Tag Archives: relationships

The Experience of Therapy

The Experience of Therapy

It can be helpful to keep in mind that, regardless of how stuck you may feel, there are many opportunities to view the world through a different lens. Many years ago, I read a poem about washing dishes.[1] The poet, Al Zolynas, made this ordinary task sound like a fascinating exploration. His poem offered an opportunity to look at something we have seen and done countless times, yet experience it in an entirely new way.

Thoughts and Feelings

I think that psychotherapy is a lot like this poem. In therapy, we take the events of our lives and their accompanying feelings and embark on an exploration in the hope that we will find a new way to see. We consider the content—the moments that have caused us grief or sadness or disappointment—and allow these buried thoughts and feelings to come to the surface. Some of what might emerge may be painful feelings that seem almost unbearable, but in the safety of working with a trusted person, we can stop keeping them in the darkness and allow them to be seen.

Like vampires who can’t bear the light of day, many of these old feelings will dissolve under our gaze while other feelings will find a way to tell us that they are reluctant to emerge. Even if it is not yet possible to look directly at some of our buried feelings, we might be surprised to find that they can often lose some of their energy and power in the course of our exploration. Just like light illuminates our path even though we don’t look straight into the sun, we can often change how we think and feel about things without looking directly at the source of the pain.

“Therapy is what happens when you are doing something else”

How does this happen? I like to say that “therapy is what happens while you are doing something else.” The conversation between you and your therapist looks like, well, like a conversation. I am often asked “what should I talk about in therapy” and I always respond that the answer is to talk about whatever you want, whatever matters to you. While you are talking with your therapist, the quiet and often mysterious work of therapy is happening in the background.

Helping you understand your partner

Some of this is simple and straightforward: for example, if you are having a problem with your partner or with your relationship and you talk about it with your therapist, you are thinking it through, formulating the words you would want to use, and practicing how you will say them. You might not be consciously thinking that this is what you are doing, but it is happening in the background. When you and your partner are together, you are likely to find that the words come more easily and you are able to talk rather than retreat or become angry.

…and your worklife

Some of it is more subtle: your boss keeps making you mad and when you talk about him with your therapist, you are not in the heat of the emotions and you can suddenly see how he reminds you of your alcoholic father. With this insight, you can be more compassionate with yourself when you are triggered, get grounded more quickly, and move on with your day. Underneath all of this is a sense of being deeply understood that helps you build more confidence to handle whatever life throws at you.

Seeing things in a different way

Psychotherapy is often called “the talking cure,” but, as you can see, talking is just what we are doing while something else is taking place behind the scenes. Our ever-increasing knowledge about how the brain works shows that our brains can actually “rewire” themselves: the neural pathways actually change when we start to see things in a different way. This can potentially lead to feeling less triggered and to a quicker resolution when things get bumpy. So even though it seems like you are just having a conversation, what is actually happening is far deeper and more beneficial!

[1] Addonizio, K. & Laux, D. (1997). The Poet’s Companion: A Guide to the Pleasures of Writing Poetry. New York, NY: W.W. Norton and Company, Inc.

Also available online by searching “The Zen of Housework.”

Questions about psychotherapy or about my approach to psychotherapy? Please see my website at www.marlacass.com and contact me at my San Francisco psychotherapy office: 415-218-2442 (phone link works from smartphones only) or at info@marlacass.com.

Supervision of Mid-Life Supervisees

Supervision of Mid-Life Supervisees

This article first appeared on May 1, 2018 in the newsletter for the San Francisco Chapter of the California Association of Marriage and Family Therapists. Click here to read the original article on the SF CAMFT website.

Feature Article:
Supervision of Midlife Supervisees

By: Marla Cass, LMFT

One of the many interesting things about the practice of psychotherapy is that it is a profession that attracts people from a wide range of backgrounds. Unlike many career paths, becoming a psychotherapist does not require any particular background prior to graduate school, aside from a college degree and a few psychology courses. As a result, becoming a licensed psychotherapist is a career people can pursue later in life, often after being in other professions and after considerable life experience. To add to the appeal for older career changers, it is also one of the few careers in which being older is actually valued.

The transition from being in other professions to becoming a psychotherapist, however, is not an easy one. Many older Interns/Trainees/Associates are moving from careers in which they felt competent and were recognized in the form of praise and compensation. While they may have anticipated the challenges of returning to school as older students, they are often ill-prepared for the experience of working under a clinical supervisor.

