“Be Kind to Yourself… For Us!”

Hugh Polk, MDAnn Green, PMHNP
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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.

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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.

15 COMMENTS

  1. That sounds fine. Community, love, friendship–these are important things, and the kind of things that everyone should be able to find in a church. The fact that some people can only find these things in group therapy under the umbrella of mental illness, speaks to larger cultural and social problems within our country, like that some people become so marginalized that they’re only offered community through the mental health industry. It would be nice if even neighbors were more loving and friendlier. I guess we could all stand to be more loving and friendlier.

    My parish only offers community for successful married people with children, or young single people. I am a leper there. I’m kind of glad that I am officially under no obligation to go there now since I only went once in a while before, anyway.

    I once had the misfortune of going to Church on a Mother’s Day when they were passing out books. I said to the woman, “Oh, I’m not a mother.”

    She said, “No, it’s for all women.” So, I went home and read it. It was for married women with children with instructions on how you should put God first, your husband second, and your children third.

    • “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.”

      Basically this “teaching,” is the problem. Since the therapists won’t actually help a person, if they don’t have an emotional, caring, human connection with them. My so called “therapists” were so distant, and ignorant, of who I was, that once I’d read their medical records, which were filled with tons of misinformation about me – and lies from pedophiles. I confronted my psychiatrist with the truth.

      He then turned into a dangerous, paranoid lunatic, and declared my entire life to be a “credible fictional story.” He wanted to neurotoxic poison my healing child, who’d been abused four years prior, to which I said no. At my last appointment with him, he tried to convince my husband that I needed to be re-neurotoxic poisoned. My husband and I reminded him that I was doing much better off the drugs, and happily walked away forever. But not before having to politely decline to sign a sheet full of clear stickers that said “I declare this is true” on them.

      I had zero sense of closeness with any, of what I learned from reading my family’s medical records, satanic pedophile aiding, abetting, and empowering “therapists.” But I guess this means they did exactly what they were trained to do? Except, of course, they broke the law, since they were all mandatory reporters, who neglected to report that the medical evidence of the abuse of my child had been handed over.

      I do agree with Caroline, real and caring relationships used to be found within the churches. And I’m saddened that the mainstream religions have partnered with the scientifically “invalid,” DSM “bible” believing, uncaring, systemic, child abuse covering up, “mental health” workers.

      But I do understand this “medical”/religious partnership allowed the scientifically “invalid,” and uncaring “mental health” workers, to systemically create a multibillion dollar, by DSM design, primarily child abuse and rape covering up, iatrogenic illness creating, “mental health” system, which is very profitable for the “mental health” workers, and the mainstream religious hospitals.

      https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml
      https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1
      https://www.alternet.org/2010/04/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america/
      https://en.wikipedia.org/wiki/Toxidrome
      https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome
      https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
      https://www.madinamerica.com/2016/04/heal-for-life/
      https://books.google.com/books?id=xI01AlxH1uAC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

      It’s sad, however, that the uncaring, primarily child abuse covering up, “mental health” workers have turned my, and maybe many, formerly Christian religions into nothing more than criminal, systemic, child abuse covering up and profiteering, organizations. How do we end, what an ethical pastor of a different religion confessed to me is, “the dirty little secret of the two original educated professions?”

      Will mainstream “therapists” ever get out of the child abuse covering up business? Especially since all of their systemic aiding, abetting, and empowering of pedophiles, has resulted in us all now living in a “pedophile empire.”

      https://www.amazon.com/Pedophilia-Empire-Chapter-Introduction-Disorder-ebook/dp/B0773QHGPT

      Was that actually the goal of the systemic, child abuse covering up “therapists?” Or are they just pawns in an evil – paternalistic to the point of being misogynistic and misopedistic – scientifically “invalid” system? The fix could be easy, get rid of the DSM.

      But since the 2013 discrediting of your DSM “bible” did not result in your flushing your DSM “bible,” as would have been appropriate. At a minimum, changing the DSM such that the therapists can bill to help child abuse and rape survivors, and their legitimately concerned family members, is needed. Plus this disclaimer, which was inappropriately removed from the previous DSMs, in the 2013 published DSM5:

      “Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.”

      Needs to be added back to the DSM5, with an amendment that includes the ADHD drugs, in addition to the antidepressants. And the DSM does also need to include the fact that the antidepressants and antipsychotics can create the positive symptoms of “schizophrenia,” like psychosis and hallucinations, via anticholinergic toxidrome. As well as the fact that the antipsychotics/neuroleptics can create the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome.

