A client of mine dreamt that she had sat so long in the bath that the water had turned cold. While I have heard thousands of client dreams, this one brought me to a realization about how dreams may be graphic depictions of client’s shifting autonomic states — images from and of the body. Far less filtered by our internal censor than waking thoughts, dreams are more image-based, visceral and fluid. Spending time with my clients’ dream images in a calm and curious way has been inherently soothing for them, and of late, I am beginning to suspect why this is so. While many have offered opinions on the nature and purpose of dreams, this notion that they are images the body projects onto the dreamscape has become clinically compelling to me. Nightmares Can Be Most Useful Dreams The late Ernest Hartmann, a celebrated dreamworker and researcher, famously said, “The nightmare is the most useful dream.” This is not meant to dismiss the real distress and terror that our worst dreams can bring. Nightmares are perhaps the most troubling symptom of post-traumatic stress injury and are prevalent in fully two-thirds of those with a mental health diagnosis. The benefit of nightmares is that they represent extreme emotional and physical states, and as such, ones that we can learn the most from. I’ve spent the last few of years investigating the link between nightmares and the autonomic nervous system (ANS) through the lens of Porges’ polyvagal theory. Although I think the implications of this for nightmare formation and treatment are still largely unexplored, I started the ball rolling with the recent publication of an article with an optimistic title: Solving the Nightmare Mystery. In it, I imply that the role of the nervous system is a missing link in our understanding of how to treat nightmares. I have been working clinically with those who experience deeply disturbing dreams for many years. One of the main things I do to help is facilitate the search for, and embodiment of, cues of safety that help alter the dreamer’s perception and experience of these dreams. Clients tell me that this embodied process of dreaming their dreams forward (called ‘rescripting’ in modern nightmare treatment literature), changes how they hold the dream in their body. Typically, the memory remains, but the emotional and physical “charge” dissipates. For example, during the pandemic I dreamt of a woman falling to her death. She is a dear friend of mine with a highly compromised immune system, and it’s clear that the dream depicted my fear for her safety. I worked with this dream and found some hope in the athletic way she leaped onto the roof (before losing her balance). In dreaming it forward from there, she used that virtuosity to land safely. This dream session helped me feel better about the situation, and later she did indeed survive a nasty bout of COVID. Nightmares as Lived Bodily Sensations Nightmares are often quite dramatic depictions of current fear and/or past traumas. There is clear autonomic activation during sleep state shifts for those who experience them frequently. Nightmares are easily recalled, and their impact is tangibly felt, as is the relief one experiences when they begin to fade or shift into a more benign form. In a clinical setting, we can easily track clinical progress for those with intense dreams because when they shift toward more normal dreams, the change is welcome and obvious. In a recent class I taught on the clinical use of dreams, I realized that all dreams might be expressions of our autonomic state, even the quieter ones. A student brought a dream with the central image of a still, dark woman in a tub. She had sat there for so long the water had gone cold. When I invited the dreamer to allow the dream to continue, her impulse was to turn on the hot water faucet, to bring some warmth to the bath and to the woman’s body. At my invitation to enter the dream further, she took notice of the tub itself. It was older, more ornate and beautiful than the one in her bathroom, where the dream was set. I encouraged her to enjoy the details of this tub, and it began to feel like a precious heirloom. Details in dreams that depart from waking reality (called counterfactuals) warrant particular attention. The dreamer’s demeanor changed in this process of warming the bath; her face coloring and smiling as she described making the bath a sanctuary, adding scent and oils, and dipping into the enjoyment of it. Later, she told me, “I continued to experience ‘mini shifts’ in the following days and was able to access and carry the felt sense of the warmth and beauty of the bath into many areas of my daily life. I noticed I feel more present when I bring a sense of aesthetics, a little beautifying and warming detail, to tackling some of the mundane daily tasks which have been weighing me down lately.” The Critical Role of Polyvagal Theory This entire dream process could be seen as an image of the autonomic nervous system (ANS) as described by the polyvagal theory. Porges’ theory updates the former conceptualization of the nervous system as paired opposites that shift between sympathetic arousal and parasympathetic relaxation/shutdown. Instead, the theory suggests that we automatically shift states in a specific order depending on our sense of threat: we move from safety and social engagement to activation in the face of threat (fight/flight), and lastly, to immobility if the threat is perceived as overwhelming. And the theory suggests we move out of these states in reverse order. The woman in the dream followed these steps as she shifted from a cold, immobilized (dorsal vagal) state, into one of animation. The changes were clearly visible on her face. Her fellow classmates remarked on the change as the color returned to her cheeks, and her physiology demonstrated a clear shift into a state of social engagement and warmth (ventral vagal). This kind of shift is depicted in the imagery that arises in working with dreams. For example, the images from nightmares are clear representations of autonomic states. Activation or fight/flight – being chased or engaged in a battle are among the most prevalent nightmare themes. What I am suggesting is that nightmares are the most obvious expression of what happens in all dreams. They are our bodies expressing, in image and sensation, our fluctuating internal state. They are a doorway into its expression, particularly valuable for those clients who have trouble hearing what’s going inside. This brings me to another of Hartmann’s famous statements: that dreams are ‘picture-metaphors’ for our most salient emotional concerns. Sometimes our most pressing feelings are repressed, historic, or fleeting enough that we don’t think about them during the day. But our dreams have an uncanny way of picturing what matters most, even if we have repressed it. Our bodies carry the charge of feelings and memories that are unmetabolized, and these find expression in our dreams. The True Purpose of Dreaming? My sense, which is shared with many dreamworkers and researchers, is that the purpose of dreaming about emotion is not to upset us, but to help us process and shift such feelings. Sometimes, the dreams do this all on their own, like a nocturnal therapist, and sometimes it helps to have another person process the dreams with us. Sharing our dreams and bringing them into company and the light of day helps them do their job better. And increasingly, I’m beginning to think that a large part of their purpose is expressing and regulating the state of our nervous system. However, I need to give the dreamer the last word here. In the example of the woman in the bathtub, the dreamer accepted that yes, the dream did depict welcome state changes. But there was more — an invitation to sink into the beauty and warmth of an elegant bathtub, and a new way of being with life’s mundane chores. In other words, the shift in physiological state is welcome and accurate, but the invitation to appreciate beauty was compelling. And please forgive the very intended pun — to focus solely on physiology and ignore the depth and nuance of dream expression would be like throwing the baby out with the bathwater. Questions for Thought How does the author’s clinical use of the client’s dream fit with your own approach to dreamwork? What might you have done differently with this client regarding her dream? What is your own theoretical understanding of dreams and their “purpose?”
Author: Psychotherapy.net Team
How Mental Illness Protects Clients Wounded by Trauma
All persons, those with and those without a mental disorder, exhibit both conscious and unconscious defense mechanisms. Conscious defense mechanisms are organized by, and act in service of the ego and seek to preserve the integrity of the person’s self-image. Unconscious defense mechanisms are organized by the unconscious mind — the mind’s mind — and serve the integrity of the whole person.
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Rationalizations and Reflections
Rationalizations about the symptoms of a mental illness (for one with a mental illness), or about the vagaries of one’s actions (for one without a mental illness), are a form of conscious defense. Reflect briefly on the excuses you make, and you can see examples of a conscious defense in service of your projected or preferred self-image.
In my clinical experience, some persons with a mental illness devise alternate explanations for their diagnosis in ways that help preserve a sense of personal integrity. “I don’t think I have schizophrenia, I am a psychic,” said one female resident at a nursing facility where I provide counseling. “I don’t use the word schizophrenia, I think I have time-travel and mind-travel,” said a male resident. “It’s not right to say I have schizophrenia,” said another woman. “I have PTSD because of the things I’ve heard and seen being done by the government and the mafia.”
If the person admits to the disorder of their mind as an illness, it could imply that they cannot rely on their mind for coherence or integrity, and so feel like a kaleidoscope of fragments without coherence. That would truly be terrifying.
The defensive rationalization might provide an explanation that bestows a special significance to the person—I am gifted; set apart from others, unique, contending with things others know nothing about. Such rationalizations exist in a borderland between the conscious and unconscious mind; they are partly delusion and partly ego repair. Rationalizations are at least partially conceived by the conscious mind, while delusions are sensed as received, and incontrovertibly true; they have the authority of otherness.
Delusions, like defensive rationalizations, tend to serve a purpose yet they may originate from a deeper element of the psyche. Delusions can sometimes offer a glimpse into the working of a broader intelligence within the psyche. Fortunately, we are more than the contents of our conscious minds. We each are served by a deeper source of intelligence and creativity, the unconscious mind that envelopes the ego and seeks to broaden its understanding and foster its wholeness.
