The Importance of Self Care

I was reading this article in the National Post, about a psychiatrist whose trained specialty is analyzing and working with violent sexual predators, who recently experienced a breakdown as a result of what is believed to be symptoms of PTSD (post-traumatic stress disorder). He has worked on cases involving Paul Bernardo, Robert Pickton, and most recently Russell Williams: all of them so-called sexual sadists, all of them convicted murderers.

To put this into context for those reading from outside Canada, each of these convicted – by virtue of the severity and depravity of their crimes – is a poster boy for reinstating capital punishment (which, for the record, I do not support). They have individually terrorized regions of the country when they were active. It’s important to understand all of this due to the nature of being a mental health professional – someone trained to see people as people no matter who they might be or what they might have done – working with people of this description.

The article describes how Dr. John Bradford simply lost his ability to keep the burden of content (and ostensibly the affect of said content) from seeping into his consciousness, whereas before he was able to separate the explicitly graphic information he worked with from getting to him. What stood out in the article for me was the following:

What he wouldn’t realize until he went into therapy was that the videos from his many cases had been gradually taking their toll and they rushed back to haunt him on that long drive home.”

 

In particular, the phrase “until he went into therapy”, which implies that he wasn’t seeing a therapist until this point. Assuming this conjunction isn’t sloppiness on behalf of the writer, I find it appalling that Dr. Bradford could have such a role and somehow not be mandated by his employer (or his governing professional society) to be in some form of regular personal therapy. It boggles my mind, actually.

We live in an odd time when the general public are being told (rightfully) the importance of mental health and not allowing toxic environments to fester within them and yet someone tasked with watching videos of killers’ victims doesn’t walk into a therapist’s office until he is exhibiting signs of PTSD and is forced to take a month off work?

Let me be clear: to my knowledge there is no explicit mandate for said procedure. I am not implying that Dr. Bradford was in any way professionally negligent. I am however suggesting that the past and current culture of psychiatry, with its “detached” experts, should reconsider its standards for those tasked with a specialty like Dr. Bradford. Self care goes both ways: it allows patients/clients/non-professionals to seek help and understanding for their issues; it also allows professionals an opportunity to explore how their work impacts their lives.

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About Blame, Shame, and the Sacred Altar of Individual Responsibility

[This originally started out as a post on my psychotherapy blog, but became so lengthy and opinion-laced that I figured I’d put it here.]

One comment I hear, particularly in op-ed sections of newspapers, is that as a society we are becoming “soft” (ostensibly because we are beginning to encourage children to discuss their emotions throughout public school life, and not just when they get in trouble or are victimized). Within this same argument is the contention that, thanks to people like me (mental health professionals), everything that is perceived to be wrong with the individual is to be blamed on other people or institutions. Thus, the contention is that individual responsibility is somehow being sapped of its strength.

I see no need to blame anyone for anything. If a client’s parents were too strict when they were growing up, it’s enough to explore it (and its effects) until such a time as the context of those events have a present-day meaning which will allow the client to lead a healthy, durable life and move on. My interest is with the client: their health, their well-being. I have no use for encouraging, casting, or redirecting blame. That is not within the philosophy of the modality of psychotherapy that I am trained in. It is certainly not within my personal philosophy. There’s not much to be gained from vilifying people and things.

Something to note is that many forms of victimization carry with it, primarily, shame (though other feelings may follow closely, like anger). The shame of not being able to avoid the caretaker who struck you. The shame of not being able to speak out about the racial discrimination you experienced in school. The shame of being sexually preyed upon by a coworker. Shame is a very deep hole to climb out of. Just talking about shameful experiences can retraumatize some clients – that is, put them right back in the original emotional context which first scarred them.

Survivors of abuse often feel responsible for their victimization, regardless of how little agency they had at the time they were victimized. In other words, if we are to talk about blame then we should talk about victims of abuse walking around blaming themselves. One of the tasks of therapy is to move the finger of blame away and to look at what has happened to a client with clarity, without an agenda. Then and only then can the process begin of assisting the client out of that deep hole I previously mentioned; assisting by paying close attention, sharing, talking. The client does the heavy work and I’m there to help in every way I can.

