I have started a sister blog to this site (pen-and-inkblot.com) that combines my interests in psychology with creative writing. Since many, if not most, novels and memoirs contain elements of psychology, I think this will be a good marriage. Check out the new blog and see if you agree.

My post there on the nature of change was inspired by the leaps made by some of the clients I’ve worked with. I recall one young woman who seemed to have everything against her. She had severe health problems that kept her confined to her home, she was very obese, she was depressed and highly anxious, and she smoked heavily. And she despised all those things about herself.

I suggested we tackle one problem at a time, but she wanted to change everything. By the third session, we had found the perfect strategy to help her focus her efforts. By the fourth session, two weeks later, she had stopped smoking, she was walking 2 1/2 miles a day, her physical symptoms had abated, she had started attending church, and she had begun losing weight.  She hated her situation so much that, when she found the right cognitive strategies, she used them as a springboard toward change.

One important strategy she used was seeing each healthy choice as a gift to herself rather than a punishment or deprivation. It isn’t a magic bullet. It won’t work for everyone, but it was great for her. Each of us will have to find the tool that fits us well.

Any feedback on this blog or the new one will be appreciated.

Recently a client asked if I use cognitive-behavior therapy (CBT) techniques. Yes, I do, if that is the strategy that seems appropriate for the client. Those CBT strategies are encouraged by insurance companies because they have been shown by research to be effective for certain problems. This modality uses left-brain techniques based on logistical thinking and the ability to verbalize. Emotions are seen as the antithesis to the client’s healing, the cause of his symptoms, the enemy to be overcome.

My clients have shown this thinking to be far too narrow. By using their right-brain strengths–imagination, emotional energy, and intuition–alone or in conjunction with left-brain thinking, they have made rapid progress. I recall one client who amazed me with her power to heal.

She was not a likely candidate for therapy. She was developmentally delayed, had been adopted into an abusive family, had little formal schooling, and, now in her late sixties, had been living in a nursing home for years. She’d suffered a stroke at some point long before I met her and, although she had no difficulty walking or using her arms, she had never regained her ability to speak. She could comprehend what was said to her, but her spoken vocabulary was limited to “Yeah,” “No,” and a repetition of the last word or two of what was spoken to her. Despite these limitations, she had managed well in the nursing facility.

Nursing home staff called me in to work with her because one afternoon she began wailing in the dining room, then raced out, and hid in a corner. Without speech, she couldn’t explain what upset her, but she was agitated, refused meals, and had disturbed sleep after that.

I met with her a few days later. By asking yes-or-no questions, I was eventually able to discern that a new resident strongly resembled a sexual perpetrator from her childhood. She was now flooded with memories and nightmares. Using relaxation techniques, I was able to calm her. I then used right-brain techniques I’ve developed to help her use her imagination to defeat the perpetrator.

She radiated joy and relief after our session. Although she couldn’t verbalize her gratitude, she gave me a hug and scooted away. For several years I met with her from time to time and confirmed that she remained symptom-free, able to eat in the common dining room, sleep peacefully, and live without anxiety. She is truly one of my remarkable clients.

Cognitive therapy is perfect for some clients and for some problems, but not for everything and everyone. I don’t have the time or the money to organize huge, random studies to “prove” right-brain techniques work, but my clients prove it for me over and over again with their resiliency and creative strengths.

Today I was reminded of a long-ago client who had broken her foot. It never healed properly and, despite surgery, she would no longer able to do long-distance running. We discussed her deep sense of loss and frustration and we worked together to put her disappointment behind her, but, after weeks of therapy, she continued to spend her days hiding in her bedroom, sobbing loudly, unable to eat or sleep or engage in any of the activities she had found satisfying prior to the injury, unable to find pleasure or peace from any source.

Finally I said to her, you have put a crown on your foot because your foot has become the ruler of all you say and think and do. Eventually, this client was able to move forward and discover many things she enjoyed. I applaud her ability to move on and to find alternative sports that were just as invigorating and exciting to her as running had been.

Now, whenever I am frustrated or worried or bogged down, I ask myself where am I putting my crown today? What is running my life and coloring my thoughts at that moment?   If it’s something superficial or negative or from the distant past or about a situation beyond my control, I remove that “crown” and give my power to issues that are meaningful, changeable, and positive.

I am frequently stunned by the ability of individuals to use their minds to overcome longstanding problems. One woman I interviewed as a participant in a research project was experiencing symptoms of posttraumatic stress disorder due to having lived in domestic violence. I asked her to describe the inkblots in the Rorschach Test (yes, they really are inkblots) and she gave responses typical of a battering victim. However, on the fourth blot, she pointed to a small shadowed area near the bottom of the card. “There.” she said, “That’s the Warrior Princess. I can’t believe she’s on there. That’s me. That’s what I could be. I can be strong like her.” The woman stood up straighter, her voice stronger, her presence more powerful.

