Tag Archives: San Francisco

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.