Variation on a blind date: Session #1 with a new psychologist

woman and man on date, woman looks bored while man is talking excitedly

I’m sure you’re all dying to know how my first meeting with the psychologist went last week. Rather than reveal the details of our conversation (boundaries, my friends), I’ll tell you how it felt to talk to her. I arrived there hopeful, knowing this woman’s training is with palliative types like me. Despite her expertise, the session felt off from the outset.

I was thinking afterward about how going to a first session with a psychologist is a lot like a blind date. Someone sets you up thinking you’ll hit it off. You set a first date and hope for the best. Sometimes it’s a match made in heaven, but other times you’re sorely disappointed. After that first date, or even five minutes into it, you ask yourself, “How could Ms. Matchmaker possibly think I’d like that person?” You have nothing in common, your world views are diametrically opposed, and you know you’ll never get that hour back.

Unfortunately, I’d liken my first session to a bad date. Although I don’t know how the psychologist felt about our time together, I imagine she questioned our future together as well. She made a few observations and interpretations that were so far fetched that I must have worn my disillusionment on my face, despite my efforts not to. I lost all hope when the psychologist suggested an intervention more commonly used with preschoolers or those on the autistic spectrum. As far as I know, I am neither. The conversation felt stilted, and I kept talking simply to try to salvage our time together. Sadly, our connection did not improve over time.

I do not blame the psychologist for the bad date; it takes two to tango. I know I am a difficult client. I am quick to judge, I expect a quick and easy connection, and I want a sense that the therapist has the potential to understand me better than I understand myself. My hopes were quickly and profoundly dashed.

Then came that awkward moment: should we have another date? Despite the obvious disconnection, the psychologist asked me whether I wanted to rebook. I hesitated a bit too long. I didn’t want to hurt her by suggesting maybe we should date other people. Instead, I took her card and fled, leaving the door open both literally and figuratively.

I am ashamed of myself for wimping out. Had I asked the psychologist how she’d feel if I dated one of her colleagues instead, I’m sure she would have facilitated an alternate referral. She’s a grown up, and she should respect her clients’ needs. I’ve had many clients over the years who haven’t taken to me. I know that if I take issue with their discontent, that’s my problem.

I may seek a private psychologist to talk to rather than contacting this psychologist for a referral to one of her colleagues. Call me a baby, but I’ve had more than my share of awkward conversations these past few weeks. I need a bit of time to get back on the dating horse. I know, time is the one thing I don’t have. Must you really remind me?

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Dying comes with unexpected perks

You know how much I love to look on the bright side. If I look hard enough, I can always find a silver lining. Take dying for example: it may seem like a real downer, but it comes with a variety of side benefits.

The day Dr. Blood Lite gave me The News, he suggested hooking me up with the palliative team, even though I might not need the team yet. (Palliative? Who me?) Not one to turn down such a generous offer, of course I said yes. Little did I know that the following day, I’d get a call from someone on the Pain and Symptom Management team, which is quite the euphemism. I had no idea who she was until she explained, “We’re also known as the Palliative Care Team.” Why is the Palliative Team afraid of using its real name?

We set up an appointment for the following week, when I’d be at the cancer centre anyhow. J. and I met briefly with a palliative nurse practitioner, and learned more about her team’s services. We agreed that I didn’t need the team’s support currently, but would welcome their involvement as my condition progressed. I may be palliative, but I’m not approaching the pearly gates yet.

The other service at my fingertips is a real live psychologist. No sooner did I admit it might help me to talk to someone than I received a call, and scheduled a session within a week. This Friday, I will be hoping to connect well with the psychologist assigned to patients just like me.

You may be wondering why I’d see a psychologist now. No therapist can prevent my impending death, so what’s the point? In the past, clients have often shared similar sentiments with me. “Why talk about my ex-spouse/dead parent/severely disabled child since there’s nothing you can do to change my situation?” All the more reason to talk, I say.

Yes, there’s nothing this psychologist can do to prevent my death, but maybe I’d still benefit from talking about my grief. I’ve had a very tough few weeks, as expected. Imagine having to tell your family that your death is looming. Then imagine having to tell your friends, and your dog. (Jelly is taking the news especially hard.) Imagine knowing you are going to abandon your beloved spouse, who has cared for you selflessly through your illness. Imagine knowing you can’t do anything to ease others’ pain because you have caused it. Sure, I feel helpless and hopeless and despairing some days.

