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When therapists are wrong

Patty vs Leslie

Two VERY DIFFERENT bosses

When you look at the ethical guidelines for therapists a whole lot of them are in place to address the power imbalance between therapist and client. In the minds of our clients, the things we therapists do or say hold greater weight than the same thoughts that, say, your hairdresser or mechanic might offer. (Except when it comes to how to do your hair or fix your car.) When we share our reflections about your life choices and relationships then we need to be aware that our clients will likely take those thoughts very seriously, which is why it can be painful and even dangerous to have a therapist get things really wrong with you.

I remember the second therapist I ever saw when I was a freshman or sophomore in college and was in love with a boy who didn’t love me back. (That’s what brought me to therapy although it turns out — no surprise — I had a lot more going on than just that.) Anyway, the therapist just loved all my stories about my super interesting boyfriend and would agree with me, “He does sound amazing! And in a band, too, wow!” which was not what I needed to hear. Now I understand that likely he was just trying to join with me (this thing where therapists go along with you to help build rapport) but at the time I thought, “Well, it’s hopeless. My boyfriend is too amazing for me to ever get over him and even my therapist loves him” and I quit going to therapy. What would have been better is if I’d come back and said, “Hey, I’m sick of hearing about how great you think my stupid boyfriend is” and then we could have had a discussion about it.

Because therapists get stuff wrong. It happens. We’re not perfect and even the best therapist is not necessarily the best fit for any given client. We will get things wrong and it’s up to you, dear clients and potential clients, to help us get it right.

Sometimes we get things wrong because we don’t ask for enough information and sometimes this is because we don’t even know we need it. You say, “Hey, my boss!” and the therapist is sitting there merrily picturing Leslie Knope and really you’re talking about your boss who is more like Glenn Close in Damages only the therapist has already decided she knows what’s going on and so things just get confused.

That happens. Although eventually situations like that work themselves out if the therapist is a good listener and asks good questions.

What’s trickier is when the therapist is wrong only you don’t know she’s wrong because it’s nothing as clear cut as facts. Instead she’s operating with a set of biases that you don’t know about. Like say she is against beach vacations and thinks everyone should go hiking in Hocking Hills and you don’t know this so when she’s discouraging you from planning your vacation to Bethany Beach you think there really is something wrong with your ideas. You wonder, “Is this what’s wrong with me? That I always go to the beach?” and it’s confusing. Because sometimes it’s true — your ingrained thoughts or beliefs are part of the problem — but sometimes it’s not. Sometimes it’s just a matter of different priorities and opinions.

So what do you do?

First of all, if you feel like your therapist is being biased, tell her. Have a discussion about it. Heck, have a debate. Good therapists know their biases (we all have them) and will be willing to engage with you. She will be able to say, “Here is my bias” but she’ll also be willing to say, “My issue with the beach is not because I’m against beaches, it’s because you’ve told me that you are allergic to sand in previous discussions and I want to challenge your assumption that you should go to the beach anyway.”

Or the discussion might help you discover that your boss thinks Glenn Close in Damages makes a GREAT boss and that you should suck it up and let her murder people and violate legal ethics and blackmail everyone because your therapist places a high value on career achievement and that’s just her philosophical starting point. In which case you can decide for yourself if that’s the kind of therapist that you want to have.

Very often you and your therapist won’t agree about things and a lot of the times, that won’t matter because our ethical guidelines state:

Counselors are aware of—and avoid imposing—their own values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients, trainees, and research participants and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.

(this is from the 2014 American Counseling Association Code of Ethics)

In other words, even if your counselor would personally love to work for Glenn Close, she ought to be able to appreciate that you would rather work for Leslie Knope. But if you’re not sure, ask her. Have that discussion. Find out what’s going on there if you feel like she’s misunderstanding your point of view or steering you away from your goals. Because even though we are therapists and sit in the big comfy chair (or at least the chair with good lumbar support because this job is hard on your back) that does not mean we know everything or that we’re the boss of you. Sometimes we’re wrong. Call us out when we are; good therapists will appreciate the discussion.

(For the record, I prefer a Hocking Hills vacation as long as there’s air conditioning and obviously I would prefer to work for Leslie Knope because I like waffles a lot more than I like murder and blackmail.)

 

 

Step One: Make the Leap

jumpingfish-insideWhen I was eighteen I dropped out of  Ohio State and spent the next few years working and trying to get my head on straight. While I was in school I skipped a lot of classes, skipped a lot of homework and generally wasted my money by sleeping through my 9am classes. When I went back to school at Portland State University I was super committed and ratcheted my GPA up by actually showing up to class and doing my homework.

