proudly resisted, as any good psychoanalytic patient will do, if she has any oomph to her.
I resolved many of my own hang-ups before I met face to face with someone who needed my help. So, when I began treating people, I felt assured I could separate my problems from the people I treat.
If I get so emotionally involved with my patients, how do I sleep at night? I do think about my patients when I'm "off duty," but I don't carry their pain with me as if it's my own. When I'm with them, I can feel their anguish, sometimes even more so than they feel it. Because I know where I end and the patient begins, I'm always aware their suffering doesn’t belong to me.
For that matter, how do I stay sane? I have to admit, sometimes I kind of go crazy. I get the wacky notion that I’m funny. Well, I am hilarious to an audience of me. So on occasion, when people are talking and especially since I try to help people use humor as a coping strategy, I see situation comedies in my mind. As Steve Allen says, "Comedy equals tragedy plus time."
Obviously, I take people very seriously. But, learning how to lighten up about that which isn't really funny can be very therapeutic. So all you need is a little bit of pain; mix in some creative juices and voila! You've got a new weird slant on an old catastrophe. If appropriate and as I do in my own life, I help people find a new version of an old story.
Why do I ask so many questions? I help people to identify their feelings by questions, questions, and you guessed it, more questions. At other times, the investigation sometimes takes the form of hypothetical statements but these, too can be taken as questions.
I know my incessant, exasperating inquiries can be tiresome but my determination is to solve mysteries— that's what the therapeutic process is all about: gathering information, searching for clues, trying to make sense of how the clues fit together, understanding what makes you tick, using this new awareness to reexamine old scenarios, getting shook up because you don't want to see what you are seeing, knowing you need to change in order to feel better, fighting it all the way, looking at why you're fighting, overcoming your fears about doing, being or feeling a different way about things and then ta da! Finally – you transform your coping style and make your life more fun and worth living. And there is no turning back.
You really need someone with you who first of all knows how to dig for more, more, more information or as I frequently and lightheartedly say to my patients: "I need data. Give me daaaaaaaaata!!!! "
Next you need this same person to be a good detective in terms of putting the clues together, helping you stick with it while you're in the fighting stage and partner with you during the whole process. Through it all, you need someone with persistence, who is cocky enough to think if she tries hard enough, she’s bound to get to solution.
Why? Why? Why? Tell me why. However, we take our time getting where we have to go but not at the expense of the person's need to take it slowly and maintain control. I do not poach on people in a ghoulish way. In good time, all will be clear to my partner in pain as well as to me.
More. More. More. Squeeze, squeeze, squeeze until we scrape the bottom of the data bank and begin to build it back up again. We get the information but the facts alone won’t do it. We need the emotion that swarms alongside the pearls of wisdom we have presently gained.
This is the kind of person I am. If I lose something, I just plug away until I figure out where I was when I lost it, how it got lost and why logic isn't working in the discovery. Not just in my profession but also in my own life, I always want to know why.
Why do therapists answer a question with a question? My answer to you has to be: "Why do you ask?"
(Sorry, I couldn't resist.)
Behind every question is a statement a person is making. I take nothing for granted as to a person's motivation. Another reason I ask why is because we’re separate people, each with our own reasons for doing things. I don't make up stories about them or try to get these imaginary treatises to fit into my preconceived notions. I have to ask, "What do you mean by that?" Okay, there I go being a shrink again, but I refuse to "kill you off", by arrogantly deciding I know more about you than you know about yourself.
If you say, "Im upset because my boss said, after I complete my report, I should show it to him", what do I assume? You don't want him looking over your shoulder? With his red pen, he's going to change around your words and it won't feel like your report any more? He will show it to others and make fun of you? You think he is treating you like a child the way your parents did who over babied you? Is it because you just don't like him?
Should I have assumed you're upset for any of those reasons, skip the request for clarification and continue our investigation without knowing the veritable answer as to why you hurt so much inside? By deciding my own plot to your story, I have essentially killed you off. You don't exist; only I do. Everyone’s life is my life. No one else in the world exists but me. Also, the stories I would make up about you have more to do with my experience and background. If I have an issue about people's breathing down my neck but you have an issue over people's correcting your work, how will I ever find out unless you elaborate on what it means for you to be "upset" with your boss?
