The Psychotherapist: From Trainee to Professional

The first reading I ever completed for my three-year psychotherapy diploma program was in the summer before starting the certificate (In the UK we get our Postgraduate Certificate before we can progress to the Diploma). I can’t remember what book it was from, but the author seemed very determined to instill in the reader that any trainee counselor was going to need an incredibly strong support system (they called it an ‘anchor’) in order to survive this course. I thought they were being overdramatic. I read this aloud to my boyfriend-at-the-time’s mother and she stated that she expected her son to fulfill this role. He left before he had to, but that’s okay because by then I had my cat, Lucy.

Lucy became my anchor – my cat was the reason I got up to go to work so I could buy her food and treats. She was the only way I began to create any sense of attachment theory. I hesitate to describe her as a transitional object, but I can’t deny that I see myself very differently now than I did at the beginning of this course. I arrived believing I knew everything but was secretly terrified of having to sit with someone face-to-face instead of over the phone (my background is in peer support hotline work). What if they didn’t speak? What if I couldn’t help? What if I wasn’t good enough? I am now leaving this program fully aware of – and embracing – what I don’t know; yet feeling much more confident in my ability to sit with a client no matter what is brought – and survive a possible hour of silence with a stranger!

My journey to becoming a counselor began many years before that summer. At age 17, I was diagnosed with anxiety and depression. Fearful of speaking to my parents about it, I took myself off to the general practitioner surgery where I was prescribed Propanolol. The doctor was my mother’s own doctor when she was pregnant with me and thus he had always treated me as an extension of a family friend. By just giving me some pills, he managed to cement my idea that I was broken and needed to be fixed. It was only after I hated the pills (initially I hated the idea of them, but then I disliked the way they made me feel) that he suggested I look into counseling, which ironically made me feel even more broken. I didn’t know anything about counseling then, other than what I’d seen in films about psychoanalysis and that scared me. I made the appointment over the phone in my friend’s bedroom and ended up sneaking out of school every week for eight sessions of CBT – cognitive behavioral therapy.

I’ve been in and out of counseling ever since. My style of therapist and senses of accomplishment have varied, as have the labels I have acquired from different professionals. I’ve stomped my feet every step of the way. I’ve been angry at the system, angry at not feeling heard, angry at feeling that my age prevented me from being taken seriously. I’ve disagreed with nearly every label and fallen out with nearly every therapist. But I can’t argue that they’ve helped get me here. I can’t say they hindered me -just that it’s been an uphill battle. My counseling history has helped me now find therapists that I enjoy and taught me how to feel comfortable in my own practice for my own clients.

I began my course angry with the way the system worked, thinking that if only I could get my foot through the door with a qualification, I could attack it from the inside and perhaps gain a greater understanding about how people fall through the net or get left behind. I could help bridge the gap. I could help make this system work.

I’m still angry and I still want to change the system. However, when I was asked why I wanted to do my course, I originally refused to give this reason, because I thought it would be mocked or seen as naive. Whilst I can still see the possible naïveté in it, I don’t believe I could continue to do this job without that anger, without that strong desire to make sustainable mental health more accessible.

So it’s ok to be angry.

It’s also ok for me to say goodbye to my course. The three years have gone by in the longest blink. I notice in my client work, I’m always aware of making sure it’s okay for my clients to leave at the end of a session; can they return to the real world as their outside selves? I really value the time it may take them to put their outside faces back on and slip back into who they need to be. I’ve done this. I’ve cried my tears. My makeup is fixed. I’m okay to leave.

I’ve said before that I think this course is really more a driving test; I’m only going to learn to drive once I’ve passed. I have a whole new journey ahead of me to discover just what type of counselor I really am, once the reins have been cut. I’m really excited to start.