I was very proud of myself.

Towards the end of my junior year I saw a notice in the school paper that the new University Studies program was looking for Peer Mentors, which was a scholarship position for juniors and seniors. Portland State was radically changing their curriculum to be more integrated and cross-discipline and the Peer Mentors would work one-on-one with professors to help incoming students in the Freshman Inquiry classes. To qualify, we had to have a certain GPA, get references from professors and offer a writing sample.

I wanted to apply but I was nervous. Even though my grades were much improved I still felt like the college slacker I’d once been and I was sure they’d see right through me. But what the heck, I thought, it won’t cost me anything but time to apply. I took a leap of faith and I got the position.

Twenty-one of us (plus an alternate) met that first day at orientation and I was positively gleeful. I’d finally proved that I had what it took to be a successful college student! I’d overcome my lackluster college (and high school) career where my bad attitude was more important to me than turning papers in on time to arrive here, in a scholarship position that would look great on my curriculum vitae. I felt like a big shot.

It was only later that I found out that exactly 22 people applied to be Peer Mentors, which meant that every single person who bothered to fill out the application got the job.

At first I was grouchy about this. I wanted to know I was a Peer Mentor because I’d beat out a bunch of other over-achievers. I wanted to believe that I’d been the best woman for the job and not just the default applicant.

But then I got to thinking. I wondered how many people were more qualified but talked themselves out of applying. Maybe the gauntlet we had to run was applying anyway — in spite of the fear and insecurity.

That made me think about how many other opportunities I’d probably missed out on by thinking there were surely a bunch of other people who had a better shot than I did. How many other things could I have done just by being brave enough to show up?

With this in mind, I started sending my writing work out. I got rejections, sure,  but I also got a few acceptances. (My first published piece was a poem that showed up in an obscure literary magazine published by Eastern Washington University. I was thrilled. So was my mom.) Then a few more and then a few more. And so on and so on.

This is my message to you: If there’s something that you want to accomplish but you’re scared to try, recognize that the fear is your biggest hurdle. That fear will stop a whole bunch of other people and narrow your playing field but you shouldn’t let it stop you. In fact, that fear is your friend because it’s going to winnow down the competition and make more room for you to do the thing you dream of doing.

What the heck, right? Just show up. Who knows what might happen?

You need to eat more ice cream

icecreambar-insideDo you remember this post? It was going around about a month ago. The mom found a note written by her 7-year old daughter listing all of the ways her daughter was going to lose weight. The mom was understandably upset and she was also flabbergasted because, “Our attitudes are reasonable and balanced. Weight has never been an issue in our home – it is, for the most part, irrelevant.” Later the mom finds out that her daughter learned about dieting from another little girl.

I’m glad the writer shared this story with us because it’s a reminder that our kids talk to other kids. And even if weight seems irrelevant in our homes, it is relevant out there in the rest of the world so we need to talk about it — explicitly and often. You want to be the boss of this conversation, right? Certainly you don’t want the media to dictate how your child feels about herself. And you don’t want other kids in charge of whether or not your daughter feels pretty. That’s why you have to talk about it.

Help your kids be critical

Point out the lack of body diversity in the media and explain why we see only one kind of body on TV. Make a point of celebrating all kinds of bodies, definitely. But you also need to talk about how not everyone thinks all kinds of bodies are just right. Explain that this is a prejudice that your family doesn’t participate in. (And you don’t, right? You don’t talk about your weight or your friends’ weight or how fat your favorite actor has gotten, do you? Because that’s gotta stop.)

Talk before their friends do

Head off the diet talk your child will inevitably hear from friends by talking about it right now. Tell them that sooner or later someone they love will call themselves fat or compare their size to someone else. Sooner or later someone will tell your child that she is too fat or too skinny; it’s inevitable. I tell kids that children — especially in the tween/teen ages when they’re trying to figure out what the heck is going on with their bodies — do a lot of comparing and they talk about these comparisons. They say, “Why do your thighs touch? Why do you have an outie instead of an innie? Gosh, your arms are so bony!” It’s going to happen but you can limit some of the harm by talking about it now. That way when another little kid on the soccer team says, “You’re eating fries?!? Don’t you care about getting fat?” your child will have an answer ready. I know this is hard for a lot of parents because they hope if they don’t bring it up their child won’t have to deal with it. Trust me, they’re dealing with it. This is the soup we’re all swimming in and as Don Draper says, “If you don’t like what is being said, then change the conversation.” I know the guy’s a louse but he has a point here.