Maybe I’d feel a bit better if I could talk about these issues with a therapist.  Maybe I wouldn’t feel so down, or so scared, if I weren’t trying to manage my feelings on my own. God knows I could use more sleep; fatigue and insomnia are horrendous bedfellows. I may know how to help others through their grief, but I can’t be my own grief therapist. This psychologist has been known to need a psychologist on occasion. Like now.

I expect other potential support services for dying people will reveal themselves over time. It will be a comfort to know what’s available, and I’ll be open to anything that might help. So will J. I believe we deserve all the support we can get.

Quote: Grief is like the ocean. It comes in waves, ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim." Vicki Harrison

 

Consent by any other name is not so sweet

One of psychologists’ core ethical principles is maintaining appropriate boundaries with our clients. We all define appropriate boundaries in our own way, but there are certain immutable guidelines. Here are mine.

I do not spend time with clients outside a therapy session, either on line or in person. This means not being Facebook friends, not going for dinner together, not meeting up for the latest exhibit at the art gallery, and not signing up for the same yoga class. If a client ends up in yoga with me, that’s different; as long as I don’t orchestrate our co-attendance, and we don’t have an unplanned therapy session during savasana, I have not violated these rules.

To take this one step further, any ethical psychologist does not engage in a sexual or romantic relationship with a client ever. Some might consider such a relationship permissible after the therapeutic relationship ends, but not me. If you can’t figure out why that shift in boundaries would be inappropriate, I’d suggest you not become a therapist.

Thus, if I am a client’s therapist, I can’t also be his employee or his best friend or his soccer coach. This philosophy is clearly foreign to the entertainment industry. Daily of late another idiot confesses under duress to behaving in a sexually inappropriate manner with one or two or 60 people over whom he has had power. These abusers’ power lies in their potential positive or negative influence on that person’s career. Maybe I can educate this industry to end these long-standing abuses of power.

The Harvey Insights

  1. If you are in a position of power over an individual, whether as a movie producer or a mentor or a coach or a boss or a teacher or a parent or a therapist, do not engage in a sexual relationship with that person.
  2. If the object of your interest is 40+ years your junior, let’s assume there is an inherent power imbalance. In other words, date someone your own age.
  3. If you hold meetings in your hotel room and forget to wear clothes, your behaviour may be construed as sexually improper.
  4. If your ungentlemanly sexual behaviour is the talk of the town, be aware that at some point the police may get involved.

If it is too late for you, and you have already made gross (in all senses of the word) errors in judgement, consider that the following are not valid excuses for your behaviour.

The Life-Is-No-Longer-a-Bed-of-Roses Excuses

  1. I was drunk and I can’t remember abusing you.
  2. I was confused about my sexual identity at the time.
  3. I have a sexual addiction. (Sorry, folks, there is no such thing as a sexual addiction, and thus no treatment for this fictitious ailment. Sexual addicts are people unwilling to admit to their propensity to abuse others sexually.)
  4. I thought she consented. (Have you already forgotten that 40+ year age difference and the inherent power imbalance mentioned earlier? Perhaps you’re suffering from age-related memory loss. You might want to investigate that. Oh, and stop flattering yourself.)

Finally, consider that not saying yes may mean no. If you put on your reading glasses, you might better be able to read between those lines, fellas. Don’t miss the oh-so-subtle signs of your subordinate’s fleeing screaming from your hotel room.

Quote: It's not consent if you are making me afraid to say no

Getting back on the therapy horse

Bride trying dress with group watching on Say Yes to the Dress

Since I am expecting a hoard of new clients to swarm my office any day now, I felt it was time to brush up on my therapy skills. I considered reviewing some of the books on my office shelves or going to a family therapy conference or ten, but I’m taking the easy route instead: I’m watching television.

I’ve admitted previously that I have an odd fascination with Say Yes to the Dress, and not just because J. and I both wore jeans to our home wedding. Before I started watching this show, I did not realize that brides-to-be took entourages to shop for the special dress. Makes sense, I guess, to seek input.