Psychotherapy supervision is a hierarchical model that requires that the supervisee take direction from the supervisor. This may be an efficient and arguably necessary structure (not to mention a legal requirement), given that the supervisor has more experience in the field and the supervisee is working under the license of the supervisor. However, it often fails to recognize the unique perspective that an older supervisee brings to his or her work, as well as the psychological difficulties involved in transitioning from a person who felt competent in his or her job to being a person who now needs to take direction.

Coming to this work with considerable work and life experience is certainly an asset with respect to understanding clients, but it can also be a liability when it comes to learning to become a psychotherapist. For example, it can be difficult to grasp the many ways in which the role of a psychotherapist is different from whatever role they may have had in their previous profession. And even where similarities may exist, therapists may approach seemingly similar situations very differently from people in other professions.

In addition, supervisees are expected to talk about their feelings and personal reactions to their work with clients, and to be vulnerable with their supervisors. In most professions, however, talking about feelings and being vulnerable with peers and superiors is inconceivable. It may take a supervisee time to adjust to this cultural shift and the process may be slow and difficult. This can be puzzling to supervisors, especially to supervisors who have primarily worked in the field of mental health where such openness is expected and normal.

As an older supervisee, it can help to slow down and try to understand the perspective of the supervisor. What is the underlying reason for the supervisor’s position? Ask questions about the concepts you are being taught and listen to the answers with an open mind. Recognize that learning to be a clinician is also an entry to a language and professional culture that may be very different from that of your previous profession.

For supervisors of older supervisees, it is helpful to recognize the experience the supervisee brings to his or her work and to consider how you can make use of this in supervision. Keep in mind that older supervisees may be used to dealing with their superiors in a very different way, as compared to younger supervisees. Older supervisees are more likely to challenge their supervisors when there is a difference of opinion, and it can be harder for them to take direction when there is disagreement. The emotional upheaval of being the learner rather than the teacher can be disconcerting and lead to frustration and impatience. Older supervisees may also feel the need to display a level of confidence that may not match the uncertainty they feel inside.

While supervision is not therapy, many of the same principles apply: listen closely, ask clarifying questions, try to understand the underlying feelings, and consider how the past experiences of the person in front of you may have impacted him or her and be showing up in your work together. Think about the transference and countertransference that may be occurring in the supervisory relationship.

Don’t forget about the cultural issues and recognize that psychotherapists have their own culture, too, which can present a steep learning curve for supervisees, especially those new to the field. Keeping these tools in mind will not only help clinicians get the most out of supervision and supervising, but they will also help to make them the best therapists and supervisors they can be.

Marla Cass (MFC 45402) is in private practice in downtown San Francisco. Her focus is on working with women who are successful in their careers but not in their relationships. She has been a group supervisor at The Boulder Institute for Psychotherapy and Research, Pacific Center, and The Women’s Therapy Center; and is currently an individual supervisor for Queer Life Space and Community Institute for Psychotherapy. For more information, please see her website at www.marlacass.com.

Questions about psychotherapy or about my approach to psychotherapy? Please see my website at www.marlacass.com and contact me at my San Francisco psychotherapy office: 415-218-2442 (phone link works from smartphones only) or at info@marlacass.com.

Therapy is About Mental Health

Therapy is for Problems…And a Whole Lot More

One of the concerns often faced by people thinking about psychotherapy is that psychotherapy is commonly associated with mental illness, rather than with mental health. This has created a stigma that, sadly, keeps many people from seeking the help that they deserve.

Daniel J. Siegel, a psychiatrist and author of numerous books about the brain and neuropsychology (the understanding of how the brain works and how to make use of that understanding to help people) poignantly begins his presentations to therapists by asking: “who here has had a class on mental health?” In a room with one hundred or more therapists, perhaps five or so hands will go up. This is a problem for psychotherapists and for the people we serve.

Therapy is for: relationships, confidence, personal growth, and more

With members of the public associating therapy with mental illness and therapists themselves primarily receiving training in how to work with mental illness and not in how to foster and support mental health, it is no wonder that therapy is most often seen primarily as a treatment for severe mental and emotional problems–and often dismissed by people who could benefit from it. Many people who find their way to therapy often experience intense shame because of this association and we have no way of knowing how many people never see a therapist at all because of this shame.

