How to Think Like a Shrink: The Good, the Bad, and the Ugly of Rookie Psychotherapy

07 Feb 2012 ⋅ by Linda Esposito ⋅ 16 Comments

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If you don’t sell, it’s not the product that’s wrong, it’s you. ~Estee Lauder

How do you sell the truth?

This is the question every psychotherapist struggles with when counseling a woman involved in a domestic violence relationship, or the overweight middle-aged man with a history of heart disease…

…or during supervision with the rookie therapist who doesn’t understand why high conflict couples often stay together.

The answer is you “sell” the facts and findings of ADHD research to the parent who doesn’t want her nine year old on meds, in the same manner that you teach the concept of “hostile dependence” to the rookie therapist, while reassuring that the majority of grad students in two-year counseling programs suck at psychotherapy.

You tell the truth.

You remind your eager charges that it’s normal for every new therapist to feel like a colossal failure for more minutes than not during the 50-minute hour.

You give examples of 12 years of clinical shenanigans with the caveat that we all make mistakes.

But nobody likes a repeat offender.

And sadly, many therapists in two-year counseling programs don’t get sufficient clinical training.

That’s why I created How to Think Like a Shrink: A Crash Course Guide in Clinical Skills Preparation for Grad Students and Rookie Therapists.

Believe me, I know about the difficulty of those first few years post-grad.

I’m no expert—far from it, but I know how good it feels to not pray that your client is a no-show because you’re uncomfortable dealing with their issues.

Obtaining clinical competence and confidence has made all the difference in how I view the world, my work and my clients.

I sleep pretty well at night, too.

The Good Part of Psychotherapy

Nothing beats helping a newly divorced client reduce stress and anxiety.

And who could argue with social proof?

The Bad Part of Psychotherapy

Sometimes counseling does not work, and it’s not always the fault of the therapist.

The chemistry will be off.

The therapeutic bond will be broken (if it was ever intact in the first place).

Sometimes the best remedy is knowing there is no ideal intervention.

You’ll have days when your intervention still feels like MSU (Making Shit Up).

But you keep on.

You pay it forward despite the grind.

You’ll get your clinical rhythm back tomorrow.

Your client will have an epiphany and stop projecting his childhood issues on his partner.

The teen eventually stops self-medicating, ditching school, and hanging out with the wrong peer group.

The Ugly Part of Psychotherapy

Two words:

Jerry Sandusky.

Because thinking like a shrink doesn’t end when you step away from the couch.

One of the downsides of the therapist mindset is you view the world differently from your brother-in-law in banking.

You can’t let certain things go like your neighbor does with a wave of her manicured hand.

Ever.

When you read that the janitor at Penn State says that encountering Jerry Sandusky forcefully doing things to young boys in the locker room “doesn’t compare to the horrors I witnessed in the Korean War…,” you don’t just will that image away.

You dwell over the lost childhood.

You question the parenting of those who witnessed these alleged atrocious acts and failed to report to law enforcement.

You wonder if the victim’s emotional maturity stopped at age ten.

Despite your inner-Zen screaming at you not to interpret Mrs. Sandusky’s silence, you can’t hide that you’re privy to her darkness and pathological complicity.

You pray that the children and their families find a mental health professional that specializes in victims of sexual trauma to help make sense of the senseless.

Someone who takes a deep breath, rolls up their sleeves and doesn’t shy away from the ugly.

And sometimes that clinician just may be a young therapist.

Because the good Lord knows us veterans can only work the intrepid for so long.

We’re counting on someone with fresh and curious energy; the person who’s not psychologically scarred and experiencing vicarious traumatization from years digging in the trenches.

Because it takes a ton of energy to treat the person who was robbed of their childhood.

You need an abundance of patience and clinical expertise to teach your abused client that despite the awful incidents, the world is basically a safe place.

Yes, there are bad events that happen, and some behavior is just plain ugly.

But there’s a lot of good out there, too.

Mental health is an imperative.

And we need more competent mental health professionals to spread that message, now more than ever.

Maybe that mental health professional is you.

I can’t promise you’ll never experience countertransference, or make incorrect interpretations, but I guarantee you’ll feel more confident, capable and energized when you think like a shrink.

Somewhere out there an inner child is screaming for your help.

If you’re interested in learning more about How to Think Like a Shrink, hit me up here.

It takes two to speak the truth: one to speak, and another to hear. ~Henry David Thoreau.

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Question for the new and not-so-new therapists:

The thing about rookie psychotherapy is ___________________ ?

Question for the non-clinicians:

How can we make psychotherapy more user-friendly?

Please leave feedback in the box below.

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Thanks!

~Linda