Welcome to a conversation between two social therapists who meet regularly to share and advance our therapeutic work. We hope these dialogues can support and stimulate others who are integrating developmental conversations into their therapeutic practices and personal growth. See the first post in the series for a brief explanation of what social therapy is and the perspectives we’re coming from in our dialogues.
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Ann: Something wonderfully weird and weirdly wonderful is going on in my therapy. I can’t wait to tell you about it!
Hugh: Wow! You’ve got my attention! What’s going on?
Ann: I’ve fallen in love! With my group! And they’re in love with me!
Hugh: That does sound wonderful… and weird, too—in a good way. Tell me all about it.
Ann: I was hoping you’d ask! Well, one of my groups has been working with someone in the group, Alma, a nurse who works in a hospital emergency room. She’s very dedicated, takes her job very seriously, and gets a lot of gratification from it. It’s a really demanding job even in normal times. With the coronavirus outbreak, the demands are beyond enormous. A couple of months ago when New York City was just beginning to stay home and practice social distancing, the group checked in with Alma to find out how she was doing. She told us that her ER was unbelievably busy, the whole staff was working flat out, 24/7—and she was determined to “work ‘til I drop.” The group was taken aback, and several people became quite upset. “We don’t want you to work ’til you drop,” one of them said. If something happens to you it’ll have a terrible impact on all of us, not to mention your patients and co-workers.”
Hugh: Can you give me some of the history? How did the group build a relationship in which they could make this kind of demand?
Ann: Well, Alma’s been in the group for over a year and during that time the group has asked her to look at how she insists on living her life deprivationally by defining her “identity” and her “self-worth” only in terms of her job. Alma tends to be very self-critical and the group has pushed her to let herself experience their respect for her. In the course of that work, the group has grown to care a lot about Alma—and she about them.
So, in the group that I’m telling you about, they asked Alma why she was committed to “working herself to the bone” now. She told us that, like a lot of healthcare workers, she feels guilty because she can’t save every patient stricken with the virus. The group objected to her self-blame and guilt. They wanted her to try and hear that they love her for her devotion to her patients—and they wanted her to take care of herself as she was taking care of others—to see that her life matters, too.
Hugh: It’s very moving to hear how they were relating to her in a way that was very different from how she was relating to herself. They were asking her to do something new: “Hey, take care of yourself. And do it for us!” How did she respond?
Ann: The next week she told us that she had tested positive for the virus and was currently quarantined. She said that the previous week’s group had made her feel cared about in a way she’d never experienced, and that—until she got sick—she had been self-consciously working to keep guilt out of the picture at her job. Now that she was quarantined, she was trying to put into practice what the group had said to her by taking care of herself as best she could. In a real way, that group had changed her life.
Hugh: How did the group respond?
Ann: They said they were very touched and proud that together they had helped her transform how she was doing her job and her life.
Hugh: It sounds lovely. How did you feel about the conversation?
Ann: I felt proud of them. They’ve come a long way from being a group of strangers when they started four years ago to having built a relationship that’s both very caring and very demanding, so that they’re able to challenge each other to grow, to do things in new ways, to change their lives. It’s extremely meaningful to me. I love it and I love them.
Hugh: Did you tell them that?
Ann: I did! And they got very emotional and said they loved me too. It was so moving. It felt very new and intimate, like we were breaking down boundaries between us. I meant it—I do love them. They’re decent, ordinary people who are struggling to be more open and help each other. I find this very beautiful.
Hugh: Yes. You’re engaged with them in this profoundly humane activity of creating new conversations, new emotions, new forms of life. No wonder you love each other.
Ann: It means a lot to me that you should say that, Hugh. I was worried that you might think I was being a little hokey. In fact, after the group I thought maybe I had gone too far. In “therapy school” we’re taught that when clients feel emotionally close to their therapist it’s to be understood as a form of “transference,” and when therapists feel close to their clients it means that there’s “counter-transference.” Both are said to be problematic, inappropriate and for the therapist potentially unethical. But the more I thought about it the more convinced I was that there was nothing “pathological” about what was going on between the group and me.
Hugh: It doesn’t sound like pathology to me—far from it. The group and you have an important relationship that you’re creating together week after week. This includes breaking down the authoritarian boundaries that keep people in their “places” so that they can’t grow.
Ann: This pandemic puts life crisis front and center—and the group grapples with how they are going to deal with crisis. The “how” of the approach makes a huge difference.
Hugh: What do you mean?
Ann: Well, how Alma was dealing with it was to do this old pattern of her self-critical behavior. But the group engaged her about that, shared their reactions and together created a new path for her and them to move forward.
Hugh: Yes, there’s a strong tendency in a crisis to just wait it out, or do the same things we’ve always done, or to ignore what’s happening. But your group didn’t do any of those things—they waded in and got involved in her life. This crisis is tragic and terrifying—and yet it also presents opportunities for development.
Thanks so much for sharing this with me, Ann. It’s inspiring.
Ann: You’re welcome.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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