Musings

I can still remember my first therapy case. This person, sitting there, probably wondering whether I could help them. And me, sitting there, having basically no clue how to do so. Fumbling through conversation, trying to be supportive, yearning for some easy opportunity to apply some bit of skill or wisdom I'd picked up along the way. Worried, above all, that my supervisor was going to watch this tape, that they'd somehow see how utterly clueless I was.

That feeling eventually passed. But life is funny because experiences like that have a way of returning. I recall working at a VA hospital over the summer, sitting next to the bed of this patient wracked with the pain of a car accident -- but the even more brutal horror of PTSD. Seeing them go through flashbacks right in front of my eyes while I sat there with my pen and paper, somehow trying to complete this silly form (a symptom checklist) they'd asked me to complete. And again that feeling of utter inadequacy. Who was I, this second year graduate student, in the face of such devastation?

Later that year, after his physical injuries healed, I saw that person again. He was still wracked by his PTSD symptoms, desperate to leave the facility so he could go back to using alcohol -- the only coping skill he knew worked for him. I remember sitting him down and saying that I thought he might be the bravest person that I'd ever met. And I challenged him. Basically I asked how he could think about giving up when he just had to make it a few more weeks off of alcohol in order to make it into a more intensive PTSD treatment program.

It worked like a charm, as it turns out. I like to think the soldier in him rose to the challenge, refused to see himself as a coward.

Was this some crafty clinical approach I'd learned in school? Nope. Something I'd even seen before? No. Was I internally calm and sure of myself as I spoke those words? Not on your life! Was I desperately making it up as I went along? Yep.

That feeling still returns at times. Like the first time I worked with a certain kind of disorder, or deal with a certain kind of dangerous behavior. Or when I might have to testify in court, or when I know my opinion will have a big impact on when (or if) someone gets their kids back.

What's different now, in looking back on it, is that my response to the feeling has changed. Now it teaches me something, whereas before it could almost paralyze. Now I can study the feeling, understand its cause, learn to manage it. In other words, I face that fear, even dance with it. I no longer treat it like an enemy.

It's tempting for me to think that it's easier for me to do this now, since I have more experience under my belt. I have a bevy of ideas, skills, techniques, approaches that I can call upon. But in the end, therapy is always to some extent just sitting in a room with someone, creating a relationship with them. It's always making it up as you go along to some extent, because ultimately healing only occurs through relationships (if skills alone could heal, then there would be no therapists -- only self-help books).

Embracing the uncertainty in such situations also means opening yourself up to possibility, to change, to hope. I like to think that's how God works in our lives as well. Calling us out of our comfort zone where we are in charge, asking us to grow, to change, to love in more profound ways. If the season of Advent is preparing ourselves for God's entry into our world, then perhaps it is partially opening ourselves up to some degree of uncertainty, of inadequacy even -- so that we might grow.