That first reading was right. This course has been testing and it has completely restructured how I view the world around me. But I think what it’s taught me most is to be my own anchor. Whilst Lucy is a wonderful companion to come home to and ride a train with, it’s me that I take everywhere I go. She cannot physically sit in a therapy room with me, although I can channel the self I provide to her to be the self I try to provide to my clients. But it’s me that I need to be able to rely upon – my knowledge and control of my selves that I need to have faith in. This has been difficult when also factoring in a long-term illness that means my body might not always be able to be relied upon and brain fog is never too far away. But I’ve done it. I’m here.

I’m ready to leave. I’m ready to pass. I’m ready to support my clients through their own versions of this journey. I’m also ready to continue learning in my own way. After seven years of university, I’m ready to let go of the ‘trainee’ title and embrace the ‘professional’ one.

 

Why a Psychotherapist?

At the end of one of our sessions, a client apologized to me for leaving me with all of their problems. This wasn’t the first time a client has apologized to me for this and I’m sure it won’t be the last. We were running out of time and my rushed response became a garbled, “Oh please don’t worry about it, this is my job.” I heard the words come out of my mouth and immediately hated them.

I should have taken them back, but I didn’t. I kept quiet because it was the end of our session and there wasn’t time to discuss this in depth and I needed to get ready for my next client. I heard the phrase, “this is my job” as it came out of my mouth and thought about what it would sound like to my client: this is my job, to listen to other people’s fears and complications. This is what I do all day, and often the only thing I want to do all day. What does that make me sound like? What type of a person wants to wade through a stranger’s misery day after day? I want to say it’s because I want to help. I think I can help.

Given the opportunity to think about it, I would have liked to have offered a short summary of how listening to their problems is what I am trained to do, that I have my own supervision and therapy I can go to if anything said to me became too much. But I would have reiterated that the space is theirs to use as they wish, as am I. There’s a part of me that wants to reassure and rescue, to reiterate how much I love my job and remind them that they aren’t burdening me with anything. But that’s not necessarily what my clients are asking. And to say they are not a burden may suggest that their problems are not as heavy to me as they feel to them, which would also be a lie.

There’s a really fine line between taking what my clients tell me and holding it in the room instead of taking what they tell me home. To hold it in the room is to do my job to support my client. Not letting it leave the room and taking it home is my job as part of supporting my own self-care. But to explicitly describe this feels clinical. Telling someone that I am sitting with them because it is my job feels superficial, as though the time they spend with me is simply a paycheck — which could not be further from the truth.

In reality, when it does get heavy, I will measure how the heaviness is affecting me and discuss that with my supervisor. I will discuss it (anonymously and confidentially, with no identifying details) with my peers and I may practice the different responses I might try in the next session in a role play. I may look for extra readings, I may work out a little more in the gym, or buy an extra bottle of wine and binge watch something on Netflix. I will endeavor to bring up how I’m feeling with my client because it may be something that they themselves have been struggling to name and my opening up might help empower them to name their own emotions. I might stomp my feet a little and berate the way the world works. I will always return to the room, to the client and sit in the muddy puddle of whatever emotion feels most overwhelming. I will bear witness and I will try my hardest to hold because that is my job – that is what I am there to do.

In truth, I believe without a doubt that this is what I am supposed to be doing. So yes, it’s ok that you tell me everything you’re worried about, everything you don’t like or even your deepest fears and your most superficial ones. Because it is my job, but also because it’s what I love doing; because it’s what I believe is my life’s purpose; because if there is some divine providence somewhere that’s dictating my life story, “Listener” is scribbled all over my book’s cover.

I would love to tell my clients just how privileged I feel to be able to listen to what they wish to tell me; how lucky I feel to know that I can make a living out of something I believe in; how yes, this is my job, but it’s also my calling; how actually, they may be giving me far more than I could ever give them back.

 

 

Contour Queen: The Power Of Makeup Revisited

A few years ago, I wrote a piece called “Send In The Clowns”. As a photography student who was enthralled by feminism and bodily autonomy, I captured my thoughts on makeup through a series of pictures that expressed my confusion- whether weaing makeup was feminist or not. Two years on, I would’ve never thought that my makeup journey would have progressed this much, and my thoughts around feminism related to makeup have finally become clear.