I imagined that the bride’s opinion would take precedence in the end. If the bride said yes to the dress, who would care if her mother or best friend or clothing-designer cousin or long-deceased grandfather who spoke through her aunt the medium said no? A lot of people care, it turns out, especially the bride.

I’ve witnessed many a bride crying in her dressing room, afraid to exit for fear of the entourage’s reaction to her choice. Many a narcissistic mother has forgotten that the appointment is actually about her daughter the bride. And many the oblivious father is unaware that his daughter is more concerned with pleasing him than pleasing herself. Because I am a psychologist and not a medium, I can’t speak for the wishes of long-deceased grandfather.

I marvel at the sales associate-cum-family therapist who, while helping the vulnerable bride-to-be find her perfect dress, manages the needs of the highly opinionated crew she has brought with her. Consider this a glimpse into family, and group, dynamics. (Turns out we often play similar roles in groups as we do in our families.) Ms. (or Mr.) Dress-a-Bride manages to keep the entourage happy while ensuring that the bride’s needs are met. This often involves skilled negotiation with widely varying personalities.

Now let’s consider another favourite nap inducer, Chopped. The chefs who participate on this show are a product of their family upbringings, as are we all. There are the only-child competitors who won’t share ingredients vs. the eldests who unscrew their competitors’ unyielding bottle tops, if you believe in that birth-order baloney.

I’ve also learned from Chopped how many adult children are tormented by their parents’ disapproval of their professional choices, despite their successes in their careers. This needing-to-please theme sounds oddly familiar. (See above.) The chefs pray a Chopped win will foster their parents’ acceptance, finally, after all these years. Will these contestants ever understand that what matters most is how they feel about the path their lives have taken and not how their parents judge that path? I fear not, barring help from someone like me.

You too can hone your therapy skills from television shows like these. Who cares how to incorporate cinnamon hearts into an entrée or whether a princess gown or a mermaid would better suit the bride? Focus on what really matters, like I do: how people are getting along.

Once you master the complex dynamic issues in these shows, we can move on to 90 Day Fiancé or even Big Brother. On second thought, maybe not. Even I have my limits.

Necessity is the mother of my Facebook page

Picture of fingers walking on Yellow Pages phone directory

My office phone has been hopping lately, and not just with free cruise offers and other robocalls. I have had a few new-old clients finding their way back to my office. All have come via a few family physicians who used to send me referrals, until I told them I was out of commission five or so years ago. Remember that brief spell when I abruptly closed my office and abandoned all my clients? Yeah, that. And, more recently, my endless moaning and groaning about missing my work? Someone has been listening to my internal pleas.

Yesterday I met with a client I hadn’t seen in 10 years. She somehow tracked down my number and gave me a call. I realized, upon checking the old file, that she’d initially been referred by one of these family physicians. After our session, I asked the client for written permission to send the doctor summarizing our contact. It would also be a way of telling the doctor that I was not dead.

I scripted a quick one pager. After the half hour it took me to recall business formatting, and the additional half hour spent printing an envelope, I finished the letter and dropped it in the mail. As they say, she who hesitates forgets.

Upon awakening this morning, I realized that I’d omitted my letterhead completely. No address, no phone number, no email address, nothing. If the doctor wanted to contact me, she’d be completely at a loss, unless she’d recorded my number somewhere or had held onto an old business card. How long do you hold onto someone’s old business card?

I am an idiot. When I told J. what I’d done, she said, “Are you sure you’re ready to go back to work?” That seemed a bit harsh. I’ve been doing the odd bit of therapy, but I haven’t scripted a business letter in five years now. I forgot how it’s done, but I believe I’ve learned from this experience and will never forget to include my contact information again. Tomorrow, in my I’m-still-alive notes to other family physicians who’ve recently made referrals, I’ll most certainly include a business card or two.

In my panic this morning, though, I asked J. to google me. Googling myself would force me to accept I’m invisible on the internet, and I don’t need that humiliation. She did a search, and found my telephone number from an office I left a decade ago. I couldn’t believe my current work number of 10 years was completely absent on line so I was forced to google myself. I discovered that a) I really am invisible; and b) my current number and my old number are equally represented. At least clients seeking me have a 50/50 chance of choosing the correct number. Perhaps I shouldn’t have been so quick to cancel my Yellow Pages account.