Manifestations of the individual unconscious can be seen in dreams, and the power of the archetypes of the collective unconscious can be seen in large social situations—witness the power of the archetype in the world-wide response to the recent death of Queen Elizabeth, for example (I think it is important, though, to view Queen Elizabeth as a rare living exemplar of the four Cardinal Virtues: Prudence, Justice, Temperance, and Fortitude).
Dream-Digging as Archeology of the Soul
Many years ago, I wrote a master’s thesis entitled “Dream-Digging: Archeology of the Soul,” in which I excavated through a stack of journals in which I had been writing my dreams over a 17-year period, examining the appearance and actions of a particular recurring image, that of a snake.
As part of my preparation for practicing psychotherapy, I had undertaken a two year long Jungian dream analysis. Each week I would type — on a manual typewriter with a sheet of blue carbon paper between two sheets of paper, so that I would have a copy — the dreams I had collected that week in my journal and would explore their meanings with the analyst.
Noticing the sometimes-ingenious incursions of the unconscious mind into daily life is not limited though, to dream analysis or to the study of archetypes. One can even notice the protective functioning of the mind's mind in the tragic consequences of trauma with dissociative features. Consider the following examples from my clinical work in nursing facilities.
Hazel’s Front Line Defense
Hazel was a 94-year-old lady living in a nursing facility. She was alert and quite talkative and actively wheeled through the building daily in her wheelchair—and always wore a red terry cloth bathrobe over her clothes. In childhood, she and her sisters were repeatedly sexually assaulted by their father who eventually went to prison for his crimes.
Hazel had an encapsulated psychosis with delusions involving possible threat from demons. She believed that many years ago demons had entered her childhood bedroom through hidden doors, and she claimed that one time while brushing her hair, she saw in the mirror that Satan was in her bedroom doorway. She felt the need to be perpetually on guard to notice and defend against any re-occurrence of demon activity.
Through the unconscious and protective functioning of dissociation, she split off awareness of her father sneaking into her room or looming ominously and projected it as having a supernatural source from which she might thereafter protect herself, if adequately vigilant. Her omnipresent red bathrobe also pointed symbolically as a sort of alarm, a warning about the earlier scene of the crimes.
Lucy’s Isolation as Protection
Similar in many ways to Hazel, Lucy was serially raped by her father and uncles over several years in her early adolescence. Lucy described leaving her body and floating at the ceiling and watching what was happening to her body below during assaults.
Due to severe trauma, she subsequently suffered from mental illness with dissociative features. She rarely chose to tell others of her thoughts and feelings because, “they’ll think it’s just all schizophrenic stuff.’ She isolated herself in her room at the nursing facility, wearing only hospital gowns, and kept the curtains drawn around her bed. She complained periodically that something had gone wrong with her mattress, and that she needed another one or it would make her ill. Lucy believed that she was supernaturally ordered not to wear clothes, and that they would make her ill if she did.
Lucy told me that the men who assaulted her were not actually to blame, because they were under the control of an evil spirit who made them do what they did. Again, we see how the symptoms of wearing only nightclothes and the sometimes-sickening mattress point to the earlier scene of the crimes. Her unconscious dissociative and psychiatric symptoms allowed her to imagine that her persecutors were not responsible for her abuse, and that she might be safe now if she lived within restrictive parameters.
Her goal in psychotherapy was simply to sustain her daily stability with as little change as possible in her daily routines. Lucy described living in her own world, which was more satisfying for her because the outer world had been so painful for her. She viewed psychotherapy conversations as a kind of visiting at the doors of our different worlds, where she could greet me and offer a report about how she was doing in her world.
***
The symptoms of mental illness can sometimes seem chaotic, yet while irrational, they may still be filled with meanings, and can point to their origins and to the unconscious strategies that help sustain a broken psyche. As a psychotherapist, I have come to notice and work with the often-clever manifestations of the “mind’s mind” as I have tried to decipher the hieroglyphic language of disordered thinking and acting that has been brought about by trauma, and by the creative efforts of the unconscious to try and manage the destruction.
Questions for Clinical Thought
Can you think of clients with whom you’ve worked where this perspective might have helped, or may help?
How useful or not are the unconscious mind and ego defenses as therapeutic concepts?
Spitting Truth from My Soul: A Case Story of Rapping, Probation, and the Narrative Practices- Part I
The Rap That Binds
“This kid really doesn’t get it,” a clearly frustrated voice blared so loudly that I moved the phone’s speaker a couple of inches from my ear to avoid any future hearing loss.
“He just won’t take any responsibility for his actions, and he doesn't give a shit…and he has 16 more months until he’s off probation! I just don’t think he’s going to make it. I don’t even think you want this one!” I recognized this voice as that of a probation supervisor I had worked with a number of times over the years, but never had I heard frustration get the better of him in such an obvious way. “I’d be happy to see him,” I said. “Send him my way.”
When I put the phone down, I wondered if my enthusiasm might have been misplaced and I would have been wiser to tell him I was overloaded and couldn't take on any more work at this moment. No more than 24 hours later I received a phone call from Ray, a 24-year-old young man who told me his probation officer had passed on my phone number to him. I was intrigued by how polite and soft-spoken he sounded over the phone, and we set up an appointment for later in the week.
My work with people involved with the justice system, whether on probation or otherwise, began nearly 13 years ago when I was just a 22-year-old graduate student in Los Angeles, California. After years of agency work, I now operate a small private practice where probation officers, schools, and word of mouth drive young people like Ray to my door.
In community agencies I had worked in the past, I met with people twice a week as mandated by their sentences. More recently, I have started getting short-term referrals, which often allow for between 4-8 meetings with people. In the case of Ray, we ended up seeing each other 9 times. Probation assumed responsibility for payment for 5 meetings only.
After that, our time was up. However, Ray indicated that he wanted to continue to attend on his own volition. This is something that happens with a surprising number of cases. I have learned that if we call the probation officer on the case, the Department of Justice will usually pick up at least half of the cost for the remaining number of sessions, something they were willing to do for Ray.
Three days after first talking to Ray on the phone, he walked into the office wearing blue jeans, a red hoodie, and had headphones dangling around his neck. As he sat down across from me, I had an intuition that he was not a stranger to this process often called “therapy,” a fact he would confirm as we began talking.
It was as if he was bracing himself for what was to come. He sat back in his chair, both of his hands tightly grabbing on to an arm almost as if he was at the mercy of a neophyte airline pilot preparing to practice landing a massive 747 for the first time. Perhaps he was expecting a barrage of advice disguised as “psychoeducation?” Or was he steeling himself for inquiries about what might be neurochemically “wrong” with him? Everything about how he was composing himself suggested to me that this young man had heard it all before.
My first query was clearly not one he was expecting. “Do you mind if I ask what you are listening to?” gesturing to his headphones. Ray raised his head up to look me in the eyes for the first time since walking into the room, his gaze a blend of skepticism and curiosity. “Styles P and Pharoahe Monch,” he replied.
“How old are you again?” I said as a smile crept on to my face.
“Why?” he inquired.
“It’s just that most 24-year-olds I have spoken with aren’t keen to the ways of Styles P and Pharoahe Monch,” I said still smiling knowing the album he was referencing was over a decade old and was not one many young men of his age were typically in step with.
“A lot of this new shit ain’t real. I can feel what Styles and Pharoahe are saying,” Ray declared.
And with this, we were off. I had been granted the great privilege of riding shotgun in Ray’s lyrical journey. For the next forty-five minutes we listened to music on his phone and critically examined the verses he found most meaningful. What follows is an example of one such verse:
I Supreme Lord and Master (ISLAM)
But at times,
The words ring empty
When I see another homie blood splattered
Dreams get shattered
Family fractured
Ugly reputations is what give television ratings
Problem story plastered
Learn the science of our plight
These depictions keep penitentiaries packed tight
But only God can judge me
Once I fade away from life.
Yet another example:
How many Super Bowls passed
My mind’s eye showing possibility so I grasp
Of a hood block,
With no patrolling cops
No empty baggies once holding rocks
Shells from a glock
But the wisdom I've acquired allows us to question what was taught
Pause in the moment
The impulse can be stopped.
During the conversation that followed I learned that not only did Ray have an affinity for rap music, but he also wrote some rhymes of his own.
A Voice to the Voiceless
Travis: Listening to you today, Ray, I have a hunch that you and rap music have been homeboys for a long time and you both share a long and storied history together. Am I right or wrong?
Ray: Yeah, I mean, I can’t remember my life without rap. It’s like it was with me from the moment I came out of the womb. You know, I’m sure that’s not true, but that’s what it feels like.
T: Wow! Are you telling me that no one has been a friend to you longer than rap has? (He nods his assent) This seems like a really important relationship. Would it be okay with you if I tried to understand the relationship you and rap share a bit better?
R: Sure, go for it.
T: I’m curious to know if anyone has ever asked you about your relationship with rap before?