Narcissistic to shape the world and make up stories according to your own needs rather than to accept what’s real, you say? Darn right. You got it. And this confusion over who’s who is not just something therapists deal with by asking questions. I see people in my office every day who make up stories about other people as if these were not fairy tales but one hundred percent true accounts. Then they shout, cry or laugh based on the reality they personally imagined rather than reacting to the “real” reality of what the recipient is sincerely imparting. The recipient retorts, “Wah, where did that reaction come from? All I said was …”
Here’s a corollary to what I’ve just said. Did you know that feelings are not facts? If you feel angry with someone, it doesn’t mean he was trying to make you angry or deliberately trying to hurt you. Just because you feel afraid of someone doesn’t mean the person is trying to scare you. For that matter, because you are afraid doesn’t mean there is anything of which to be afraid. For all you know, you are experiencing free floating anxiety: You feel the usual sensations that accompany fear – rapid heart beat, sweaty palms, maybe even light headedness, but you don’t know why you are shaking like this. There’s no danger to behold. You attach a meaning to this experience of invisible danger because it’s too uncomfaortable to feel the nebulous emotion without being able to say, I know what ails me. Maybe you decide that if your insides are jumpy, it’s because someone else is going to hurt you or someone else is being unfair. The reason doesn’t matter as long as you can put your anxiety onto someone or something.
Why do I ask you, "How do you feel about that?" Naturally, people aren't always prepared to feel things. Many of us spend our whole lives trying to shed the ugly, repugnant, unmanageable feelings we were told make us bad, bad, bad human beings.
Author, John Irving, wrote a book around an observation the main character made as a child. Afraid of intruders, she said she had heard the sound of a person trying not to make a sound. With my patients, heck with myself -- I sometimes glean that this person has the feeling of a person not wanting to feel.
Yep. I, too, the human being that I am, have fashioned external ways to avoid the aches of life. The problem is, it's the evasive methods themselves that develop a life of their own and cause the harm (which for anyone, could be eating or drinking too much, overdosing on pain medication, taking it out on your wife, putting yourself down, sabotaging your success, spending too much money and thousands of other detour tactics that end up hurting you in the end.) Therefore, as I encourage my patients to do, I endeavor to figure out what's in my underground by being alert to my characteristic way of disguising the dreadful truth.
People ask me: How do you remember so much about me? Don't you confuse me with the other people you treat? My good memory derives partly from my faculty of concentration. Also, I'm an unrelenting detective and my visual memory is acute. I "see" people's words in my head along with the images I associate to what they are saying. If I don't remember something by visual memory, I discover it by good detective work. I'm the finder of lost objects in my house. For people close to me, I put myself into their brains and walk through the places they've been. Knowing a lot about how they process thoughts and feelings, I take a guess as to where they would go next and how they could have inadvertently misplaced the item. Same with psychotherapy: the things you learn as a child get "misplaced" or become connected to the wrong beliefs. Together, we must retrace our steps and work through the confusion.
Why is there so much repetition in therapy? Each time, we repeat something in therapy, we end up where we started, back to the person's roots or closer to the core of the existing problem, but, each time, we travel to the depths of the truth and re-experience their lives on a more meaningful level. I often imagine our sessions as a metal carving, the kind where you take a chisel and keep pressing in deeper so lines are formed which get more entrenched, so the foreground gets more prominent. Each time I ask a question or a person gets in touch with something about which we've talked before, our etching becomes more of a masterpiece.
This is why I love T.S. Eliot’s quote which is on the wall of my waiting room because it describes therapy to a tee: "We shall not cease from exploration and the end of all our exploring will be to arrive where we started and know the place for the first time."
And now you and I are back where we started in our discussion, pondering the decision: Do I have the courage to pursue therapy? Do I want to change or not? Is it worth my time and money?
Of course, I'm biased. After all my years of partnering with people to facilitate their transformation, I am forever impressed anew at how hardy people are, how, despite their internal deliberation: to change or not to change, people who initially arrive feeling and acting like victims, emerge at our good- bye session as full fledged, mature and mentally healthy people.
After all we've been through together, saying good-bye is so bittersweet. From the beginning, the end is where we wanted to go. But now we must give each other up. As I'm closing the door for the last time, I often say to people, "Have a good life!" Here's a poem I wrote that reflects the ambivalence of ending one's therapy:
CHOICE
My numbness wanes like a fading mist;
I crack my plaster mold and bargain for a new cast.