      And I guess, retraining the DSM “bible” believing “therapists,” who were taught that it’s “unethical” to care about your clients, would not be easy to do. It’d probably be easier, in this day in age where many are being declared to be “non-essential,” to just declare all the non-caring, “invalid” DSM “bible” believing “therapists” to be “non-essential,” since they actually are.

      And as we return to as normal of a functioning society as we can, we should be hiring non-DSM brainwashed, caring people, to help the legitimately distressed people. Since the DSM brainwashed, “all distress is caused by chemical imbalances in people’s brains” believing, non-caring “professionals” will never actually work to help anyone, other than themselves, and the evil “elite,” who brainwashed them in the first place.

  2. “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”

    By now, now that we are all “enlightened”, and continue to become more so, perhaps someone at “therapy school” should broach the idea that the “transference” has already occurred when the therapist “digs”, and the “client” divulges massive secrets that not even her closest friends know.

    Is there ever an honest relationship in “therapy”? When is there that moment when it is just “two people talking”?

    • I would submit that the moment when we are “two people talking” is when real therapy can take place. As for “countertransference,” it is totally and completely normal for therapist and client to form a bond, and for them each to have feelings about the other. The difference SHOULD be that the therapist uses his/her feelings in the service of therapy, and does not take advantage of the client’s vulnerability in even the slightest way. I often found it helpful to share my feelings of the moment with the client when it seemed likely to increase trust or open up a new perspective. After all, they’re sharing their feelings with me, shouldn’t they get to know that they are having an impact, that I’m not a block of wood trained to say, “Go on” every three sentences? People want to talk to another PERSON, a REAL PERSON who interacts with them in a meaningful way. Nobody wants to talk to a “blank slate.”

      That’s my experience, anyway, but I was not a DSM-trained standard therapist. I pretty much made it up as I went along, depending on the client. Kind of Milton Ericson style. I’d probably be fired in a second from most places nowadays.

  3. This is all very well and good but medical doctors do not want to participate in groups. and social workers, when they do participate in groups, they want to be in charge of us and run the whole show. Not counting one doctor who does not keep up her prescribing license, i do not currently know any doctors who I personally trust enough to tell them the truth about how I feel. I generally avoid going to see doctors because I am afraid of their power to harm. I only know one social worker who is not bossy or judgmental. One social worker chided me for insisting that my daughter’s behavior was being driven by the toxic drugs and the lack of ability to go outside and she cut me off from contact with my daughter. I would love to be in groups involving professionals, but how can I? My heart has been broken and I feel afraid to be in the same room as them

  4. Sometimes when professional therapists enjoy dropping boundaries and being human to human I feel angry… I put extra walls up. The privilege is not mutual. The picture in my head is of a party with a paid server who helps themself to the cake, the private information, a warm feeling, and a paycheck before going home to an undisclosed location. If you need to confront them later for the footprints left on your carpet they go back behind ethics again. Disappear. Untouchable. Protected. We love you too but if I can’t leave the patient role within the relationship, you don’t get to come in and out of therapist either.

    I can’t ever take my secrets back. Even if I do get to be your equal, a colleague… my guts are already all over the place and yours aren’t.

  5. Maybe it was just edited out here, but i’m concerned that we see nothing here about “Alma’s” feelings of guilt at not being able to save every patient. So-called ” toxic guilt” is a valid issue, and has well-developed means for addressing it. It’s too long and involved to go in to, here…. But i’m encouraged by what i read here. Problem i see, is that you folks are simply NOT “radical” and “reformist” enough!…

  6. I wish i’d read the CV/bio of the authors BEFORE i wrote my first comment. The pseudoscience of psychiatry is the personification of MEDICAL FASCISM. To the extent that anybody supports the FRAUD and SCAM of psychiatry, they also support the ongoing CRIMES of psychiatry. There can be no compromise with human evil. And psychiatry is the personification of human evil. The banality of evil. That’s my opinion, hard-earned by being tortured by psychiatry. If it was within my power, psychiatry would cease to exist. Keep trying, kids….

  7. Thank you for telling such a human story about your practice. I’ve never been a big fan of analysis (of any kind) because it makes it more and more impossible to see people in all their wonderful conplexity and contradictoriness. I appreciate that the love and community you and your groups are creating doesn’t mean anything more than what you are creating together – and will continue to create together, so bravo for having the courage to love!

  8. I see what people are saying about how important it is to have kindness and care in our communities. I agree. It seems like the work in the group Ann Green and Hugh Polk are talking about could be of support in that effort since it is part of the world. I don’t think that people’s growth stops at the door to the therapy room. They (like all of us) could continue building caring community.

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