R: (pauses 10 seconds or so) I mean, not really. My homies and I cypher back-and-forth about it, but… you know… I haven’t really broken down my relationship with it if that makes any sense.
T: It does make sense. Thank you. Other than your homies, does anyone else ask you about your relationship with rap?
R: No, except for like teachers and probation and other adults throughout my whole life trying to tell me it’s violent and the music of the devil (takes his index fingers and makes horns over his head) and shit like that (laughs).
T: So, if I’m hearing you correctly, Ray, those adults don’t really ask you about your relationship with rap, but rather tell you the sort of relationship you should have with it?
R: Exactly! It’s like they don’t know shit about it but want to tell you it’s the root of all evil.
T: This is really remarkable to me, Ray! Would it be okay if I asked you a few more questions about it?
R: Oh yeah, no problem.
T: If it gets boring to you or you would rather go in another direction just tell me, okay?
R: Word (a hip-hop phrase that in this context verbalizes agreement).
T: What do you think the adults you just mentioned, like former teachers or people involved with probation, could stand to learn from your relationship with rap?
R: They would never learn anything because they won’t listen. Their minds are already done made up.
T: Do you mind if I ask what kind of headphones those are, Ray? (pointing to his neck).
R: These? Oh, man, these are Beats (a popular brand of headphones).
T: Now I heard you say that those folks wouldn’t listen, and I want you to know that I absolutely believe you. Even still, I want to invite you to imagine for a second that we could take a pair of Beats, maybe even magic Beats, and slip them on to the people that can’t or won’t hear while they were sleeping, and the message would sneak through their ears and permeate their minds whether they wanted it to or not. Imagine now that they have woken up. What education would rap have given them?
R: Man, I wish you could pick me up some of those headphones (said laughing)!
T: That would be pretty cool, right? Maybe that’s a project we can work on later (both of us laughing).
R: For real! What I think they would learn is that there are a lot of people in the world who don’t have a voice. If you are someone in the world who does have a voice, you know, that’s great. Good for you. And by voice I mean, you know, we all have like a voice box that works. What I mean when I say voice is a voice that others can hear or will really listen to. My whole life I’ve never really had that voice because I’m poor and black… except when I rap. This is true, you know, for like pretty much my whole crew in my neighborhood, too. Rap is our voice.
T: Are you of the opinion that the people who won’t listen that you referenced earlier would learn from the “magic Beats” that rap could serve as a voice for the voiceless?
R: Exactly. I mean, if everyone listens to everything you say anyway, then fine, you don’t need something like rap. (Begins rapping):
The more I wild out
Allows me to achieve that street clout
While lives are turned into tools
Did dominant narratives actually raise a bunch of fools?
Our escape from a jumpshot or a hip-hop plate?
While theirs is school?
But either one of us can lose
Trying to chase what Lupe articulated as The Cool,
White men in suits don’t have to jump
Still a thousand and one ways to lose with his shoes
R: You know, that line, “White men in suits don’t have to jump,” that’s what I’m talking about.
T: Right, there’s that old saying, “White men can’t jump,” when it comes to basketball. Did those lyrics do something clever with it?
R: For sure. White men don’t have to jump to make money and white men don’t have to rap to be heard. Don’t get me wrong, I write rhymes because I love to. Sometimes when I write it’s just about partying or females or something light. But I also write because it allows me to have a voice. You know, it’s like rap says to the world I’m going to say shit how it is whether you like it or not.
Of Protest and Freedom
It was becoming increasingly clear that Ray’s relationship with rap, and the hip-hop culture in which it resided, was one of protest, freedom, and inspiration. As our conversation continued to traverse the electrifying and winding roads of rap music, we alternated between listening to songs on Ray’s phone and discussing, almost philosophizing, at the conclusion of each. That served as inspiration for the following exchange:
T: Do you think rappers are philosophers?
R: No doubt. Rap is philosophy but without all the old white cats (said laughing).
T: Socrates is not the father or first philosopher of rap?
R: No! (Laughs harder)
T: Who do you think is?
R: Probably KRS-ONE.
T: What in your opinion is the job of a philosopher?
R: To make people think, like hold a mirror up to the world so they can see how foolish they are. (Begins rapping):
Peep the crucifix
Comes across mysterious
With I(j)ehova hanging from the partisan nails of politics
The origins
Governing men of Romans
Did agree to its means justifying capital punishment
For the minds
They despised
To keep all the sheep in line
While revolution sparked divine
Christ
But check the rhyme
What if they lynched him hanging from the branch of a tree
Then burned him half alive
Peep manipulation B
We would pray to a tree
Then human torching eventually
Fire associated with hell
Overstand irony
When a bullet burns its way into your brother's physical
Laid to rest in a wooden casket
Damned its cyclical.
T: What do you hear in these rhymes?
R: It’s like it exposes hypocrisy, you know what I mean? People believe things about God or religion or whatever without even opening up a book or thinking. They just accept a history they like or feel comfortable about or that some cat on TV tells them is right.
T: Are you of the opinion that there are multiple histories?
R: Oh yeah, no doubt. The history that you get in history books is the only one most people read, though.
T: Where do these histories come from?
R: Usually from your teacher and books in school.
T: Where does the information in those books come from?
R: I mean, that mostly comes from white people and their ancestors. You know, I took a philosophy class in college like 4 years ago and I don’t think we talked about one brother the whole time. That’s part of the reason I never fit in there.
T: And the fact that the only history that was discussed was from a white perspective, what does that mean for the other histories?
R: You see them in like Roots (a television mini-series from the 1970’s depicting the life of a black slave in the United States) and shit (laughing). We had to watch that in high school. That shit is so weak.
T: What would be a stronger portrayal?
R: You just heard one (in the previous rap). But it’s like I told you earlier, people don’t want to listen to those.
T: Do you believe you are a philosopher?
R: I never really thought about it like that. I know I’m a writer. But I guess that means I am a philosopher.
T: Do you mind if I tap into your own philosophical expertise?
R: Sure. I know what you’re go to say next (said with a wry smile). You are going to ask me about my philosophy on shit.
T: You know me too well already, Ray!
R: My philosophy is simple. It’s to see the truth even when they try and obscure it. It’s to go deeper. If you don’t, you’ll believe a lie.
T: How do you see deeper?
R: You have to do what my grandmother says: ignore the noise. You can’t believe everything you hear. You can’t even believe everything you think you see.
T: Is your grandmother a wise philosopher, too?
R: She’s the wisest person I know.
T: What has her philosophy taught you about the person you want to be?
R: She always says I didn’t raise no fool.
T: Would you say that your grandmother’s philosophy and the philosophy of KRS-ONE are similar?
R: Hmm… (pauses for 10-15 seconds) that’s crazy, bro. I never thought of it like that, but I guess so.
T: In what ways would you say they are similar?
R: Both of them are encouraging me to think in my own way. To be my own person. Basically, just be wise to the ways of the world.
T: Do you think that it would be helpful in our work to call on the ideas of great philosophers like your grandmother and also KRS-ONE as we try to navigate the situation that brought you to see me?
R: Yeah, it’s just crazy though because my grandmother hates rap. Like she thinks it “corrupts the youth” (fingers on both hands raised to make air quotes).
T: If only we had those “Magic Beats.” Do you think she would be more open to it then?
R: (Smiles and then laughs) Yeah, and maybe she would see that I’m rapping about like the same shit she’s saying but in my own way.
T: Have you ever thought that maybe the spirit of your ancestors and their struggles can be channeled through your raps? Maybe rap is like your history book?
R: I mean… that’s deep! I ain’t never thought of it quite like that, but yeah, my raps are about me, where I came from, and where my people came from.
T: Would it be okay if we cracked open your rap’s history book in our work together?
R: Yeah.
T: Do you think it might provide us with some stories that the regular history books miss?
R: Oh, no question! Stories that regular history books wouldn’t even touch!
So engrossed did we both become in the progression of this conversation that time itself seemed to melt away. Ray continued writing his own history through various rhymes and interpretations of them.
Removing the Shackles
At one point Ray could not conceal his enthusiasm for a verse he located on his phone. He said he had been listening to it for a few weeks with a great deal of frequency. It moved him so much that he immediately stopped the music after it had played and rapped the verse himself again.
With these I see
Crimson stains on this project concrete
Yellow tape barricade
Homie wrapped in white sheets
It's a struggle just to eat
So how the fuck do they rationalize judging me or my deeds
Grab a pen
Clear the phlegm
Then commence to bless the beat
Give ya'll a tour of my life
Without walking on my streets
It's my life!
Being scribbled on they college ruled pages
Escape when we cipher up
That type of freedom is amazing
My life!
I watched him intently and took a few deep breaths before breaking the silence we had both fallen into by my first query.
T: Ray, I noticed that you listened to this verse and then stopped the music and rapped it. Were you, by any chance, deepening your relationship with the lyrics by rapping it yourself?