Now, if I squinted and held the card just right, I could almost see what she was indicating. But I was there only as a catalyst. What mattered was that she could see that blotch of dark and light as a symbol of her potential. It was the start of a journey that led her out of abuse and into a satisfying life.

As an intern, one of my very first clients was Martha C*, a tiny lady, middle-aged, about 5’2”.  Now, 5’2” is not extremely short, but this woman seemed very small. She looked at the floor, hunched her shoulders, and wrapped her arms tightly around her torso. Her steps were mincing and her voice a whisper. I got the distinct impression that she felt she deserved as little room in the world as possible.

She came to treatment because she was facing two crises. Her husband, Mac*, had been in prison for two years, but he had called (collect!) every day, cursing and berating her. She had been too terrified to refuse his calls. Now, he was due to be released in a month. To add to her troubles, she’d been bullied at work by an unfair boss, and eventually fired. How would she pay her bills? What would her husband do when he found out she’d lost her job?

I worked with Martha to reduce her anxiety, increase her assertiveness, and improve her understanding of boundary-setting, all seeming without success. We explored childhood experiences. She acknowledged she’d been mistreated, but felt she’d deserved it. She couldn’t see the connection among her many experiences of abuse. We continued to spin our wheels until the day she learned that a three-year-old niece had been molested.

She was furious! And her outrage toward that abuser allowed her to feel angry toward her childhood abusers, her husband, and the bullying boss. She decided to go to court over her job. She also contacted the police prior to her husband’s release about his history of battering her.

“Don’t worry,” a sympathetic police officer said. “If he even threatens you, it will be a violation of his probation. We’ll pick him up right away.”

Her husband was home less than an hour when he threatened to punch her. She immediately contact the authorities. “We’re sorry, Ma’am,” a policeman said. “People can say whatever they want. We can’t arrest someone for that. He’s got to actually do something physical.”

So Martha hung up. A day or two later, when Mac shoved her out the door, Martha called 911 again. “But did he hurt you? A shove isn’t really hurting someone. We can’t do anything about that.”

Soon after, when Mac pinned her against the wall and threatened to kill her, the police officer asked, “Did he leave a mark on you? If he didn’t leave a mark, you’ve got no evidence. We can’t help you. Call us if he leaves a mark.”

The lack of response by the police disheartened and confused Martha. We continued therapy, but she was becoming more and more depressed and hopeless. So I was astounded when she came to the next appointment with her sleeves rolled up, her head high, a broad smile, and a rakish swagger.  What had happened since the last session? Had the police finally come through?

Hardly. After Mac threw a heavy ashtray which left a large bruise on Martha’s thigh, she marched into the police station, showed the bruise, and demanded help. “But he didn’t have his hands on you. He needs to have his hands on you before we can arrest him.”

That did it for Martha. She knew it was up to her to save herself. The next time Mac came at her, she shoved him away. “I won’t be treated like that anymore,” she told him. “You can pack your bags and leave right now.”   When Mac recovered from the shock of Martha standing up to him, he cried and begged to stay. Martha folded her arms and glared. “We’ll see how you are. If you act like that again, you’re leaving.”

She also had appeared in court where the judge ruled that she’d been fired without cause. He ordered her former employer to restore her job. “I don’t want that job back,” she told me. “I just wanted them to know they couldn’t treat me that way.”

I worked with Martha for several more months while I completed my internship. Her demeanor had changed and she now presented as a strong, self-respecting woman. I still had doubts about whether Mac had changed, but I was confident in Martha’s new-found ability to handle the situation with courage.

She had given herself permission to act on her own behalf and to believe in her ability to save herself. In doing so, she’d found more power than she ever thought possible. When I meet friends or clients who don’t believe in themselves, I tell them about Martha and about the steps we took together to reach her strongest self.

*Names and specific information have been changed to protect the identity of these individuals.

During my 16+ years as a psychologist, I have attended countless classes, a multitude of lectures, and many conferences. I learned much. However, I have learned at least as much, and probably more, from the flashes of insight, words of wisdom, and extraordinary coping strengths of my clients, friends and family members. These real-life skills are what I find myself turning to time and again in the therapy room as well as in my own life.

I have always seen the psychotherapy process as a journey undertaken by therapist and client together. The therapist is not a guru with all the answers, but a fellow seeker of solutions. We walk the path together to see where it leads and what we learn along the way.

What I’ve learned is too good not to share. So, without compromising the identity or breaking the confidentiality of those I’ve worked with, on these pages, I’ll share the best of what has come my way.