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I’ve had to defend my choice to wear makeup amongst feminist circles countless times, which was disheartening, to say the least, when I started out experimenting with makeup. I’ve always seen makeup as a form of self-care, so to be met with negativity (especially from people I looked up to) made me question whether I was damaging my feminist integrity.

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I can’t say when the turning point was. I just stopped caring. I slowly began to realise that I loved what makeup could do for me, and starting owning it. Being a perfectionist, I would spend hours upon hours replicating beautiful looks I’d seen, getting frustrated when I couldn’t get it 100% right. However, slowly but surely, I started getting it “right”. I didn’t have to meticulously plan out every look I was doing the night before, making sure I had all the right palettes ready for me to start first thing in the morning. It was so empowering.

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I still had thoughts that were harmful to myself and others around me; maybe I was better without makeup on, more natural, maybe I would be seen as intimidating to others by having strong brows and bold lips. Was I supporting an industry that makes it’s money by tearing women’s self-confidence down, telling them that a blemish is the end of the world, and that no one will love them if they have chubby cheeks? After some tough talks with myself, I came to realise that it was the intention behind my cosmetic obsession that what was really mattered in my personal journey. I wore makeup as an extension of my personality, as a creative outlet, and as part of a self-care routine; and identifying this felt profoundly feminist. 18579307_1898696840350555_2027954573_n

From this long and exhausting journey, I started to love my own skin. I became aware of why my skin would break out, and learnt to forgive myself for mistakes. I became more conscious on what would give me the best value for money in regards to what products I was buying, and hugely boosted my creativity. I stepped out of my comfort zone, and reaped the benefits of it. As I realised that I was good at what I do, I was being told that I looked confident, and I felt it.

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I have become aware of the flaws in the beauty industry. I try not to ignorant. I give advice where I can, and I learn as much as possible. I dedicated my Instagram to purely makeup (give it look here), and I practiced, practiced, practiced. I write makeup pieces for Rosewater. But most importantly, I feel confident, inside and out. This weird and wonderful art of makeup has allowed me to embody the sharpness of my eyeliner wings, the glow of my highlight, and the holographic wonder of my glitter. And even after a long, hard, exhausting day, if my cheekbones are contoured sharp enough to kill a man, it’s all worth it.

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Are you ok?

I’ve always hated it when people tell someone they look good because they’ve lost weight. Instead, I’ve always wanted to ask that person, “are you ok?” because weight loss can often be a sign that something’s wrong. areyouok2-01

Can’t you see I’m blue?

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Sometimes it’s hardest to tell your loved ones when you’re feeling down. They know you so well that you assume they can see through a fake smile or a distant gaze.

Can’t you see I’m blue? Not today. Not you, too.

The Case Against Trigger Warnings

TW: This piece may contain material that is upsetting or offensive to some audiences.

On the Origins of the Trigger Warning

Trigger warnings (TWs) on the Internet began as an earnest, potentially useful way to give audiences a heads up before delving into serious issues like rape, eating disorders, or domestic violence. This way, individuals who may not be emotionally prepared for that kind of discussion (generally victims themselves) could safely, comfortably dip out when necessary, for self-preservation. Simply, the early TW was a refreshing dose of online empathy for those battling post-traumatic stress disorder. Even so, the effectiveness of TWs for people with PTSD remains to be seen, but we’ll come back to that. Trigger warnings were assigned to a fairly narrowly defined set of subject matters, and, in fact, were borne out of the feminist blogosphere.

But as its usage has evolved and expanded over time, it’s been rendered, at worst, condescending, infantilizing, and anti-intellectual and, at best, meaningless. Trigger warnings have infiltrated an ever broader scope of subject matters, they’ve popped out of online forums and into university classrooms, and the definition of “trigger” itself has become a catch-all for things that may cause discomfort and/or not align with our belief system. These days, the TW is doing more harm than good.