I cannot think of something which better defines individual responsibility than someone recognizing that something deep down within them needs to change, and undertaking the time and effort (and pain, and, yes, in the case of working with a therapist, money) to rework their understanding of themselves, to lift themselves to a higher point of view – and all that this entails both in the therapeutic space and in the outside world.

If by “soft” critics mean weak, then the individual who helps herself is not “soft” – she is not weak. She does not blame herself as she once did. She has taken control of herself and has worked hard to build awareness, and through awareness resiliency.

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The Pause Button

I don’t believe our identities ever settle, to become static. This isn’t to say that they fly willy-nilly like laundry in a windstorm. There are two great wheels: the one inside of us and the one outside. Both move forward regardless of our individual philosophies.

The outside wheel is time. It is the inevitable movement of progress, the passing-on of events, linking like the teeth of a sprocket on a bicycle chain. Whether we stand still or keep moving, this wheel keeps turning.

The inside wheel is our own development: our learning, the expansion of our comprehension of things, as well as our personal growth. It also keeps moving, again, whether we stand still or move.

Development is growth, and growth is sometimes painful, especially when we suspect we have been travelling on a path which does not intuitively serve our needs any longer. The temptation can be strong to “hit the pause button”; to stop looking at how the outer wheel affects the inner wheel, the learnings contained within their interplay. I’m not sure if it would be fair to call this wilful ignorance, but some would.

I’ve known people, particularly those from school, who seem to have “hit the pause button” at some point in their late teens or early twenties: they dress the same, they obsess about the same music, they ask the same questions they asked at that age – it can seem as if they are exist in a still photo of a past universe. I speculate that they see the larger wheel, the world, turning (one cannot wilfully blind oneself from seeing this), but don’t wish to acknowledge that the inner wheel, identity/personality, still turns and evolves also.

It makes me sad, and yes I realize that is a judgement. I don’t wish to categorize people since we live in a society which already puts such an emphasis on a divisive winners/losers binary. It makes me sad because I have a relational tether to those who are in this way: I know what it’s like. It’s also quite common.

I could speculate all day about whether this is fear-induced, shame-induced, whether (from a psychoanalytically informed perspective) there is a concern about narcissistic rupture at play in this. All I know is that it exists, and that the temptation for some to “keep things the way they are”, regardless that this is kind of impossible, has a strong lure.

 

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Mondays

For a number of reasons – one of which is gaining more diverse therapeutic experience – I have started a practicum with the Sutherland-Chan School & Teaching Clinic on Mondays, as one of three rotating in-house counsellors. Our purpose is to “be there” for students enrolled in the clinic.

I wasn’t sure, at first, what to expect. My home practice is moving along and my clientele growing modestly. Their needs for seeking a psychotherapist vary: some have acute issues, others less tangible (more existential). At the clinic, all of the students I counsel have the same thing in common: they are all training under the same roof and have the same tests put upon them. Yet, beneath the homogeneous surface stirs a diversity of thoughts, feelings, and reflexes. It’s not unlike a group of people making their way through an amusement park, who are each mandated to experience each ride on the midway, each game in the arcade: each person will have a particular skill-set, a particular threshold. The rides or games which do not lie within their sets of skills, which require resilience beyond their particular threshold – these are the events which differentiate, which personalize the common experience.

Even within a prescribed course of study, where one would expect common dips in personal performance to happen at certain compression points of time and workload, on their own our blindspots, our subconscious organizing principles come to the fore. Often in spite of us. It is here where I have people knock on my door at the school, and ask whether they could talk with me.

And we talk.

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My Psychotherapy Blog

As some of you (now more of you) know, I recently began a practice as a psychotherapist. I have a website, which gets a fair bit of traffic (allowing that summer is a traditionally slow time of the year), but recently I added an adjunctive blog.