I need to create a web presence pronto. For now, I am creating a business Facebook page, complete with my correct telephone number and email address. I hope potential clients are able to find the right Annie, since there are two Annies with my last name on Facebook. FYI, in case you can’t tell from the picture, I’m not the Annie from Fresno, California.

Siri, do you seriously think you could do my job?

Cell phone displaying, "What can I help you with?"

I have nothing against modern technology. I save a lot of time banking on line rather than going into my branch. When I run into the grocery store for a few things, I check them out myself rather than waiting for a cashier. Driverless cars may scare me but I’ll likely die of natural causes before they take over the road.

Nonetheless, when Siri recently threatened to horn in on my territory, I took offence. C’mon Siri, what are you thinking? I’m grateful that, if I choose to, I can ask you the weather or directions to the nearest bakery. I’m sure you could tell easily me when the Roman coliseum was built if I cared to know. You might even be able to help me not to overwhip my egg whites, and to determine the best oven rack for my baked goods. More power to you.

But counselling? Really? Will I have to listen to your annoying computer voice for a full hour at a time? I realize that Employee Assistance Programs and even some real clinicians are experimenting with newer modes of communication with their clients, ones that do not involve sitting in the same room facing one another. Clients text and email their therapists these days, but I want to believe they do so mostly to book or cancel appointments, not for the therapy itself. Then I heard of someone who participated in counselling solely through email–he never met the person who was helping him. Is this negligence or am I just old fashioned?

Could you really address my most vulnerable problems, Siri? How will you grasp inflection and intonation and other subtle aspects of language? What about all the things I don’t say, that I communicate solely through my body language? You’ll have your work cut out for you, Siri.

Since I haven’t been to see my therapist for a while, I thought I’d try Siri out for myself. I started with, “Hey Siri, I’m feeling blue.” Siri responded appropriately, “Sorry to hear that.” When I said it again, she said, “I would give you a foot rub, but I don’t have hands.” Whoa Siri! If this whole therapy thing is going to work, you’ll need instruction in maintaining appropriate physical boundaries with clients. When I told her I was feeling sad, Siri said, “It’s your party…you can cry if you want to,” which I didn’t find that comforting. When I asked Siri if she ever got sad, she said, “This is about you, not me.” Touché, Siri.

I’d like to think I have the upper hand on that whole clinical-intuition thing, Siri. Knowing when to push a client and when to back off, when a client is holding something back and how to help them let me in, and most importantly how to help a client feel comfortable and safe. And you, Siri?

For now, I’ve decided not to feel overly threatened by your plan to expand into my territory. You’ll need some time to get up to speed, and I’m not sure you’ll ever master the tough stuff. I hate to dash your hopes, Siri, and I know my services may cost a little more, but I think I’ve got you beat for now.

 

Respecting privacy: a case example

Have you heard of Elements Calgary (formerly Calgary Association of Self-Help)? Elements provides support to people with severe and chronic mental illnesses, including people who are under long-term psychiatric care. They may have schizophrenia, severe depression, bipolar disorder, or some other debilitating mental illness. These people are often poor or have unstable housing, and sustaining employment, whether temporarily or permanently, is often beyond reach.

Elements provides a warm, supportive environment where these people can socialize with others and access services. They have access to mental health counselling, life skills and vocational training, and opportunities for social interaction.

I have never been disabled by my supermarket-variety anxiety the way these people have been by their malfunctioning brain chemistry. I admire them deeply for plugging along despite their mental-health challenges, and I’m relieved that agencies like Elements are available to them.

PALS visits Elements once a month. Jelly and I have signed up for the Elements visits for several months now. We have met many of the regulars at Elements. These people are often unable to care for a dog themselves, so they’re always grateful for a visit with a PALS dog.

Jelly and I went there yesterday for the first visit since June and were greeted by many familiar faces. One fellow was especially pleased to see PALS. Mr. Success Story shared that he was doing so well he was readying himself to return to the workforce. At one point, his illness interfered with his capacity to work, but he had made great strides in recent months with Elements’ support.

Mr. Success Story wanted us to know how much Elements, and the PALS visits, had helped him through his darkest period. I imagine that he is still alive because, when he was at his lowest, he found an accepting place where he could go. He realizes that physicians and mental health workers may refer clients to Elements without fully appreciating the good the agency does. He plans to find a way to get the word out through social media.