Overkill

Many opposed to trigger warnings have argued they’re a grand, exhausting exercise in political correctness, an attack on the final remains of our oh-so-endangered (Gasp) FREEDOM OF SPEECH! A) Yawn. B) How many people who make this unoriginal, misguided argument could accurately define “freedom of speech”? That’s rhetorical. We’ve got bigger fish to fry.

I’m not bothered by TWs because of their PC nature, but rather because I believe—assuming they ever were—they are no longer serving their intended purpose. And in the meantime, they are stifling our ability to have complex conversations about difficult subjects.

In their well-intentioned quest to protect the emotionally vulnerable, they have, at once, politicized mental health and  protected the easily offended from critical thinking.

Let’s take, for example, academia.

Dr. Mark Neumann is a professor at Northern Arizona University’s School of Communication. He believes some students use triggers warnings as a means to “[…]object to hearing something they disagree with, something that might challenge their world view.” “I’m not here to insulate you from ideas,” he says, “Faculty don’t choose course material because they’re trying to harm or upset. They choose material because they believe it illustrates a point worth making and discussing. It’s a disservice to students to create an environment that’s entirely comfortable.”

He offers up a report on trigger warnings, published by the American Association of University Professors (AAUP) last year. The report, he says, is representative of his own views.

The authors write, “Institutional requirements or even suggestions that faculty use trigger warnings interfere with faculty academic freedom in the choice of course materials and teaching methods.” They question the ethics and effectiveness of taking away a level of autonomy from educators.

The AAUP report reads:

There are reasons, however, for concern that even voluntary use of trigger warnings included on syllabi may be counterproductive to the educational experience.  Such trigger warnings conflate exceptional individual experience of trauma with the anticipation of trauma for an entire group, and assume that individuals will respond negatively to certain content.  A trigger warning might lead a student to simply not read an assignment or it might elicit a response from students they otherwise would not have had, focusing them on one aspect of a text and thus precluding other reactions.  Trigger warnings thus run the risk of reducing complex literary, historical, sociological and political insights to a few negative characterizations.  By calling attention to certain content in a given work, trigger warnings also signal an expected response to the content (e.g., dismay, distress, disapproval), and eliminate the element of surprise and spontaneity that can enrich the reading experience and provide critical insight.

Some discomfort is inevitable in classrooms if the goal is to expose students to new ideas, have them question beliefs they have taken for granted, grapple with ethical problems they have never considered, and, more generally, expand their horizons so as to become informed and responsible democratic citizens.   Trigger warnings suggest that classrooms should offer protection and comfort rather than an intellectually challenging education.

Under this far-reaching, broadly-defined idea of a “trigger,” students are given permission to opt out of discussion for the sake of comfort. “Being unwilling to confront some other idea that isn’t your own—that’s not PTSD,” says Neumann. There is a distinct difference between those suffering from PTSD and those who are opposed to new perspectives, but he fears the culture of TWs has blurred the line.

Worse yet, TWs allow students to leave class simply because they can. A friend of mine observed this in a graduate-level course at NAU. His professor provided a trigger warning for a conversation about rape. “Half the class, mostly skater bros, left. They started laughing as soon as they got into the hallway,” he says.

Neumann says, “I don’t know what students are going through, or what their past looks like, but memory is very associative, and I cannot try to anticipate for a class of 375 students what will be triggering to any one student. It could be a song, a smell, any number of things. Nobody is saying, ‘Well, fuck the people who have PTSD,’ but mandating a policy on [trigger warnings] opens the door to a lot of things. The spirit of trigger warnings is empathy, but what’s the scope of that? That’s where it becomes a problem.” Essentially, TWs could very well be accidentally inviting willful ignorance into institutions meant to represent the very antithesis of ignorance.

Some faculty, however, do use TWs voluntarily in the classroom. Aaron Hanlon, an assistant professor of English at Colby College, contributed an opinion piece to the New Republic wherein he argued that both students and professors need trigger warnings. Faculty across the nation remain divided on the issue.