The current suit is rubber.
It can stretch with my every move.
I cry in it, and it does not break.
I can punch it from the inside,
making bulges here and there -
wherever I choose.
I can laugh within the walls
and savor the dusk of its cocoon.
I give you the old frame
as a reminder of what I was.
Gently place it in your feathered vault.
You can never be mine again, so I must choose:
The old me with you or the new me without you.
The fresh cover hurts sometimes.
It makes me itch sometimes.
It makes me bleed sometimes.
It reaches out for itself, bending into a coil,
as I forever await your return.
Years ago, after completion of our work together, a patient whom I shall call, Chuck, sent me a letter in which he described his experience in therapy. I was so taken by his words; I asked him if I could share it with my colleagues, of course without using his name. He wrote back: "You can certainly feel free to quote from my description of 'The Journey.' Use it as an example however it can be useful."
So here is one person's take on therapy, a very unique experience between two people - therapist and patient. When people first come to see me and ask what it is we will be doing to get them to feel better, I try to share a little of my approach. Chuck does a wonderful job for me. I am quoting him exactly as he wrote it:
The Journey
I decided to take a journey. This is not an ordinary journey. It is one in which I first embarked on with trepidation but later with enthusiasm. The change from trepidation to enthusiasm was because I know now that I have a special friend accompanying me on the journey. When most people begin a journey, they know where they are going or where they will end up. I have no idea where I will go or what I will experience; neither does my friend. This is my journey. However I vow to share everything I learn along this journey without hesitation no matter how much pain I experience with my friend.
The First Step
I put on my boots, slip on my pack and grab my walking stick and begin to walk through this gray matter. Some might describe it as a brain memory perhaps or even forgotten or buried documents that haven't been to the surface in years. Some pleasant, some not so pleasant, while others are sobering. My friend and I keep our pace for a while then every once in a while stop to enjoy a cave or crevice never knowing what we will find. Sometimes we laugh, Sometimes I cry. I think my friend wants to cry with me but refrains. I can tell the tears are nearby by the fullness that comes to my friend's face. My friend won't admit this but I know. Some days not a word is spoken. We just keep walking till we see something and then we begin to dig. In my pack I brought along a shovel and pick. It's a good thing; we use them a lot. We find ourselves digging for days, never satisfied until every piece of gray sand is sifted through and brushed aside. This type of work is very arduous and tiring. We always push on till we surface with a sigh of satisfaction or relief even though we are very far below the surface of this gray mountain.
One particular day we actually have to use our mountain picks to pull ourselves up the side of the gray mountain. This is very painful. I am particularly tired. If not for my friend I think I would be overcome with exhaustion. But my friend being a true friend is there to comfort me. On one adventurous day I almost slide from the surface of the gray mountain but my friend is there to grab my hand and right me back upon the gray mountain.
As you see, my friend and I explore a lot together. This journey helps me see things from another perspective. Our discussions along the way are very meaningful. My friend is a good guide. I remember being at the entrance to a cave and not particularly interested in confronting the inhabitants of the cave when my friend said, we're here, we made the trip, how could we pass up this wonderful opportunity to make a discovery. More data collection I thought. Boy was my pack getting heavy.
Then one day we walked on through to the other side. I feel as though the glue that once held me back was gone. The gray is still gray but seems brighter. I seem to be walking faster with less friction. Is it possible to experience a vibrant gray? Well it seems that way anyhow. We are no longer on the gray mountain. Our journey has taken us from one side of the mountain, along every switch back to the top and down to the other side.
I think I am in a fog for part of the trip. I didn't realize what effect the journey has on me. Looking back could it be possible that I climbed this mountain? It is true I did climb the gray mountain with my friend. I've come to realize that if I need to go back to visit the gray mountain I can. It's always nice to make a journey with a friend.
I responded to Chuck as follows: "It was wonderful to hear from you, Chuck. I enjoyed your account of our journey together and I hope you are 'traveling' on and the terrain isn't too rough these days. You are a hardy person and can weather the 'mountains' yet to come. I hope also that you are enjoying the 'caves and crevices' you pass along the way and that you make time to examine them. Your letter is a beautifully poetic account of the therapeutic experience. Thank you for sending it."