As you can imagine, there are strict privacy rules in an agency such as Elements. We certainly cannot share people’s names or identifying information, and I’ve been so vague that you could walk by Mr. Success Story on the street without realizing I was speaking of him. I wanted to share his story nonetheless because I was moved by it.

The same privacy rules do not apply to us: PALS members are shameless about having our pictures taken. Not knowing this, and wanting to respect our privacy, Mr. Success Story kindly asked the PALS volunteers (human and dog) whether he could take photographs during the visit. I may not like looking in mirrors, especially the side view, but I will pose for a PALS picture with Jelly without hesitation. If Mr. Success Story felt that those pictures might help him to garner publicity for Elements, we’d be in there like a dirty paw. “Snap away!” I said.

Best of luck, Mr. Success Story. You deserve all the credit for how far you’ve come. I’m glad Elements was there to help you along in your time of need.

So much for fresh-picked apples and honey on Rosh Hashanah

Very run down country home, holes in roof and walls, abandoned

I have an annual ritual before the Jewish New Year. I go to the market the weekend before the holiday and buy the best fresh-picked apples I can find for dipping into honey. This year my favourites, the crispy tart Macs, are in season. I had a busy weekend with few windows of opportunity but I thought Sunday afternoon was clear.

It wasn’t. Remember last year when I thought I’d found the house of my dreams but we who hesitated were lost? Since then, we’ve continued to keep our eyes open to homes in our neighbourhood. We have a very specific set of criteria and a price range, and when a house comes up, we’re checking it out. We are frequent attendees at open houses.

So far, we haven’t had much success. Each home we’ve viewed has been wanting: a bedroom short, yard deficient, run down, overpriced. J. loved one recent listing beyond our price range so much that she rushed out to buy a lottery ticket. She said, as she always does during her semi-annual lottery-ticket purchase, “We’re good people. We deserve to win the lottery, don’t we?” She wasn’t even hoping for the jackpot, just a few hundred thousand dollars to cover us. Guess how that panned out?

Sunday afternoon, smack in the middle of my scheduled apple picking, a home that looked absolutely perfect was open for viewing. The listing said it was the right size at the right price on the right street. Pictures suggested it had a nice yard and a spiffy kitchen and three decent-sized bedrooms. The separate entrance with stairs to the basement would even give it office potential.

(Did I happen to mention I have not one but two clients scheduled this week? Maybe if I worked a little more, J. could stop buying lottery tickets.)

Reluctantly, I set my annual apple buying ritual aside. Off we traipsed to check out the house, showing up at 2 p.m. alongside the realtor. The crowds were eager to enter as he changed his “Coming soon!” sign to “For Sale”. But J. and I weren’t waylaid by his tardiness: we went straight to the backyard first.

Somehow the gorgeous photos didn’t capture the many doggy deposits and the ashtray overflowing with cigarette butts. While we were watching our step, we met the friendly furry depositor, who’d been left at home to greet potential buyers. Had we only known it was a dog-friendly home, we’d have brought Jelly, who would have loved a tour of the home, especially if it involved racing around after the four-legged resident.

I regret to inform you that those gorgeous interior pictures must also have been Photoshopped. The inside of the home was in shambles. Counters were filthy, appliances were dented, blankets were strewn around couches, toothpaste dotted the washroom floor. I could go on, but I’ll spare you. Because I am infection prone, we didn’t linger.

Our look-and-dash left me time to go marketing, but my hopes were so profoundly deflated that I needed the time to mourn. All is not lost, however. Maybe the next house will be perfect, even without Photoshop or a lottery win. They say you’ve gotta kiss a lot of frogs….

The sun will come out tomorrow.

Quote: Here, take my advice, I'm not using it.

I was not surprised when I found the newspaper on the landing the day following the muffin pickup. Even better, Mr. RAK wrote a note on it, thanking us for the muffins and signing it with his name. Thank goodness at least I can call him by name next time I see him.

Did you know that yesterday was World Suicide Prevention Day? Neither did I, until I read a story on the news. Suicide seems as good a topic of discussion as any, don’t you think?