R: I do this all the time. What I like to do is take a verse that someone else wrote and then just add my own flavor, kind of like sampling (a hip-hop term for taking an older song and mixing it with a new one) or remixing.
T: Do you mean that you take the original rhyme and add your own story?
R: Exactly.
Ray was so engaged that by the end of our conversation it was as if he were a different person than the one who walked through the door an hour before. Certainly he was a poor match for the description of the detached and uncaring young man who lacked any semblance of motivation that the probation officer had provided for me earlier in the week.
The fact there wasn’t much sand left in the hourglass of our first meeting had sneaked up on both of us. My mind was left spinning with possibilities for where our future conversations could go. With just five minutes remaining, I invited Ray to reflect with me on what had transpired which broke us both out of our enthrallment.
Travis: Would it be all right if I asked you a little bit about how our meeting today is going?
Ray: That’s cool.
T: Thank you, as I know I have asked you a lot of questions today. I appreciate you hanging in there with me. I’ve noticed that it’s very different when we are just speaking as opposed to when we invite rap to the party. Have you noticed this?
R: Yeah, for sure.
T: How do you understand this?
R: It’s like when I rhyme… I spit truth from my soul.
T: How is rapping with your soul different than talking with your mouth?
R: When I talk, I think. I thought that’s what we’re supposed to do in therapy, anyway. That’s what all those other fucking shrinks did.
T: Would it be all right if we made up our own therapy and put aside other kinds of therapy you have been through or heard about?
R: Yeah (said with a chuckle and skeptical eyes).
T: What can your soul rhyme that your mouth sometimes might have trouble saying?
R: Freedom. It’s like when I’m rapping I can feel the words come through my body. It’s natural, like I don’t have to think about it.
T: By that do you mean to say that rhymes remove the shackles that are attached to your soul?
R: Right (said turning his head to one side as if in deliberation and then nodding).
T: I saw your face light up. I wonder if inspiration is brewing in your soul this very moment? I know I am guessing so I could very well be wrong.
R: No, it’s just that I thought of a verse. (Begins rapping):
It's like we being played
When they say
Strive for a slice
Of they cake
They filthy hands holding hate
Choke out fate
But the rhyme melts the shackles
Oppression disintegrates
Even just for one moment
When we flowing on stage
It goes on and on and on…
T: Have you had shackles on your soul that rap music helps you break free from?
R: Yeah, sometimes it feels like rap is my only way to break free.
T: I notice when you rap that your whole body changes. For example, when we were just talking earlier you were kind of slumped down in your chair. But when you rap, your back straightens up, your face lights up, and your hands are active. It’s almost like I can see you breaking free right in front of me. What do you think would happen if rap made more frequent visits to your life?
R: I would feel more alive and like I have a voice, you know what I mean? Like being on probation it feels like I have no voice. I just get told what to do and it’s like they tell everyone the same thing and don’t really care what really makes someone tick. It’s like we are cattle just being pushed through the gates.
T: Do you think Rap music could be a great way for us to understand what makes you tick?
R: The best way!
T: I get the sense you have many important stories to rap about. Would you be willing to write a song between now and next time that paints the part of the picture that probation and maybe other people in your life don’t get about you?
R: (Nods affirmatively)
T: Do you know what I mean?
R: Oh yeah, for sure. I already feel a couple of ideas (pointing to his head). Like people automatically assume I’m stupid and like I’m some kind of bad person or criminal or something. They don’t even know me.
T: Might writing a rhyme about the parts they don’t know release the shackles from your soul?
R: Yeah, but not all the way.
T: It might take more than one rhyme to release them all the way?
R: Yeah.
T: Do you have many stories to tell?
R: Oh yeah!
T: I want you to know that I will support you in writing as many rhymes as it takes.
R: You’re the weirdest shrink they have ever sent me to. Not weird like bad, not bad at all, but does probation know you do this?
T: Do what? Ask people to rap?
R: Yeah!
T: They know I help people find the kinds of therapies that best work for them. Do you think this one we’ve come up with today might work for you?
R: Oh yeah, but I don’t even know if this is really therapy.
T: What would you call it?
R: It’s like a studio session where I’m making beats with my homies or something.
T: Should we have a studio session once a week together?
R: (Smiles and laughs) For sure.
Spitting From My Soul
Ray returned for our second conversation with his black New York Yankees hat turned to the side looking somewhat, but perhaps not yet completely relaxed as he sat down. He reached into his pocket and pulled out a folded piece of paper as his right leg bounced up and down. He quickly unfolded it and scanned over its content. “Here are a few lyrics,” he said quietly but with conviction as he handed the document to me. I was feeling a bit caught off guard that Ray had picked up so quickly where we left off in our last conversation.
T: Ray, I have to be honest, I feel so privileged to hold this is my hand right now. I wonder if I am holding a gift from your soul?
R: You could say that (kindly smiling at me).
T: I just had an idea and I’m curious if it would be okay if I shared it with you? (Ray nodded in the affirmative). Last week you told me that rhymes come from your soul when they are rapped. I could be wrong here, but I’m just wondering if I read the rhyme on the paper if it might lose some of its soulfulness? And the last thing I want to do is strip the rhyme of its soulfulness.
R: I’ve got a baseline for this (pointing to his phone). It’s dope (a hip-hop term that means good or of high quality) You want to hear it?
T: I would be honored, Ray.
As the music percolated through the small speakers on his phone I noticed I couldn’t help but bob my head. I looked up and Ray was doing the same. Our eyes caught and Ray smiled slightly with the left side of his mouth. In this moment I pondered whether or not I should invite him to rap, but I hesitated not wanting to make him feel uncomfortable in our second conversation. A few seconds later, Ray reached his hand out indicating he wanted the document with the lyrics on it back from me. I obliged. Ray bobbed his head a few more times and said, “This still needs a little more time in the lab, but…”
What happened next as Ray began to “spit truth” was almost like a detonation. The words rhythmically rolled off his tongue with an intensity that made me suspect something important was transpiring. I didn’t just listen to what he said, I felt it. Ray’s passion was palpable, and I could feel its infusion through my body. We now bobbed our heads in unison and for a brief time it was as if the world had shrunk and we were the only two people that now could fit in it. It was the kind of attunement and connection with another person that was equal parts mysterious and exhilarating.
Grandma said I should reconsider law school
That means I wear a suit and bend the truth and feel awful
Hell no, got a degree but what that cost you
You make a good salary just to pay Sallie Mae
That's real as ever
Ducking bill collectors like a Jehovah's witness
When they showed up at your door at Christmas
Praise God it's hard to stay spiritual
How they got these people on the TV selling miracles
You mean to tell me everything gonna be fine
If I call your hotline and pay 29.99
Well damn, why didn’t you say so
Take this check and ask God to multiply all my pesos
T: I am so captivated by what just happened, Ray! Would it be alright if I tried to understand your rhyming genius a little better?
R: For sure.
T: May I ask what is it about this rhyme that reveals a part of yourself that other people often fail to get?
R: People think that because I don’t have a college degree I’m stupid. They make that judgment up front. Now I’m not trying to say that college is always a bad thing (said looking at me knowing that I’m also a college professor), but, you know, sometimes it’s like a scam. Like, I'm a poor kid. Think about how much debt I would rack up by going to college. Dude, it’s astronomical. I tried community college for a year. Is that even a good investment? You know, I think a really good rhyme exposes the way people think. So that first part is just like a challenge. You know, just because these are the rules you play the game by doesn’t mean they are the only rules.
T: Do you think rhyming helps you create your own rules while also challenging the rules people tell you that you should follow?
R: No doubt. And sometimes you challenge rules in rhymes just to make people think.
T: Is that like what you were saying last week about rap as a philosophy (I asked Ray this very much hoping the conversation meant as much to him as it had to me).
R: Exactly, like KRS-One!
T: (Feeling relieved that we seemed to be catching up right where we left off last week, I continued) Can I tap a bit further into your rhyming knowledge here, Ray?
R: Sure.
T: Are you of the opinion that challenging rules is a good thing? (Ray nods in the affirmative) And why do you think it’s a good thing to challenge rules?
R: If no one challenges rules, shit gets stale. You know what I mean? Like people start to take things for granted. Sometimes a good rhyme is just like grabbing someone and going (pretends like he’s physically shaking someone). It’s like, wake up, yo!
T: Do you believe there are different ways to challenge rules?
R: A lot of different ways.
T: Are some ways of challenging rules more effective than others in your experience?
R: Yeah, I mean, look how I ended up here on probation.
T: How do you mean?
R: Ever since I was a kid, I would find myself in certain situations where I would get angry and step (a hip-hop term that means to challenge someone physically, often to a fight) to someone. Yeah, and it’s stupid, I know. I’ve been getting that lecture my whole life.