But the authors of the AAUP report write, “The classroom is not the appropriate venue to treat PTSD,” a medical condition for which TWs are an “inadequate” and “diversionary” response. Perhaps then, the Internet is no better of a home for TWs.

The Psychology

In clinical psychology, trauma triggers refer to anything that causes a person to experience flashbacks from a traumatic event in their life. Triggers will often cause people to again feel intense emotions that they felt at the time of the original trauma. Trauma triggers are associated with PTSD sufferers.

Trauma triggers are, by definition, rare. A 2001 study in Biological Psychiatry found that while trauma is a common human experience, developing PTSD from it is far rarer. The authors surveyed 2,181 adult subjects, finding that 89.6% had experienced a form of trauma, but just 9.2% developed PTSD. That said, among survivors of sexual assault, PTSD is markedly more common, but many rape survivors who meet the symptomatic criteria for PTSD immediately following trauma will recover from these symptoms within months. A study in the Journal of Traumatic Stress examined 95 survivors of rape or attempted rape, and found that while 94% met criteria for PTSD roughly two weeks after the trauma, that number dropped to 47% by roughly three months after the trauma.

“So what if a comparatively small portion of the population suffers from PTSD? It takes so little time and effort to throw out a #TW. Just because they are few doesn’t mean they don’t deserve protection!” I hear you, empathetic Tumblr user I made up. I really do.

But a famous study by the Institute of Medicine found confronting trauma triggers is more effective than avoiding them. In fact, avoidance of triggers can actually exacerbate symptoms of PTSD. Moreover, making trauma a central part of one’s identity—something TW culture may aid in—has negative effects on mental health. In other words, hypersensitivity to triggers may very well be more harmful to a PTSD sufferer than helpful.

Miri Mogilevsky disagrees. Her opinion piece for Daily Dot details how she, as a trauma survivor, engages in complex, but positive ways with trigger warnings online. She doesn’t always use them to opt out of reading triggering material, but rather to emotionally prepare herself for the material. Mogilevsky resents the “You must be exposed to triggers in order to overcome them” argument against TWs, believing it is arrogant, ersatz concern for a survivor’s well-being. She feels TWs help put her in control of her own mental health.

Mogilvesky writes, “In my experience, most survivors of serious trauma—the ones that get triggered by things—are either already accessing mental healthcare, are unable to access mental healthcare, or have tried it and found it unhelpful. Please stop with the condescending advice to students to seek mental healthcare ‘instead’ of asking for trigger warnings.”

Neumann responds, “Suddenly now she’s the spokesperson for [PTSD] because she has anecdotal examples? I’m sorry, but I don’t buy it as the end-all-be-all.”

Her story does capture perfectly what the trigger warning was intended to do. It’s functional. I get it. I like it.

But the problem remains: Trigger warnings have become so widely used and in so many contexts that they currently cause far more problems than they solve.

So what’s your point?

Trigger warnings have outlived their original intended function and, subsequently, their greatest potential for good. A friend asked me, “Is over-sensitivity a crime? Isn’t life shitty enough? Why can’t we live life in bubbles?” I wondered, too. Is it really a problem if people are extra sensitive? Does long-term exposure to difficult subject matters really make us healthier, more open-minded, more free-thinking people? In short, the answer is yes. The general consensus of the scientific community is that empathy is a function of exposure.

In the case of the skater bros leaving class simply because they were given permission to, the TW was detrimental. Here, exposure to a meaningful conversation about rape might have otherwise incited some empathy.

So, how do we handle triggers? Some have suggested that instead of using “trigger warning” we use “content warning.” I’m not so convinced that a small shift in semantics would settle this one. But I’m also not convinced that saying, “Life’s triggerin’, baby, and that’s the way it’s gonna be” would settle it either. It might just be time to re-evaluate the meaning and function of  trigger warnings by untangling the increasingly intertwined meanings of the words “triggered” and “offended.”