Of course, psychotherapy can be very helpful to people who suffer from specific problems such as depression, anxiety, PTSD, etc., but the benefit of therapy are not limited to just people with particular problems. Many people turn to therapy as a way to understand themselves better—why they do what they do, what events happened in their past that have shaped them, and how they might reassemble these pieces to create a more satisfying life.

You Can’t Always Do It Alone

While it may seem like it would be easy enough to do this work on your own, and, to some degree, that is certainly one way to approach this, there is no substitute for what happens when two (or more) people meet in a room with the sole purpose being the understanding and personal growth of one of them. Many psychotherapists have a word for this: the “third,” meaning that something new and unique is created that is the result of the combining of the conscious and unconscious minds of two people. The “third” can only be created by the two specific people interacting. A metaphor from chemistry class might help: oxygen and hydrogen atoms combine to create water, which is greater than the sum of its parts.

Therapy as a Place to Talk and to Listen

Another purpose of therapy is simply to have someone to talk to who will listen, offer ideas for thinking in a different way, and, most importantly, does not ask anything from you in return, other than for you to be there at the agreed upon time and to pay a fee for that time.

The content of what is talked about may vary greatly from week to week, from dealing with pressing problems to understanding yourself and your relationships in a deeper way. Regardless of what is talked about, being able to share your inner thoughts and feelings with a trusted therapist can help you to let go of some of the things that weigh you down and hold you back without the added burden of having to take care of the other person.

Surprising Voices for Mental Health

Although I am admittedly not much of a podcast person, I was recently moved by a podcast that was featured in the Daily Telegraph by Bryony Gordon, a columnist for the newspaper. In her series, Gordon speaks with different guests about their own mental health and how they have dealt with problems. As she introduces us to the podcast, she reminds us that “the point is, mental health issues affect everyone; one in four of us…it is really, really, really normal to feel weird. In fact, it is weirder if you feel normal the whole time.”

In the first podcast of the series, Gordon interviews Prince Harry, who speaks quite candidly about his own experiences with therapy and how talking with a therapist has helped him. (If you are interested in listening to it, here is the link:  https://bryonysmadworld.telegraph.co.uk/e/mad-world-prince-harry/.)

And in another great article, basketball star Kevin Love talks about how therapy helped him deal with depression and anxiety attacks: https://www.theplayerstribune.com/kevin-love-everyone-is-going-through-something/. As more and more public figures talk about how therapy has helped them, hopefully, more and more people will feel comfortable seeking the help they deserve.

Questions about psychotherapy or about my approach to psychotherapy? Please see my website at www.marlacass.com and contact me at my San Francisco psychotherapy office: 415-218-2442 (phone link works from smartphones only) or at info@marlacass.com.

Psychotherapy for Successful Women

A Note to Successful Women

Therapy for Professional Women in San Francisco…You’re great at your job

Does this describe you? You are an intelligent woman, and you are fortunate to be in a career that you love–or, at least, like well enough. You are successful in your work, which, if you are living in the Bay Area, might be in one of the STEM fields: science, technology, engineering, mathematics, or business. You enjoy status and respect and you are well rewarded financially. At work, you feel comfortable and confident. People seek you out for your knowledge and experience, and you are often called upon to share your wisdom and to mentor colleagues. From the outside, it all looks great. When you are at work, it looks great to you, too. Work is a rewarding and comfortable place. When it comes to work, you are feeling pretty lucky.

…But maybe not so great at your relationships

But when you leave work, something else happens. You might be in a relationship, but it isn’t working very well. You are often in conflict with your spouse or partner, but you aren’t always sure why. You just don’t seem to understand each other. Maybe you are dating and finding it hard to connect with others. Or maybe you have given up on the whole relationship thing because it never seems to work out for you and it feels a lot easier to be single. You are frequently accused of being emotionally distant and, not so deep down, you wonder if this might be true.

You’re a problem solver

One of the ways you have been successful in your work has been to be a great problem solver. So when your partner is having a problem, you naturally want to help by brainstorming and finding a way to fix the problem. After all, people are always interested in solving problems, right?

…But you haven’t been able to figure out this one

The trouble is that we are all wired differently. For you, the path from problem to solution is a straight line. No point in wasting time going in circles. But for your partner, the path from problem to solution may not be so obvious. It is even possible that finding a solution is not the goal for your partner. To you, that may seem like a waste of time, but to your partner, it feels as organic as breathing. Just as solving problems feels natural and intuitive to you, feeling heard and processing feelings feels natural and intuitive to your partner.