T: How do you understand the relationship between rap and anger?
R: When I would write rhymes, they would keep me out of trouble. Like if someone was pissing me off, I would just go home and make a beat about it. It’s like my anger would leave my mouth through my rhymes.
T: Let me see if I’m hearing you correctly, Ray, because I don’t want to get this wrong. Are you saying that rap is able to put anger in its place?
R: Yeah, I don’t end up doing something stupid.
T: Maybe this is a long shot, Ray, but do any rhymes come to mind that capture what we are talking about here?
R: No, not really… (pauses in a pensive fashion for 30 seconds or so)…actually, yeah, one does (he composes himself and then begins rapping):
References
Radical Listening: A Key to Therapeutic Success
The space between musical notes is called an interval, I just learned. French composer Claude Debussy described music as “the space between the notes.” Without the space between, it would just be a cacophony of noise. The space allows for the notes to resonate and reverberate and mature into their fullness of expression. It gives room for relativity and reflection and response. This analogy could be applied to many things in life to improve their experience and outcome: dialogue, relationships, life, and psychotherapy.
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Being untrained in the art and technicalities of music, I listen to and appreciate music more intuitively. I hear the Gestalt of the composition or song rather than attempting to discern the nuance of their parts. Knowing this about music, and then extending it analogously to other areas of life, clarifies and shines a light on the “space between” in some illuminating ways.
Competing for Space in Relationships
Sometimes in relationship conflict, when two people are vying for space to be heard, there are times when there is little space for absorption, reflection, and appreciation of the other. Defensiveness and/or attack predominate. Or sometimes one person needs space and the other does not provide it, pursuing relentlessly, forcing the other into either complete retreat and shutdown, or drawing them reluctantly into defensive engagement. It is a simultaneous and continual banging of pots and pans and blasting of horns with no space in between.
In this particularly heated kind of context, creating “space between” facilitates relative quiet and calm. It allows for reflection time. It provides the opportunity to digest the other’s words, and for words of retort to be more considered and chosen. It gives feelings time to catch up. It allows each to be heard and seen. For the uninitiated or unaccustomed, to break through requires the practice of self-reflection and awareness raising. It also requires getting in touch with one’s bodily sensations to change the state of one’s nervous system. The space between — the intervals — needs to be conscientiously placed in between the notes, just as in the writing of a piece of music, like the unfolding of an experimental jazz set.
Sexual Abuse and the Need to be Heard
I was inspired to think about the space between in a relatively new job I am working in. It is in a community legal clinic providing counselling support to adult survivors of sexual abuse. For many of these clients, it is the first time they have spoken about their childhood abuse, particularly in any detail. They trust us, the intake team, counsellors and lawyers, especially considering most of our work is done on the telephone. In most cases, clients and staff never even meet face to face.
Being in this new role and working within a new modality for me (telephone-based counselling), I have been in observer mode, taking in the similarities and differences to my previous counselling roles and clientele. I noticed a tendency in some clients to talk ceaselessly and seemingly uninterruptedly for the full hour, quite easily and without allowing anything much in return from me. I can sometimes barely get a word in edgeways. How dare they! Are they not aware of the wisdom and insight they are missing out on? Did they not come here for my well-honed techniques of reflection and Socratic enquiry? My gifts are going to waste! I am not here to just listen! Besides, I have got a wealth of experiential Gestalt learnings to practice (I am currently a student of this art).
After composing myself, I realized that this was exactly what they needed right now. I had to adjust. They needed to be heard. Needed to be seen. To be believed. Some clients did not have any meaningful contact, let alone any contact at all, with another person in the space between our phone calls. Many have very deeply entrenched fears around trust and relational intimacy. It was their time. I had to adjust. I needed to be the one to provide the space between.
I am there to just listen. And this is a powerful ally for many for where they are right now. I continually receive feedback from clients about how grateful they are and how important it is for them just to be listened to. To be acknowledged. To be given space, just for them. It is sometimes difficult to accept and implement. Nevertheless, my greatest wisdom is to just be minimal. Not always, of course, but to know when and how.
The Power of Space in Group Therapy
I recently participated in an experiential group facilitation workshop. It was taught by an extensively experienced Gestalt and Psychodrama practitioner. It was a profound learning opportunity for me, the standout technique which I observed being “space”. I was like Ludwig van Beethoven, I imagine, witnessing…hmmm, I don’t know…help me out here Google…Herbert von Karajan conducting Bizet’s Carmen? Sure, why not? The space the facilitator provided to the group, to those doing a piece of work, was enlightening to observe. The empty space they allowed for the subject and other participants to sit with their feelings, their uncertainty, the potential void, without jumping in to fill the space or to offer insight or comfort, seemed so natural. But it was not natural. Well, not for me. They seemed to know exactly when to allow another group member to break the silence and when to pause them, when to slow things down. It impacted me deeply. It inspired me to be a better space maker in my work. For, while in this group, I was imagining what I might have said during moments of others work, how I would have broken the silences possibly out of anxiety or impatience or those egotistical impulses that often lurk just beneath the surface. I was moved by the experience, emotionally and practically, for a few reasons. It led group participants into new ways of experiencing ourselves, giving more room for us to feel into the phenomenological moment, and because it once again revealed to me a learning edge of mine, shining a light on another way of being with clients. With people. And with myself.
***
The space between is a fertile ground. I have noticed that when I do not allow for space in between life activities, my world becomes a cacophony of noise. It is less beautiful. And there is less space to understand myself, my feelings, my impulses, or for insights to emerge. I miss out on flowing with the natural rhythm of life, the hidden laws of being perhaps. Part of my development is to extend this ‘space between’ to more areas of my life — counselling to be specific. To increasingly get myself out of the way, and to tune in better to the needs of the moment, to the needs of my client.
Looking Back on a Year of Challenges for Psychotherapists
As much as I’d like to, I won’t presume to summarize this soon-to-be-past year in our world, because we each see that world differently. We each experience and live in that world uniquely. And the fields of psychology and psychotherapy are but minor lenses through which to perceive those worlds — and those of our clients.
So, as I look back on some of the events and issues we’ve experienced in 2022 as clinicians, clinical educators, and trainees, and the editorials you’ve contributed around those issues, I’m not surprised by their depth, range, and import.
A constant among the editorials we’ve featured has been a focus on the craft of psychotherapy. Not just the technical aspects of treatment, but the qualities of self that make for a “good enough” clinician — empathy, self-awareness, presence, and a commitment to growth and competence. These qualities, these aspects of self that the clinician brings into the room are often the unmeasurable ones, but are also those that help us to connect with diverse clients. They are the qualities that help clients make meaning of their stories, and when clinical stars align, to make meaningful changes in their lives whether they are experiencing the ravages of depression, battling with anxiety, adapting to situational stressors, or finding a peaceful and perhaps final resting place for ancestral trauma.
Then there were the essays that focused on the business of therapy, those that held a mirror to some of the very real-world pressures that clinicians must address to build their practices, their brands, and their reach. These are the ones that dealt with the benefits and challenges of teletherapy, advertising and branding considerations, and the lure of private equity firms with their singular focus on bottom lines, profits, and valuation.
Our editorials, whether shorter “blogs” or longer, in-depth “articles,” have also addressed some of the more complicated issues that clinicians and clients share as citizens of an increasingly divided local and global society. They aim to make sense of and adapt to the seemingly ceaseless presence of division, anger, disease, and war — all while keeping an eye on the horizon for goodness, connection, and hope.
And then there were our interviews; those opportunities to dive deeply into some of these issues by chatting with thought and practice leaders in the field like yourselves. These conversations highlighted a fascinating diversity of topics, including the proliferation of mental health apps, the realized and un-met promises of neuroscience, the importance of kink-affirming clinical practice, therapy in the digital age, behind prison walls, and even psychotherapy as an act of rebellion.
Quite a litany, of which I am proud and for which I thank YOU and promise more to come in the year ahead. Be safe, stay healthy, remain connected.
Lawrence Rubin, PhD
Editor, Psychotherapy.net
Critical Counseling Tips for Guiding Parents of Gifted Children
Jimmy is seven. He started reading on his own when he was 4 and is now devouring the Harry Potter books. He asks his parents questions about death they cannot answer. He knows the states and their capitals and the differences between dinosaurs. He loves numbers. In second grade, they are teaching addition and subtraction while he is already multiplying and dividing. Jimmy loves learning but is disappointed in schooling. While he was so excited to start school, he now comes home feeling angry and defeated. Jimmy is longing for friends, but the other boys are not interested in his love of the dictionary. He is very sensitive, empathetic, emotional, and lonely. He is showing signs of anxiety and having meltdowns after school. Jimmy is gifted. His teachers do not know what to do with him. His concerned parents are anxious and do not know where to turn. They come to you. What do you tell them?
