The Mental Emotional Health Blog

Every once in a while I want to get out a jumble of thoughts I have accumulated from therapy sessions. Somehow it helps me refine my therapy style and clears my mind. There are also times when conversation in session progresses to a deep enough level that I find myself considering ideas beyond the therapy room. Here are my thoughts today, and remember that this a glimpse of a few things that fly through a therapist’s mind:

• If the client feels he or she has no options, widen the perspective.
• If he or she feels overwhelmed, narrow the focus.
• Always provide hope.
• Everyone has normal in them, and some forget that.
• Laughter isn’t just the best medicine, it is like pure, cool water that prevents your soul from being dehydrated.
• Music has many great qualities (if it’s good music), and two aspects of music that stand out are its ability to calm your mind, and its ability to affect your mood.
• If you talk on the phone until your ear gets sweaty, you may be on too long.
• Therapy feels like a juggling act to me sometimes. It’s like I have different ideas flying around, and pick one at a time to toss to my client. Sometimes the client drops it, and other times we play catch for a while while I continue juggling.
• People really are interesting.
• Some people are boring, but I generally prefer that to loud and overly dramatic.
• Every person has an opportunity each day to expand his or her mind. It doesn’t need to be earth-shattering or profound. Sometimes a little growth that happens consistently allows the mind to remember its creativity, energy, and power. 

According to George Carvalho, “stigma is the shame that individuals in society place upon others suffering with mental health issues to distance themselves clearly and definitively from them” (http://www.namiscc.org/newsletters/April02/ClientStigma.htm).  Although I don’t necessarily agree with everything he states in his article, it’s a short and interesting read.

Stigma in mental health has decreased somewhat over the past few years, in part due to a slight adjustment by the news media, television, and movies. More often, however, I think it has been the combined effort of mental health providers, medical providers, social workers, and some government officials that have worked to lessen stigma. In 2004, Wisconsin’s Lt. Governor Barbara Lawton joined the fight against mental health stigma in a big way (http://www.wimentalhealth.org/userimages/LawtonHonorary.pdf). Thank you, Lt. Governor Lawton!

Actually the best way to defeat stigma is word-of-mouth, person-to-person, by people that are educated about mental health. Mental health concerns can be debilitating and frustrating. Continuing the stereotypes about mental health, and using derogatory terms like “crazy”, “psycho”, and “wacko”, make life more difficult for people that many times are trying to get better. Jokes and laughing about mental health stereotypes on television shows and movies don’t help either.

As I said before, the best way to defeat stigma is person-to-person. Remember that everyone is a person, so try to say “He or She is a person with Bipolar”, instead of “He or She is Bipolar”. Everyone has normal in them, and everyone has something that could be considered a mental illness trait. But we’re all human.

Signs you might be experiencing burnout as a therapist/counselor:

• You forgot how to get to your office.
• Watching the fish in your aquarium for 8 hours seems more enjoyable than going to work.
• You’ve already missed work time due to watching your fish.
• You asked one of your colleagues if you need a billing slip to talk to yourself.
• Your diagnostic summaries include, “This patient is almost as messed up as I am”, and that doesn’t really bother you.
• You suddenly start believing there is no such thing as counter-transference.
• Your patient was yelling and calling you names for the first 3o minutes of the session, and you found it vaguely interesting that the patient didn’t seem to have any capacity for emotional expression.
• 4 hour lunch breaks
• A colleague tells you the following joke, “How many therapists does it take to change a light bulb?  . . . Only one, but the light bulb has to want to change!” , and after you hear the joke you seriously cannot imagine why your colleague thinks a light bulb can have motivation since it’s an inanimate object.

Short entry today, since I’m worn out after a long week.

As a therapist, I pretty much picture myself as a sponge. I soak up all kinds of stress, tension, and emotions each day in the therapy office. Most of the time, I can “wring” out  the thoughts I have about a therapy day once I walk out the door. So I don’t often think about clients away from the office. The tension and stress stay with me, and I need to deal with those things outside of work. Dealing with the mental-emotional residue is a lot easier to do if your clients are likable people, and thankfully most of mine are.

Do you ever feel like your energy has just drained out of you? Sometimes it is due to lack of sleep, or a frantic schedule. For me, the emotions involved in being a therapist tend to drain me. Usually it isn’t the clients or the sessions though.

I’m talking about the part of therapy outside of the sessions. This involves writing progress notes, completing diagnostic evaluations, writing letters, and treatment planning. It’s a necessary part of the job, and I benefit from the “administrative” end of therapy.  Documenting my sessions and treatment planning help me remember where I am and where my clients are in the process. Writing out my “therapy thoughts” also help me clarify what actually happened and what it might mean. Making phone calls also isn’t too bad, and writing letters on behalf of clients almost always help them feel better. So I have clear reasons for doing all those things outside of sessions.

It’s just that I like listening and talking with people that need help in one form or another. I want to be a person that provides hope and encouragement. For most of my clients, I am one of the few people (with some, the only one) in their life who always has kind words to say, who tends to not blame or criticize, who doesn’t call them names or use sarcasm, and is someone who clearly wants to help and encourage.

So when I’ve just connected with someone, listened, and given them some hope or a new perspective, it often feels too minimizing to write that down. There are documentation words and phrases that can accurately summarize what happened in a session, but leave out the emotional feelings and amount of energy expended. So many times, the words just aren’t there to express the depth of a session. Plus, I am always concerned about privacy of records and some detail just doesn’t need to be in a person’s chart. Anyway, writing down what I talked about with a client seems to cheapen the experience, and that bothers me.

Go figure, I get emotionally drained. Hopefully this is somewhat interesting to all of my wonderful readers. But if not, I felt the need to get it out anyway. And it is not a subject I hear discussed very much from other therapists/counselors/social workers.

By the way, I take enough care of myself that I am stable and okay, even when drained.

Have a great day, everyone!