Tips for dealing with your relationships

Relationships are complicated things that can have lives of their own. One of the keys to making your relationship successful is to spend some time learning to understand your partner, even if it might sometimes seem like he or she is speaking a foreign language. If you decided to live in France, you are definitely the kind of person who would not only learn French, but seek to be fluent. You would reason that you might be able to get by speaking English if you were a tourist, but you would never be comfortable with the limitations that would place on you. You would want to learn as much as you could about the language, even if it felt awkward to you and even if you sometimes failed at it. You would take pride in your successes and resolve to do better when you were unsuccessful. Even when things were frustrating, you would stick with it. That is just who you are. This is what you do at work and why you are so successful. Why would dealing with your relationship be any different?

In my work as a psychotherapist, I have found that what makes women successful in their careers can often lead to frustration and feeling unsuccessful in their personal relationships.

When we seek a mate, we are often driven by unconscious motivations, as unromantic as this may sound. One of those unconscious motivations can be qualities in the other person that you wish you had more of yourself. This is the well-known maxim “opposites attract.” So if you are an introvert, you will likely end up with an extrovert. If you are driven by your intellect, your partner is probably driven by her emotions. In some secret way, usually unknown even to ourselves, we do this because we think we will land somewhere in the middle—she will be influenced by our introversion and you will be influenced by her extroversion and the two of you will live happily ever after somewhere in the middle—but the more likely outcome is that what drew you to this person to begin with, often becomes what repels you and leads to difficulties when the honeymoon stage is over.

Learn to listen

This often results in frustration, anger, and disappointment, but it doesn’t have to. Couples can learn to listen to each other, to understand each other, and to find that elusive middle ground. One place to start is to listen—really listen—to what your partner is telling you both in her words and in her actions. Try to stay as present as you can, make eye contact, and imagine what she might be experiencing. What may feel like an attempt to push you away may actually be a bid for more connection. If you listen hard enough, you might be able to hear something you have never heard before.

Questions about psychotherapy or about my approach to psychotherapy? Please view my website at www.marlacass.com or contact me at 415-218-2442 (phone link works from smartphones only) or at info@marlacass.com/

The Buck Stops Here: More Thoughts about Money and Relationships

The Buck Stops Here: More Thoughts About Money and Relationships

You have decided that the way you and your partner are handing finances is not working for you. Or perhaps you would like to take a step forward with respect to combining finances. Now what?

When Things Aren’t Working the Way They Should…

If the way you and your partner handle finances is not working because you are concerned about how s/he is spending money or for another reason that makes you want to take a step back, you might want to first, consider whether it is even  possible to talk with your partner about his or her spending habits. If the answer to this question is Yes, it can be helpful to think about what you might want to say and to pick a time when other stressors are most likely to be absent. This is not a good conversation to have after a difficult day at work or while you are preparing dinner for your in-laws.

During the conversation, try to stay away from anger and frustration. When we become angry and frustrated, the parts of our brain that are logical and reasonable turn off. The conversation can quickly disintegrate into an argument where no one feels heard or understood. Instead, consider turning your concerns into a collaborative effort to find a solution. Rather than telling your partner how angry you are about how s/he spends money, you might want to ask how you might work together to agree about how the two of you spend money.

If it doesn’t seem possible to talk to your partner about money, you might want to take a deeper look at yourself and/or your relationship. Is there something about you that might be getting in the way? How was money handled in your family? How was conflict handled in your family? Do you have concerns about the relationship or your commitment to your partner that makes it difficult to talk about sensitive issues? Therapy is one way to create a space where difficult topics can be discussed. A competent therapist can help the two of you look at the problem and find ways to talk about it in without resorting to the same old arguments and patterns.

When Things Are Working Well…

On the other hand, you might be looking for ways to create more financial connection with your partner, hopefully because your relationship feels solid and is moving forward. Connecting financially has a number of potential pitfalls. It may create an unanticipated legal bond between the two of you, e.g., if you purchase a house together and both of your names are on the mortgage, failure to pay the mortgage can ruin the credit of both parties. Putting money in a joint bank account can create financial vulnerability if someone gets mad and withdraws the funds. Opening up a credit card together can also be risky if your partner doesn’t recognize the consequences of running up credit card balances. Many forms of financial connection will also create a situation that ties the parties together for a time period that may be greater than initially intended. For example, if you buy a house together, yes, you can sell it if things don’t work out with your partner, but it may take months before you receive your share and the financial pieces can be picked up. Destroyed credit can take years to repair.