I recently saw a client who was chastising herself for feeling down because there were so many people around her dealing with much worse. She kept telling herself she had no reason to be depressed because her road was relatively easy. Can you hear her completely devaluing her own experiences and feelings? Why do we use others’ challenges as the benchmark for how we should feel? I do this all the time, and I should know better.

What could I do for this client but give her heck, gently of course. (I realize I was telling her to do as I say, not as I do. Please don’t tell her.) Who cares what other people are confronted with? All that matters is what’s on her plate and how she feels about it. If she was finding her challenges overwhelming, she needed to respect and acknowledge that. Then she could find her way through it.

As our session was ending, I asked her whether she felt it helped at all to talk. Her response was lukewarm, with reason. I didn’t say anything she didn’t already know, and she had no great eureka moment. She left the session looking as down as when she had arrived.

We all have bad days. I can wake up in a funk and have trouble pulling myself out of it, but thankfully my funks are usually short lived. The distraction of exercise and dog walks are probably my best funk abaters. Because of my own experiences, I appreciated my client’s despair, and wished I could have helped her more. By session’s end, I worried I had let her down.

This client contacted me the next day. She wanted me to know she’d woken up feeling a bit better. I was relieved for her and grateful that she’d contacted me. Clients are more likely to call when they’re feeling distressed than when they’re feeling better. I welcome the distressed calls, but I love the happy calls.

I often worry about my clients. When they come in feeling down and leave feeling downer, I fret the most. But I can’t forget that people are resourceful, and usually those who leave my office feeling the worst arrive at their next session feeling remarkably better.

So next time you’re feeling down, I ask you to trust that tomorrow, or the next day, or even the next week, will be better. Give yourself time to muddle through, and get help if you can’t do it on your own. If you don’t feel comfortable talking to a friend, call a crisis line or get yourself to the hospital. Whatever you’re struggling with, suicide is a crappy solution.

Dr. Whatever, for now

I write you today with some trepidation, knowing that I will lose at least my favourite follower because of the subject matter. After the last post I published on gout, J. informed me that she would stop reading my blog if I wrote ever again on this subject. Her point was valid, but I can’t just make this whole saga go away. I have provided due warning for what follows.

Lost readership or not, I know you’re dying to hear about my visit with my new specialist on Friday. I told you the appointment was upcoming, I solicited creative doctor names, and now I have to tell you how it went. I’ve said before that I’d never leave you on tenterhooks, mostly because tenterhooks sounds painful.

Dr. Whatever–I’ve not yet committed to a name–was lovely and thorough. She reviewed my medical history, and then completed a physical exam, bending all my joints this way and that. She questioned me about joint stiffness because deposits are inevitable after prolonged high blood levels of uric acid. I may be uptight, but I am not stiff, I told her. “It must be the yoga,” I said.

Dr. Whatever informed me that I might be surprised to notice my joints moving more freely as these deposits disintegrate with the help of my magic pills. I couldn’t help but ask, “Will I be less clumsy?” She laughed at this question, which was probably her kind way of saying no, you will forever be a klutz.

Then she took a look at my not-so-little inflamed finger, the one that has been haunting me for weeks now. It is much improved but the progress has come to a halt of late. Because it is still so “angry” (her word), she would like me to get a teeny weeny ultrasound to determine what’s going on under there, and to rule out an infection. In fact, she seemed somewhat alarmed by the inflammation. Depending on the results of the ultrasound, she may enlist a plastic surgeon to fix me up once and for all.

I am sharing this information with you because I’m imagining that this intervention may make it difficult for me to type my blog, unless I can recall the two-finger typing that got me through graduate school. Like any good therapist, I’m providing ample warning of my unavailability so you can find other vacuous ways to fill your time in my absence.

Premature baby undergoing ultrasound on headThis little surgery, if needed, may not happen until August, however. One of the few downsides of public health care is that a doctor’s sense of urgency may not result in an immediate appointment for assessment. My attempt to book my “urgent” ultrasound resulted in an appointment three weeks hence. But I understand. I imagine there are many preemies in line for those teeny weenie ultrasound machinies. I will gladly wait.

Boy, J. is going to have no idea what’s going on in my life if she ditches my blog. You old faithfuls may have to fill her in.