The purpose was to get more of me out there, rather than have people rely on their preconceptions of what a psychotherapist is/does just by staring at my business card. I figured it would help both me and potential clients (including curious onlookers) deal up-front with questions that often go unasked yet which people would like answered.

For example: Do I need to know what’s wrong with me in order to see a therapist? Will I lose my creativity if I see one?

These are some of the things people ask, sometimes in passing, sometimes directly to me. I was inspired to address them, if only so that I could clarify the process of therapy.

That said, it’s a challenge. Unlike this space where I can tear away at preconceptions without concern for who I may be offending, I have to alter the timbre of my voice when blogging for the benefit of those who may be potential clients – it’s not always cut and dry. I ran into this recently with a post I wrote about men and how men tend to have preconceptions about psychotherapy (and how some of this may have to do with the language/imagery predominant in the latest barrage of public service announcements). My partner brought to my attention that what I’d wrote (and published) was in fact meant for this blog, not the one I originally thought it was intended for. So…I went back and changed the voice, as if I were revising a short story.

The lesson? Know your audience. People curious about psychotherapy don’t need to read hard-hitting op/ed-style commentary – the challenge was to go back and revise what I’d done so that, rather than focusing on a political critique of the way society isolates men from seeking help and agitating for personal growth, I retreated/reverted/went back to the more digestible core point of therapy is good for men, too.

Perhaps I will post both versions here to demonstrate how I revised it. In any case, feel free to visit the other blog (and tell your friends).

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Health & Illness

There has been a lot of work done over the last few years to bring to the foreground how mental health and well-being affects everyone, from every quadrant of society, regardless of their geography, culture, race, or class. And I say, as both an emerging mental health professional and citizen: bravo.

There is, however, something which bothers me in the midst of this accelerated (but otherwise welcome) media awareness campaign. It is the habitually casual use of the term “mental illness”, rather than “mental health”. There is more than a semantic difference between the two.

“Illness” is a medicalized notion. It correlates to somatic cause and effect: the patient’s body is sick, so the patient must take x to get better. When you have an illness, you take drugs to get better. Illness implies sickness, which implies the prescription of medicine. “Health” is a generalized notion, which may incorporate the taking of medication but certainly also encompasses needs which do not strictly apply to treatment via medication.

When we lump such disparate problems as schizophrenia, post-traumatic stress disorder, cigarette addiction, and behavioural/emotional anxiety under a catch-all phrase, that term should not imply that everything which falls under its domain be medicalized or seen as a medical problem.

If you fear that you may have a problem which is affecting the quality of your life, slapping the word “illness” on it is needlessly stigmatizing. Illness = something is wrong. And when “illness” comes after “mental”, it can then seem to someone that they are wrong or somehow broken. In other words, the constant use of “mental illness” as a generalized term for discussion actually perpetuates a needless (and ironic) branding upon those who are affected.

Quite frankly, to use “mental health” is to say that someone who feels that something is affecting the quality of their life is not ill. They may not feel well, but they still have agency. It’s well-documented that what may appear to some as “symptoms” of behavioural or emotional disorders are in actuality subconscious attempts by the person affected to become healthy. We can facilitate this quite easily by not stigmatizing the language around mental health with terms that needlessly cast an onerous light on the problem.

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A Better Person

Before I had an office, and well-before I started seeing clients, I was with my wife and friends at a busy restaurant. We were talking over the enjoyable izakaya ruckus and, as was the case with friends who didn’t know at the time, I mentioned how I was switching careers, to be a psychotherapist.

Telling someone, whether you know them well or not at all, that you are going to be a psychotherapist is like telling someone that you’ve written a novel (*ahem*). They inevitably want to know more, and that inquisitiveness often leads to questions that, at least for the first few months, you struggle to form into sound-bite-sized snippets.

I think I was able to describe the hows and whys and whats effectively, and was about to reward myself with a slug from my porcelain choko of sake when I was asked: “Do you feel pressure to be a better person?

Continue reading

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The Ides of March

Basement: mostly done.