Before moving forward with creating more financial connection, it might be wise to evaluate both the solidity of the relationship and how responsible your partner is with money. For that matter, it might be wise to evaluate your own level of responsibility with money. What do you already know about your partner’s relationship to money? What about your own relationship to money? How solid is your relationship with your partner? Is your relationship able to withstand any potential disagreements about money? Like having a child to save the marriage, creating shared financial responsibilities is not a good way to save your relationship. It can make your relationship stronger, but only if your relationship was already strong.

Making Talking About Money Fun! (Yes, it is possible…)

Talking about money with your partner does not have to be drudgery. Do it on a regular basis and try to make it fun. Pick up a pizza before going over the receipts. Reward yourselves with a movie or a walk. Congratulate each other on a job well done. Look at it as a way of spending time with your partner, growing together, and learning more about her or him. The process can be enlightening and the rewards are priceless.

Questions about psychotherapy or about my approach to psychotherapy? Please contact me at 415-218-2442 (phone link works from smartphones only) or at info@marlacass.com.

Thinking about Money in Your Relationship

Thinking about Money in Your Relationship

When it comes to the subject of money and finances, people are often far more comfortable talking about their sex lives than about their financial lives. Talking about how to deal with money in your relationship can feel awkward, unnecessary, and like something you would rather avoid. Unfortunately, disagreeing about money is one of the primary reasons for discord in relationships.

As a Therapist Who Works With Couples, This is What I Think About…And You Should Think About This, Too

When I work with couples, or, for that matter, with anyone who is in committed relationship, I am always wondering about how money is being handled. How did the couple come up with whatever system they are using? Is money kept separate or is everything combined? Something in the middle? What does this say, if anything, about how the members of the couple view the relationship? Is the current situation working for everyone involved? Why or why not?

Combining Funds Is Not For Everyone

Before we consider this issue further, it is important to recognize that there may be many excellent reasons for finances to remain separate. For example, there may be business reasons, children from a prior relationships, debt, or concerns about credit scores. Each situation is unique and you may want to consult with an attorney or tax accountant for advice. This article assumes that there are no legal or accounting reasons to choose a particular approach to handling money.

If each person keeps his or her finances separate, does this say something about the commitment to the relationship? Does it imply a lack of trust in the other person or that the relationship will last over the long haul? Will it provide a convenient exit strategy that could make ending the relationship easier? On a day-to-day basis, how does having separate finances make things easier or harder? How would you handle finances if one person lost his or her job or became ill? If you currently have children or decide to have children, how would you handle who pays for what expenses as they relate to your children? How did you decide this?

Some Ideas for Sharing Money

Separate funds can also bring up numerous logistical challenges. A couple could decide that each person contributes a percentage of his or her income to a joint account; or perhaps the percentages vary depending on the income level(s). Sometimes, each person contributes a set dollar amount each month. Maybe payment of expenses is alternated, or one partner pays the bills while the other partner pays the rent. Often, the partner earning more money may pay more of the expenses. Navigating these questions requires honesty and solid communication skills.

What about couples that have decided to combine their finances? For some people, this can seem like an easier road, however, it can bring up numerous concerns. Combining finances can be a way to try to keep a relationship glued together by creating a financial bond in the absence of an emotional bond. Joint finances can also bring up difficult questions: what if I don’t like the ways my partner spends money? What if s/he spends too much money? Do I need to ask my partner before I buy anything? What are the limits in terms of how much money I can spend without consulting with my partner? Will it feel comfortable to combine our finances if I make more/less than my partner? If I make more/less than my partner, am I keeping a mental accounting about how much I contribute or how much s/he contributes to our household? What feelings does this bring up? How will you handle money that you had before the partnership? What happens if the relationship ends?

The list of issues that can arise when we talk about money is endless. In my next article about money, I will talk more about these issues and consider some ways to talk about money with your partner.

Questions about psychotherapy or about my approach to psychotherapy? Please contact me at 415-218-2442 (phone link works from smartphones only) or at info@marlacass.com.