As I sat across from my new 12 year old patient and her mom, I saw the look of dread in the girl’s eyes and in her body language. Sweatshirt hood was up, looking down into her lap, arms crossed. I am a psychologist and work at a medical center in an eating disorder’s program. I have seen this look of dread many times over the years.
“Oh, she didn’t want to come today,” the mom explained almost apologetically.
“Only crazy people come to places like this” her daughter blurts out, the first words I have heard from her.
“Well, I can totally understand why you would feel that way,” I said. “A lot of people feel that way about coming here, but actually most kids and teens who come here are just like me and you, just normal people with the normal variety of challenges.” The girls shoulders relax a bit. “It takes a lot of courage to ask for help,” I say. A little bit of eye contact now. And we have our starting point.
I have reassured countless numbers of kids and teens and I can genuinely say that I understand how they feel. It is scarey to ask for help. We are at our most vulnerable as parents and as kids. We have to talk about that which feels most yucky inside.
The problem with the mental health profession, my profession, is that by its very nature it looks for pathology so that those pathologies can be treated. Good therapists also look for strengths, but families are sometimes looked at with skepticism as in “what are they doing to cause or contribute to this?” Most all therapists have good intentions. They/we want to help. We really do. However, it is easy to fall into a them versus us thinking. I have witnessed it many times even among therapists who I otherwise respect.
And even if the therapist is not scrutinizing the parents, it is completely normal for parents to feel that they are. As the mother of three children, one who has ADHD plus, I have had the humbling experience of being on both sides of the couch. I have felt criticized at times, actually hated those who have helped me (in the moment – just being honest here), but most of the time I have felt incredibly grateful for the help of some amazing professionals who have played a critical role in maintaining the health of our family despite some big hurdles.
I know that patients sometimes worry that they are crazy and assume that the therapist has it all together. Parents can assume that the therapist has all the answers and lament that they have none. They might even assume that the therapist’s own kids must be perfect. What could be further from the truth? And sadly, therapists can sometimes fall into the trap of feeling bolstered by their professional status and this feeds the separation between therapist and patient (Your nuts. I’m not.). Therapists have to consciously fight against this.
At times I have sought some comfort from my professional role as a psychologist. After all, I do get respect from most people because of it. I’m not going to lie. However, I have also been overwhelmed by the lack of separation between me and my patients. I too have been the patient seeking help. I too have been the parent desperate with worry about my kid and I too have been the out of control teen, self destructing, feeling judged by every corner of my world.
There have been many times where I wanted to tell parents that I understand how it feels to be in their shoes with specific examples from my life. I have also had the urge to tell a teen that I also felt worthless when I was their age, but that my life got so good when I became an adult. And, I’ll admit, there have been a handful of times when I have said something general like this to a suicidal teen, for example. But this is over many, many years. This decision has to be a rare one because it has to be based on sound clinical judgement and confidence that doing so would truly be helpful to the teen. I never want a patient’s time with me to be about me. It is sacred time for and about them. But I always hope that I will be able to convey my understanding and empathy in other, useful ways.
On some occasions, I have to admit, that I have felt wholly inadequate in terms of being able to help parents and their kids/teens when I have been at such a loss with my own. “What the hell do I think I am doing?” I despair. Fortunately, these times are few and far between, especially because I have come to accept the fact that we are either all nuts or all just human beings doing the best we can to live life. This perspective feels a lot better. Also, most therapists feel as I do, truly honored to work with such amazing kids, teens, and families.