Therapy Isn't Radio

“Therapy isn’t radio.  We don’t need to constantly fill the air with sounds.  Sometimes, when its quiet, surprising things happen.”  -Mary Pipher, “Letters to a Young Therapist”

One of the most difficult skills to master as a therapist is the art of when to speak, and when to shut the hell up.  There’s a certain cadence to therapy, and as a young therapist I felt constantly at odds with myself.  An incessant desire to meet clients’ tears and struggle with grace, openness, and love, while also ensuring that I meet their practical expectations of their therapist.  How soon is too soon to offer an intervention?  How long is too long to sit with tears?  How do I determine whether my client has the self-efficacy and the ego strength to walk through overwhelming emotions?  How do I move from emotion to the intervention? 

In some moments, I excel as silence.  One warm April afternoon, my client cried softly, fiddling with the frayed upholstery on my nonprofit organization’s second-hand couch, and I’d sit patiently, leaning slightly forward as I was instructed in graduate school.  They would pause- dab their nose with a single ply tissue- and I’d lock eyes with the heartbroken.   I’d make eye contact with their red, weepy eyes, and cock my head to the side, nonverbally convincing them that “I’m here.  I’m not going anywhere.  We can walk through this together.”  We’d sit as the clock ticked on, minute after minute, the silence prevailed, until their breathing grew patterned and regular, parallel to my breath.  The container we built together held the heartache, indeed- and in this moment, silence in solidarity said far more than I ever could have. 

On another afternoon, I was serving as the cofacilitator for group therapy, during the frenetic days of my clinical internship.  A client was raging over a significant injustice in the workplace, and the fellow group members watched, wide-eyed, as she raged.  Finally, she paused, panting, and a thick, heavy silence fell over the group.  As a young therapist, pre-licensed, my stomach fluttered with bated anticipation.  “When do I speak?,” I wondered silently, and even more, “what can I possibly say?”  If I offer an intervention too soon, it’ll feel dismissive of the painful emotions my client was sharing.  If I don’t speak up soon enough, will the group spiral and, as a result, the other group members feel unsafe with her anger, or without direction and structure from the facilitators.  How long do I allow one member to rage without taking action to secure the safety and the sanctity of other members? 

Unfortunately, in this instance, the outcome was not solidarity, nor was it psychoeducation, nor was it healing of any sort.  In my wide-eyed naivete as a clinician, I spoke, sharing more of a reflection than an intervention of any sort.  And if I’m being truthful, I spoke because the silence grew intolerable for me.  So I made a misstep:

“Wow.  You must be feeling really lousy.  I guess I am without understanding of Colorado law, and I don’t completely understand the guidelines and requirements for hiring and firing.”

(Today, I give myself a D minus where helpful responses are concerned.  But I was young!  And inexperienced!  I did the best I could.  shrug)

Rage flashed across my client’s eyes and she sucked in a quick, but surprisingly deep breath, before unleashing blame and disappointment and frustration with me.  I should know basic laws surrounding hiring and firing, this was not a useful reflection on the situation as it stands, how dare I speak out of turn about something I know little about, such as hiring and firing policies.  She was frustrated and ultimately, she brought that energy into the therapy room. 

Looking back, I had little to do with my client’s emotional state.  She was angry- boiling to the brim, in fact- and I was certainly a safe target for her vitriol.  Ultimately, I had made a rupture to our relationship, and it took several weeks to rebuild her trust in me as a facilitator.

When I look back today, as a slightly more experienced mental health professional, I am struck by the power of silence.  The magic that can happen in those moments, where we share the space and all the emotions swirling around, is profound.  If there’s anything I have learned in the more high-stress, emotional interactions in my therapy room, it’s that less is more.  More often than not, if the cadence is off, or if the therapeutic interaction feels rushed, awkward, or uncomfortable…. I take a step back.  I breathe; I ground; and I check my own discomfort level so I don’t unintentionally fill the space that could otherwise be used to experience, and to mourn, or celebrate, or acknowledge the emotion.  Feeling my feet on the floor and my bum in my chair; maintaining strong awareness of factually what’s happening in the room, which is entirely separate from my upbringing, my values, my insecurities, etc.  It’s not about us, as clinicians.  As displayed the afternoon of my group facilitation, it wasn’t about me.  But I did get in the way of clinical work transpiring. 

I misstep today, from time to time.  But I do so with a more recently developed awareness of how I show up in the therapy room, what impact I make, and I try to stay out of my own way, all while reflecting on less is more. 

Let the magic happen.