The Drama of the Gifted Child
I have been working with gifted children and adults since the mid-1970s, first in education and now as a psychotherapist. Starting as a teacher of middle school gifted kids in a pull-out program, then providing classes for teachers and parents, I have learned over the years that these kids and their families often have certain traits and experiences in common. Certainly, there are many differences and much complexity among the gifted. There is even very little agreement over what giftedness actually is and how to define it.
Even so, there are some obvious characteristics we can identify and specific ways to help parents navigate the school system and negotiate life while raising a gifted child. These parents are struggling and feel misunderstood by a world that assumes having a gifted child makes parenting easy. It doesn’t. If you have some basic knowledge of the needs of these children and their families and can provide specific resources, clinicians can have an important impact on a population that is often overlooked and surprisingly underserved.
The controversy over how to define giftedness has existed since before I entered the field in the 70’s and it continues to this day. For our purposes here, I will briefly share my understandings based on my years working with these students and clients, and also share details of a recent case.
We might all agree that giftedness in children starts with advanced intellectual capacities. This is often measured by an IQ score but there are other, sometimes more reliable, clues. Usually, these kids reach typical milestones early. The easiest developmental step to notice is early verbal ability and an advanced vocabulary. Parents often report these children learn to read before school starts. The kids are extremely curious, ask complex questions, and are eager learners.
Typical gifted children also have many sensitivities, a range of intense emotions, creative thinking skills, and deep empathy. You see many of them speaking out at an early age for fairness, justice, and environmental issues. These children may feel pressure to be very high achievers if they have been praised too much for their “smartness.” A paralyzing perfectionism can then become an issue. They may never feel good enough or smart enough if they keep raising the achievement bar to not disappoint parents and teachers, or if parental expectations are inappropriate. Even if they are not over-praised, they may naturally set high standards for themselves. This intrinsic desire for excellence is not always problematic or unhealthy. It can be what provides our world with its symphonies and cathedrals. But if the drive comes with too much self-criticism, it can become problematic.
Granted, not all gifted children fit this description. Some are linear-sequential thinkers, and some are highly competitive. There are gifted children who perform well in school and others who don’t. Not all of them deal with perfectionism. Some gifted children have what is called “twice exceptionality”, which means they have learning differences or disabilities along with the giftedness, which adds to the complexity of parenting, teaching, and helping them in counseling. The concerns parents of younger gifted children bring to me are usually around schooling, anxiety/emotional regulation, and finding meaningful relationships.
The Case of Jimmy
There is so much pressure on teachers these days and so many needy children in the schools. It was easier to be an educator back when I was in the field. So how can we, as clinicians, both understand the stresses teachers and parents experience while also finding ways to provide an appropriate education and home environment for gifted children? As you can imagine, these kids are often sitting in their classes being taught material they already know. In many cases, this is true day after day and year after year. The expectation is often that these children will be fine on their own because they are “so smart,” but inappropriate schooling experiences can have long-lasting serious consequences.
Jimmy’s mother, Joan, contacted me because her son had been identified as gifted in first grade and she was noticing some issues with increasing anxiety, emotional regulation, self-esteem, and difficulty making friends. She was wanting to find solutions and learn how to approach his teacher because Jimmy would come home from school agitated and complaining of boredom and loneliness. His frustrations would often be expressed in emotional outbursts at home.
Jimmy was already reading in first grade, and in second grade enjoyed chapter books. His math abilities were also quite advanced. They were teaching addition and subtraction while he was excited by division and fractions. Like many educators, his teacher was not trained in differentiating instruction for gifted children and so Jimmy was made to complete the same assignments as his classmates. In the beginning, he was compliant and completed the required work, but the tension he felt in school would explode at home.
Jimmy also had trouble finding friends who had similar interests. No one else in his class was reading the books he loved or had the interests in astronomy, mathematics, and so much more. Luckily, he did have some athletic ability so he was able to find other boys to play with at recess and could experience the joys of teamwork on an after school soccer team. But his anxiety and emotions were getting harder to handle, and his sense of being inadequate and an outcast were growing.
What I suggested to his mother, Joan, will hopefully be helpful to clinicians working with parents of gifted children:
1. Look for the teachers who are more sensitive, flexible, and creative. Ideally, they have some training in gifted education. But even if they don’t, some will teach in ways that work better for these kids. Methods that work better? Project-based learning. Independent reading programs. Interdisciplinary approaches. Open-ended assignments. Acceleration. Flexible deadlines.
2. Volunteer in the classroom if you can. Be supportive of the teacher and share your concerns directly. Offer to work with a small group of the more advanced kids. Run a book club in the class or after school. Start a chess club or find one in the district. When he is older, debate is often an activity these kids love where they can find others like them.
3. Suggest to the school administrator which teacher is the best fit for your child, and that you will be a very agreeable and grateful parent if your child gets placed there. It is good educational practice to match a child with a particular teacher. Get support from the school or district gifted coordinator.
4. Learn about curriculum compacting, which is a way to allow a child who already knows the material to test out of or skip the regular assignments and work on projects that are more appropriate for his rate and level of learning. Look into teaching materials designed for gifted kids in the classroom. Prufrock Press is one publisher of curriculum. Gently suggest his teacher check them out. Provide samples.
5. Suggest to the school administrator that they use cluster grouping. This is the practice of placing the gifted children of a certain grade together in one class. This gives the kids a chance to find intellectual peers and provides them with a buddy so that they are not off alone doing a different assignment. It also allows the teacher to design curriculum for more than one student so it will be easier to plan.
6. Consider acceleration to the next grade level or for a particular subject. If your child is extremely advanced, consider home schooling.
7. Look for friends outside of school in different activities if there is no one in his class. Friends can be older or younger. Arrange play dates with potential friends and get together with the families.
8. Find mentors who have interests similar to your child. Mentors can be high school students, neighbors, and family friends. A good mentor will be an important support for developing his interests. Parents may not have the same interests or abilities to answer the many questions these kids ask.
9. Teach him self-soothing techniques such as deep breathing, visualization, drawing, exercise, and mindfulness. Tapping or Heartmath can also be useful. Remind him that his deep, intense feelings are a wonderful part of who he is and learning how to manage them in certain situations will help him in his relationships and in life.
10. Use active listening to validate his feelings. Reflect what you hear so he feels understood. This will reduce the intensity of a meltdown. Once he is calm, problem solve with him. Brainstorm solutions together. His frustration in school is real. It makes sense he will feel angry some of the time. Let him know you are working on solutions. Thank him for his patience.
11. Explain to him what it means to be gifted, including the fact that it does not mean advanced in all areas all the time. Talk about his strengths and weaknesses. He may feel rejected or like something is wrong with him, so these conversations are important. Help him understand that other kids may not have similar interests or abilities, but they all also have strengths and weaknesses. Include explaining sensitivity and empathy. Understanding giftedness won’t make him arrogant. It will help him feel more comfortable in his own skin.
12. Role play how to make friends. You may need to give him some basic skills for talking to other kids. He is more likely to tell you how he feels if you are doing an activity together, using puppets/artwork, or if you are in the car. He may be very smart in certain areas but need lots of guidance in others.
13. Take time for yourself and your partner. Find good childcare and take breaks from parenting. Make time to rest, relax, and pursue your own interests.
14. Find a therapist for yourself if parenting is bringing up your own unresolved issues. If you are also gifted, how did your parents understand or misunderstand you? What was school like? How are you similar or different from your child?
Joan met with the classroom teacher and the district specialist in gifted education. It took a few meetings, but the school made accommodations for math with a third-grade teacher who was warm and welcoming. Although the scheduling was not ideal and the math was still too easy, Jimmy was happier at first. A sensitive and creative teacher can make a big difference even if they do not make big changes in the curriculum. That said, Jimmy was uncomfortable leaving his class to go to the third grade. This is often the dilemma for these kids. They need advanced material but going to another class can result in bullying or missing more appealing subjects. I was hoping Jimmy might just move to the third grade full time since the teacher was better equipped to handle gifted children, but Joan was concerned about friendships, which is also a real issue. It is important to consider multiple factors with acceleration.
Joan planned to get to know more of the teachers at the school and started doing research in other schools to see if there would be a better fit for the next year. She volunteered in the classroom and started a book club for interested students. Jimmy began to find a few friends for recess and after school activities. His mom arranged play dates with a couple of boys who had some similar interests. She continued to look for a mentor for his science and math interests and a reliable babysitter so that she and her partner could get time away.
To manage Jimmy’s anxiety and emotional outbursts, Joan started practicing active listening and teaching him some self-soothing techniques. I think she was surprised at the positive impact. I often explain this tool to parents, and they can be skeptical at first. They may think that they are already deeply listening! But this method which we all know as counselors may still not be understood well or practiced by many parents.