We pushed ourselves hard to get everything (doors, baseboards, furniture) cut/fitted/assembled. The result is beautiful. The space is marvellous. I could not have asked for a more comfortable working environment.

Novel: revised, but sifting through new notes.

I spent two months grinding through a very large, complex recommendation on my novel – that it be written in 1st-person rather than 3rd-person. A tall order. And yet, I went through with it because it made perfect sense. The narrative style I was using was such an intimate sounding 3rd-person that switching to 1st-person felt more natural – the fact that I was using 1st-person for the follow-up novel I was already working on also helped.

The new notes only regard the first part of the book – not a huge deal, and yet I will admit that I’m tired of going back to this beast. I tell myself: if it makes it better, if it improves my understanding of storytelling, if it’s still my book in the end – then it is worth it.

Film job: crazy.

Dealing with battlefields in Los Angeles, Toronto, and Seoul, it’s not hard to imagine that I’m getting emails 24-hours a day. Most of the people I’m working with are professionals who are dedicated to making this project a success. Some of the people are, for various reasons, driving me crazy. That’s pretty much par for the course.

Psychotherapy practice: saw first client.

Therapist-client confidentiality notwithstanding, I am happy to finally be getting my practice off the ground. It is a new beginning and it feels great in all the right places.

 

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Why Psychotherapist (pt. 2 – tangent)

In the course of moving towards a practice (which has begun, if gradually), my wife and I have been renovating our basement for nearly the past year. Yes, one of those reno’s. The purpose of which was so that I could work out of the house as opposed to rent office space (which is not cheap in downtown Toronto).

It’s been a learning experience: learning about renovations, learning about doing long bouts of manual labour beside a loved one, learning about the ways in which two people can live together, be married and all that, yet have different approaches toward planning and executing large-scale operations. On this note, it’s also been about communicating, dealing with stress, and knowing when to take a break (from the basement).

Most recently, my wife – who is an amazing designer – designed a compact website for my practice: please visit. With the basement almost done, and a website online (heck, I also have business cards), it seems all of the hallmarks (and clichés) of “change” are ringing true.

Of course, the practice is in its infancy. I am still working hard on a Hollywood 3D dance film, and waiting to hear back from my agent (can’t get used to typing those two words) about the most recent revision to my novel that I submitted.

I will let you know how it proceeds.

Here’s an interesting question someone asked me, when they heard I was studying to practice as a psychotherapist. I will discuss this in an upcoming blog post:

“Do you feel pressure to be a better person?”

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Why Psychotherapist? (pt. 1)

It would seem a bit of a 180° turn, to go from someone who works behind the scenes of film and TV shows to becoming a psychotherapist. It’s not a dramatic story, but over time I’ve found that my strengths have always been interpersonal, particularly when talking about weighty matters. Friends have always valued what I offered in our discussions: impartiality, a different perspective – something more than just sympathy or advice. Combine this with my artsy leanings, my active life as a fiction writer, and the simple fact that I’ve had more than one person say “You should be a therapist”, I decided that it was something to look into.

Actually, it was something I mostly talked about, rather than looked into. It was my partner who happened upon the website of the institute that I ended up enrolling in. The more I looked into it, even though it had been a very long time since studying anything relating to psychology or psychotherapy, the more it felt right (or at least, worth the risk if it didn’t turn out to be something I liked).

And, slowly, I came to this place: a year-and-a-half later, an almost-renovated office in the basement, business cards and website in the works. I’m still enrolled in the program (halfway through my second of three years) and hope to take on clients part-time in the next month as a therapist-in-training. Of course, I’m still going to be working in film until I’ve completed the projects that I’ve started. I have no clue how the transition will go: slowly, quickly, easy, bumpy. Not sure.

That said, being a psychotherapist, I am discovering, feels natural. I have no hesitation sitting in the therapist’s chair and sharing time and space with someone who needs to talk. It is an obviously challenging career, but one that I feel better-suited to than what I am currently doing.

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