Diet really is a four letter word

Diets are bad for kids and other living things. Food deprivation — not eating when we’re hungry, not eating until we’re full — screws up our metabolisms and there are a slew of studies that show they are especially bad for children. Calorie restriction (says the research) actually makes children fatter. Really. And it also messes with their natural ability to read their bodies’ satiety signals.

Eat more ice cream

This is why you have to eat regular old “junk” food now and then. Now I’m not telling you to hit the golden arches every time you have your child buckled into the car seat but you do need to teach them how to be competent eaters. That means not avoiding a whole class of delicious food because it doesn’t meet high nutritional standards. Denying is tatamount to dieting and remember we need to avoid that. Our children need to see us eating food for fun and for celebration and because it’s delicious. They need to see us model enjoying our food and not feeling guilty about it. They need to see us push our plates away when we’re full and dive in full of enthusiasm when we’re hungry. We need to learn to be competent eaters, too.

Don’t demonize food

I know this is hard, especially when we’re having such intense discussions about organic and go local and factory farming. These are important discussions to have but when our kids are young they need to figure out how to listen to their bodies first and foremost. I worry when I hear about parents showing their young children Fast Food Nation or Forks Over Knives. These documentaries can get in the way of a child’s natural ability to understand appetite. You can live out your values in ways that help our kids instead of harm them. By all means, go to your local farmer’s market and get everything you need to make a big, beautiful salad but don’t beat yourself up (and definitely don’t do it in front of your child) if you end up at the local Big Box supermarket picking up non-organic lettuce some weekend. Likewise you can help your child talk about how he feels after he eats a box of sour gummy worms without shaming him. Kids are going to eat too much sometimes. Eating is opportunity to learn, which means sometimes eating too much or too little or not what our bodies want. Making mistakes is part of the process.

OAB Roundtable: What is open adoption to me?

leafwater-insideTo me, openness in adoption is an attitude. It’s a belief that our kids are best served with honesty, respect for their origins, and the understanding that caring about, connecting to and loving one family does not preclude caring about, connecting to and loving another. Openness is making decisions with this attitude that open adoption advocate Jim Gritter calls “hospitiousness” towards our children’s birth families.

Adoption researcher, author and therapist David Brodzinsky, PhD, makes a distinction between two kinds of openness. There is structural openness, which might include cards, letters, phone calls or visits. And there is communication (or communicative) openness, which is when adoption topics are respectfully and honestly dealt with by the parents.

For adoptive parents, structural openness may be out of our control. Our children may come to our families via closed adoption because the birth family members cannot be found, such as in many international adoptions. Or our children’s family of origins may not be safe for them, as in some foster-to-adopt situations. But communicative openness is always in our control. No matter how much or how little information we have, we can create openness in our attitudes towards our children’s stories.

Many families have communicative openness without structural openness and some families have structural openness without communicative openness. I have heard many stories of adoptive parents who have open adoption in name only; those who have regular communication with birth parents but keep a lid on any adoption discussion in their homes. Maybe they’re hoping that structural openness is enough. Unfortunately, it isn’t.

According to Brodzinsky’s study, “Family Structural Openness and Communication Openness as Predictors in the Adjustment of Adopted Children,” it’s clear that those of us who are living structural openness have more prompts for communicative openness. For children who have the presence of birth family members in their lives, there tend to be more opportunities for questions, answers and discussion. But most adoptive parents aren’t really given any instruction about how to respond to those prompts and many are flailing.

Lots of studies show that openness benefits children (research says they have better self esteem and fewer behavior problems than children adopted in closed adoptions) but this study in particular ties this to communicative openness. In other words, how the family processes adoption is a stronger predictor of positive benefit than how the family structures adoption. Says the study, “… communication openness appears to be a stronger and more consistent predictor of children’s adjustment than the extent of structural openness that exists between the adoptive and birth families.”

This is good news for those adoptive families who are unable to have structural openness; your child can still reap the benefits of openness in adoption provided you are able to foster a sensitivity and respect for your child’s birth origins and are able to convey that to your child. And it’s a reminder to those families who do not have communicative openness; you need to learn how to talk to your kids.

I will write more about how you can do that, too, in future blog entries.

This is my entry for the Open Adoption Bloggers Roundtable #44: What openness means to me. Check out the other entries here!

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