Girls Need Our Support, Not Our Silence

“What’s that there?” A grandmother points to her granddaughter’s belly. The girl is large. This is not an insult. She is very tall, very strong looking. Everything about this body exudes capability and health. For a group of women sitting in a nursing home, I am surprised that the body under scrutiny is that of a young, thriving girl.

Her mother looks and calls the girl’s stomach a spare tire. The girl turns pink but stays quiet. “We all have one,” the mother says. She is obviously embarrassed for her daughter, but does not defend her. I watch,uncomfortable. I know what it’s like to be the fat girl. The mother then redirects the conversation. “Do you like her shirt? It’s new.”

I said nothing. And I am sorry.

For women, there is nothing new or surprising about being critiqued for our weight, and yet I was still amazed when I watched it happen to someone else.  I don’t remember when or how I came to struggle with my body, or how I came to hate it, but for many women, it becomes just a part of growing up.  And in this one moment, I understood how insidious and normalized this behavior was. I could tell that this was not the first time this girl had been critiqued for her size. She blushed, and cast her head down, a sign of shame. Somewhere along the line she has learned  that her body is shameful and not worth defending. To her, it  was acceptable for her body to be pointed at and ridiculed in public, and that she is supposed to take this abuse quietly.

We wonder why girls as young as 10-years-old worry about their weight, and we blame the media. However, we fail to realize that we inflict just as much, if not more, damage on these girls. You may feel like you don’t have anything to do with this. You may think that you would never dream of saying these things to a child, and you may sincerely believe in all the lessons the body positive community has taught. However, that just doesn’t cut it.

It felt like a slap in the face when I realized that I had watched this whole exchange in silence. I had watched something that I morally disagreed with, but did nothing. As I watched the scene, I felt that I should speak up, defend her, but I didn’t. Part of me realized that my silence was the result of social rules—knowing that it was considered impolite to interrupt someone else’s conversation, but another part of me realized something much sadder; that my own internalized body hatred kept me quiet, kept me passive. I know what it’s like to be that girl, to be teased and joked about. I knew that deep down there was a part of me that believed that I still deserved to be spoken to like that, that I didn’t deserve to be treated with respect. A despondent piece of me tried to say that this was just what girls like she and I had to live through.

Everyday I have to reaffirm my body to myself—to tell myself that it is good, capable, and sometimes even beautiful. I wish it was something I didn’t have to do. It feels like an obligation, and sometimes it feels like I am lying to myself. It was with a sense of guilt I realized that my silence was only perpetuating this cycle. More and more young women would grow up and see their bodies as burdens. I should have looked out for this girl. As a feminist, I should have disregarded social codes and my own self comfort to reach out to her. It could have been a small gesture, something as tiny as saying “I think you look great.” This is an element of my feminism that is often hard to execute. The realization that I have to put myself out there sometimes, that people may think I’m being rude. However, I can’t even imagine the good it would have done me as a young girl to have someone tell me I looked fine the way I was. For so many girls, our compliments are pointed: you’d look good if you did this, if you lost a little you’d look amazing.

I have to remind myself that if I want women to be happy in their bodies, I have to do my part, no matter how small.

Nothing is ever accomplished by silence.

Stop Girl Hate

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by Esperanza M.


Five times a week I sit in classrooms where the majority of people are girls.

Five times a week I sit in classrooms where girls hate other girls.

And twice a week I spend two hours in a classroom where things are particularly bad.

Twice a week I have to be in a classroom where things are worse than in any other I’ve seen.

And I can’t help but feel angry and uncomfortable.

Twice a week I spend two hours hearing comments about some girl who is a slut,

About some girl who didn’t lose weight for her wedding day,

About some girl who has the ugliest clothes,

About some girl who tries too much,

And another one who doesn’t try enough.

Someone told me lately:

“Sometimes other women are a bigger problem than the patriarchy”

And I think they don’t realize.

We women can be part of the patriarchy too.

And I think the first step to fix this is:

Love and respect other girls.

We are made of the same.

Just stop the hate.