Joan began to feel some relief when Jimmy was less reactive at home. I continued to support her as she navigated the school system. For these parents, being engaged in the schooling process is necessary throughout the child’s K-12 education. This is often exhausting and discouraging. Getting support is critical. Along with this support, we also began to look at her own experiences as a gifted child and the effects of her family of origin on her own sense of self. Often giftedness has a genetic component, and it can be quite therapeutic for parents to examine their own experiences of growing up gifted.
***
Parenting gifted children brings a particular set of challenges that are often misunderstood or overlooked by educators, therapists, and the general public. If therapists understand the complexities that come with giftedness and provide guidance for these parents and families, it can make a big difference. Not only for your clients, but really for us all.
Resources
National Association for Gifted Children
Laughter and Humor Can Be the Best Therapy
A client once burst into my office for his first session and collapsed onto the couch. A little startled, I began with my usual protocol, asking what he had come for help with. “I’m a teepee,” he said. I stared at him, unfazed. “I’m a wigwam,” he continued. I nodded. “I’m a teepee,” he repeated. “I’m a wigwam!” I took a deep breath. “Obviously,” I explained, “you’re two tents.” This story didn’t happen, but it’s my favorite therapist joke. (If you haven’t gotten it yet, read it again aloud). People who know me outside the therapy room tend to think of me as a comedic fellow. The reason being, I surmise, is that I am in fact a comedic fellow — if I must say so myself. Some of them wonder how I could possibly be a therapist as well. Often, they do this aloud and in my presence. People generally regard therapists as serious professionals helping people with their serious problems in a calm, soft-spoken, (non-comedic) manner. It’s a fair question, and one answer is that I actually do have a serious side. It comes out mostly when I’m asleep, but it also makes appearances in the therapy room. If you wanted to psychoanalyze me, you might discover that my powers of humor derive from a sincere desire to spread joy, happiness, and empathy — which I maintain is foundational to all therapy — and is consistent with that desire. The other answer is that humor can be a powerful tool in the therapy room. Many people come for their clinical visit feeling terribly nervous and uncomfortable. This is especially true in my area of expertise, couples counseling, in which two people come to meet with a complete stranger to share their most personal moments (especially the most personal failures). Can they be blamed? Who’s excited about discussing their sexual dysfunction with anyone, let alone someone they just met? In this particular venue of counseling, I have found humor helps loosen us all up. It helps chip away at some of the discomfort and the shame and the resistance that clients bring with them. Donna and Dwayne As an example, consider Donna and Dwayne, an African American couple from Baltimore City who came in for help with their relationship. She walked in looking timid but hopeful. He followed behind looking P.O.’d from the get-go. He literally sat back on the couch, crossed his very muscular, tattooed arms, and glared at me. I started off with the usual pleasantries and asked them what brought them to therapy today. Donna looked at Dwayne, who didn’t move his gaze from me. She began to explain that they were having problems in their relationship. I listened for a few moments, nodding. When Donna finished the broad overview, I looked at her, then at him, and replied (mostly to him), “Uh-huh. So let me see if I get what happened: she’s unhappy with you, so she said, ‘hey, let’s go talk to a scrawny white Jewish guy about our problems and that’ll make everything better,’ and you were like, ‘that sounds GREAT!’” He did a very subtle double-take when I tagged myself as a scrawny white Jewish guy, then cracked a smile. That loosened things up enough for me to get a foot in the door with a client who was clearly not excited to be there to begin with. Humor has been a great connector for me, inside and outside of the therapy room. Someone somewhere said, “Everybody laughs in the same language.” (I just Googled it — turns out it was Yaakov Smirnoff, another comedic scrawny white Jewish guy. Go figure). Research tells us that the single most important factor in the outcome of therapy is the relationship between the client and the therapist. Nothing helps build relationships like a good shared laugh. Clients know when they come see me that it’s not going to be an interrogation or a kumbaya circle. It’s going to be a real conversation between real people. It’s going to be deep, but it’s going to be fun. It’s going to be us connecting to help them manifest change in their lives. I don’t think that can be accomplished by the clinician being a detached professional. At least not this clinician. But you can’t do that as a friend either. The sweet spot shares some features of both extremes. Pete Pete was a young man who I was seeing for depression. He started off one of his sessions with a new concern: “I think I may have some short-term memory loss,” he suggested. “I know,” I replied. “You told me that five minutes ago.” He looked concerned for a moment, then he broke out in a grin. Pete “got better” in due time. Not from that joke, you understand. But the camaraderie that undergirded our intense conversations, and the jokes that peppered them, certainly helped. Poking a bit of fun at the problems can also make them less menacing. “I need help with my procrastination,” said Avi, the husband of a couple I was working with. “We can talk about that later,” I replied. Of course, you have to know your audience. You don’t make a joke about memory loss with a senior. You don’t make off-color jokes or (do I need to say this?) racist jokes. Self-deprecating jokes are usually a safe bet. Puns likewise are not terribly risky, but let’s be honest, also not terribly funny. Sure, some of my jokes fall flat. But that happens in real life too. I’d say that just makes the therapeutic relationship all the more genuine. You know what I think? Laughter is love. And love is the most buoyant of human experiences. If you’re coming to me for help, I’ll use whatever tools I’ve got to lift you up. Comedy is just one of them. But yeah, it’s my favorite. Questions for Thought and Discussion How does the author’s premise about humor in therapy sit with you? How do you use humor in your own clinical practice? Have there been instances when humor facilitated therapy? Hindered it? If you appreciate humor in your life, do you bring it into therapy? If not, why?
Radical Listening is the Secret Ingredient to Successful Psychotherapy
I recently woke up feeling sick. I had a sore throat and could hardly utter any words beyond a whisper.
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“I need to immediately call and reschedule all of my private practice clients,” I instinctively thought. However, I began considering how frustrating it is when my clients cancel on me at the last minute. They were expecting to see me, so I decided to work. I work virtually so there was no risk of getting anyone sick. I also felt as though I had enough energy to actively engage with clients as I regularly do. The only problem was my raspy voice.
Despite my attempt at fortitude, my mind wouldn’t quite let me off the hook. I became flooded with a barrage of critical thoughts about whether my clients would view me as being “less than” if I communicated with them through a hoarse voice. At one point, I conjured up a fantasy of being fired by one of my more critical clients. Further, I even imagined that if my voice was only at 30% of its capacity, I should only charge 30% of my rate. This flurry of thoughts helped me to empathize with many of my clients who struggle with overthinking.
As I proceeded throughout my day, I quickly became aware that most clients interacted with me as usual. Either they didn’t notice or didn’t care. I did have one teen ask if I had been practicing ASMR (Autonomous Sensory Meridian Response) — a pleasurable sensory experience — and another client asked if I was sick. Two out of ten clients wasn’t too bad. In the days that followed, I noticed a similar trend of clients being more concerned about their own problems than they were about me sounding a little different.
However, the experience offered a great lesson in self-awareness. Though I pride myself on “active listening,” I tend to talk way too much in therapy. I guess that I enjoy hearing myself speak. After all, I worked so hard to get a Dual Master’s in Counseling Psychology and I deserve to be heard, right? Talking makes me feel brilliant, but it is not always effective when getting clients to tell their stories.
Having a sore throat forced me to shut up more often than I wanted to. At times, I felt enraged with myself for not being able to point out patterns in my client’s distress or offer carefully planned interventions. Fortunately, over time, I accepted my fate as a somewhat voiceless therapist and stopped trying. To my surprise, clients did well with more space. They even made connections on their own without the imposition of their self-aggrandizing psychotherapist. Perhaps Carl Rogers would be proud of me.
But, how about the client that I fantasized about firing me? Towards the end of our session, I shared this fantasy with her. She had been talking about struggling with intrusive thoughts and I thought that this disclosure might be appropriate. She found my concern humorous, and I used it to help her understand how she could accept negative thoughts without necessarily having to change or challenge them.
Now that my voice has mostly recovered, I still find myself utilizing the lesson I learned from when it was hoarse. I remind myself to have clients lead and be the main experts in the room. As a therapist, we can sometimes be speechless and still have a voice.
Questions for Thought and Discussion
Did the author’s plight resonate with you? If so, how?
Do you tend to talk more than you think you should with clients?
Are there particular clients with whom you tend to talk more? Less?
What could you do to improve your presence with clients?
Storytelling in Counseling Is Often the Key to Successful Outcomes
Clients come in all shapes and sizes, seeking services for a wide range of reasons. No two clients are alike. But I have noticed something that many of my clients seem to share when they first come to counseling: they all want to tell their story.
I mean, it makes sense. When I visit my medical doctor about my aching lower back and they want to know about physical symptoms, I, on the other hand, want to tell them the story of how my aching lower back came to be. When a client comes to counseling and I want to hear about mental health symptoms, they, on the other hand, want to tell the story of their mental health. People think in terms of stories. People live their lives in terms of stories. Memories are organized around stories, and hopes and dreams travel along narrative lines too. It’s no wonder why a client would want to tell their story when starting out therapy.
My Early Experiences
I didn’t always hold stories in high regard. When I first started out in counseling, I became rather annoyed with clients when they launched into what felt like a long-winded story. “Just answer my question” or “Just tell me the facts” I would think to myself. Stories, in my mind, were just ways for clients to frustrate me and drag out the process. I didn’t realize or capitalize on the therapeutic power contained within stories until I realized that stories are more than straightforward vehicles for communicating information.
Stories are a way for clients to share who they are. They are doorways for connecting with a client. They contain feelings, hopes, dreams, desires, fears, worries and more, all wrapped up in a narrative about the client’s major life experiences. I’ve come to realize that listening to a client’s story is incredibly important. As a counselor, I have slowly learned that I should not allow myself to feel rushed, or hurried by the demands of billing insurance, scheduling, lunch breaks, consultations, supervision, records requests, and the mounting unwritten therapy notes that await completion of the client’s story. Slowing down and listening to the client’s story is the key to exploring their intricacies.
The Therapeutic Power of Storytelling
There’s another dimension to storytelling, though, that I’ve haven’t mentioned. Storytelling is a two-way street. The client tells me their story, but I also tell the client their story back. Telling a client’s story to them allows them to reflect, to take perspective on aspects of their experience they may not have considered. Furthermore, I may highlight certain aspects of a story that the client often neglects or avoids. By listening with intent and curiosity, I can shine the spotlight on a client’s resilience and fortitude, even in the face of tremendous suffering and challenging circumstances.
But telling a client’s story doesn’t always have to be a matter of sunshine and roses, and may instead reflect the dark parts of a client’s narrative and life. It can be deeply affirming and validating for a client to hear their pain acknowledged, to know that what they went through mattered, and that it played a crucial role in shaping them. Storytelling is life-affirming. It coheres disparate elements of a client’s life into a continuous narrative that imbues them with a sense of purpose and meaning.
Storytelling in Practice
My perspective on the importance of storytelling’s role in counseling isn’t just theoretical. I’ve come to this view by working through the trenches of clients’ heartbreaking, tragic, bitter stories. One case in particular stands out. I remember working with a single mother of an especially challenging child. For his age, this child was very angry, aggressive, and prone to violent outbursts.
The mother attributed much of the behavior she saw in her child to the abuse and violence he witnessed from his father who was no longer in the picture. I worked with the family for some time, but it always seemed as though little progress was made. The mother, however, possessed an indomitable and unwavering belief in her son. Despite the family’s difficult past and her son’s concerning behavior, she saw strength and potential in him. She viewed their past as an opportunity to grow and develop in new patterns that would not resemble the abusive father.
“Defender of the Weak”
At particularly difficult moments with her son the mother would say, “This is not who you are. You are a kind, strong, caring young man, who will grow up to be a defender of the weak.” This was a powerful narrative the mother was giving her son, one that allowed him to conceptualize his behavior in such a way that he knew it was wrong, but not representative of who he was. Instead, it gave him a sense of who he could be.
After an especially bad week marked by multiple setbacks, I took a moment with the mother to share with her the story she had told me. “I see a strong mother, who despite her circumstances, is relentlessly committed to her son. I see a mother who believes the best in her son; whose every action slowly pours goodness and kindness into him. And one day, all that hard work will pay off. With each investment of time and love, your son will grow to be a kind and caring man before your very eyes.” As I shared this story with her, I could see her eyes well up. She said, “Thank you.”
After our professional relationship ended and several years had passed, I bumped into her at a coffee shop. Doing my best to protect her confidentiality, I proceeded to order my coffee and not disturb her. Having apparently seen me, she stopped me and shared that her son was an entirely different person than the young boy I knew. He was doing better in school, no longer violent, and treated her with respect and kindness. To say I was shocked would be an understatement. This case was one that always stood out in my memory. When working with them, I had very little hope that the young man would come around.
***
Many factors played an important role in the young man’s journey. But from my perspective, a great deal of importance should be attributed to his mother’s strength-based, life-giving, love-fueled narrative that she willed into existence. I also believe that the affirming and hopeful narrative sustained her just as much as it did him. The kinds of stories clients construct and tell about themselves shape the kinds of lives they live. The journey of the mother, her son, and myself are living proof of that.
How to Resurrect a Dying Relationship One Emotion at a Time
In my practice, I have borne witness to many romantic partnerships that have failed with time —often to the shock and dismay of one or both partners. For many of these couples, it is a stunning development that was mostly or even completely unforeseen. This downward relationship spiral is most poignantly captured in the phrase, “death by a thousand cuts.”
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Retrospective analyses or “relationship autopsies” of these deteriorating ties often evince what I have come to call an “erosion of affection.” When hotbed issues between partners are not adequately or amicably addressed or resolved, chronic grievances fester and lay the foundation for irreparable damage. Affection is diminished and negative perceptions replace whatever positive ones might have previously existed.
Case Study: Amy and Mark
Exemplary of this point is the case of Amy and Mark. Amy had been after Mark, her husband, for over a year to put his dirty socks in the hamper. Mark had repeatedly promised to cooperate, but rarely if ever did so. This exchange between Amy and Mark went on nightly and eventually both became angry with each other. Amy felt disrespected and powerless. and Mark, who came to think of and eventually call his wife “a nag” for her constant pursuit of his compliance, seemed even less inclined to cooperate with her incessant badgering over something that seemed so insignificant to him.
Perhaps at an unconscious level, Mark became disinclined to “give her” what she had been asking him for. More importantly, the stalemated issue of the socks had changed the atmosphere in the relationship. Amy’s frustration had grown into resentment both because of the socks on the floor and being called a name as “punishment for my persistence.”
It was helpful to learn — and apparently for the first time — that Mark had been diagnosed with Oppositional Defiant Disorder earlier in life and had a history of troubled interactions both personally and professionally. In his individual and marital treatments, he came to understand and accept his role in what he subsequently referred to as “the absurd socks situation that I created.”
Unresolved Issues Lead to Erosion of Affection
Therapeutic work with Mark and Amy benefited enormously from a rather unusual collaboration between me and the clinicians who were working individually with each member of the couple. The continuous informational exchange enhanced everyone's understanding of the historical antecedents to their difficulties with each other and provided valuable guidance for each therapist as the three treatments simultaneously continued. Initially, the level of anger about this and other unresolved issues between the two marital partners were causing considerable damage to their relationship.
An important effort was to help them to use their anger to strengthen their communication and accomplish stated goals rather than to continue to cause possibly irreparable damage by their verbal abuse toward each other. Once the anger eased and the overall emotional climate improved, I often had Mark and Amy replay their earlier troubled interactions. The “before and after” provided an important opportunity for them to see the differences and enjoy the benefits of their overall improved manner of relating to each other.
The Spotlight Shines on Negatives
An often-unrecognized consequence of unresolved issues like this one is that they infiltrate the marital system and lead to other accusatory and blameworthy exchanges. This pattern sets the stage for lower tolerance for the partner's other quirks, foibles, and irritating behaviors that earlier had been either trivialized or ignored. The spotlight shines with increasing brightness on the negatives since they might be the new focus, especially if there has been little or no conflict resolution.
In the case of Amy and Mark, the idea of dirty socks “laying around” unattended seems an apt metaphor for the degradation of their relationship. Cleaning up this mess seemed an equally powerful and positive metaphor for their improved relationship.
Seeking Counseling When the Erosion Has Passed the Breaking Point
Many couples who eventually seek my counseling assistance for their troubled relationships arrive at my office when the erosion of affection has already passed the couple’s breaking point, causing irreparable damage. This makes the therapeutic enterprise a more complicated, if not doomed, endeavor.
It certainly helps if both partners have, or can be helped to have, sufficient reflective awareness to acknowledge responsibility for the now troubled union and be willing to do the necessary work of restoration and repair. It is especially helpful if neither partner has quietly consulted an attorney and if the subject of separation or divorce has not been part of the recent dialogue between them.
***
I did not write this piece as an advertisement for couples therapy. However, I suppose I am recommending that couples and individuals seek help to avoid creating a collection of unresolved issues and unaddressed grievances that carry the potential to ruin their relationship. Much like knowing when to consult a physician if a worrisome physical symptom appears, partners in a relationship need to be reasonably alert to the development of potentially harmful issues that can subvert the quality of their relationship. This is especially true if those issues threaten to erode their affection and make their bond difficult if not impossible to repair.
Final Questions for Thought
What therapeutic strategies do you employ with couples like Mark and Amy?
What feelings did the case of Mark and Amy provoke in you?
How do you address your own feelings when working with couples destined to separate?