The Circle of Life (But Really)

I feel like I'm about to get really conspiracy theory, "We didn't land on the moon," adjacent, but lately I have been noticing how it seems like everything in therapy is related back to a circle. Patterns of behavior, reaction, and emotions that we cycle through in every aspect of our lives. One example is the cycle of anger:

Example A, the Anger Cycle, provided by Therapist Aid.com

The idea of the anger cycle is that naturally, when you get angry, your behavioral response is actually someone else's triggering event.

Here's an example:

I walk into the living room and notice my husband left his socks on the couch (Triggering Event).

I think: He never listens to me. I'm not his maid (Negative Thoughts).

I feel unheard and disrespected (Emotional Response).

I feel my face flush and my heart start pumping (Physical Symptoms)

I rush to the office and toss the dirty socks at my husband (Behavioral Response).

And then from my husband's perspective…

I'm working in the office and Ashley chucks some socks at my head (Triggering Event).

I think: Shit I forgot again! She's so pissed (Negative Thoughts).

I feel dumb, forgetful, and frustrated with myself. (Emotional Response)

I shut down, physically tense, up and my mind is racing with what to say (Physical symptoms).

I yell, "You could just tell me to get them next time! (Behavioral Response).

Y'all can guess what happens next. We yell, over and over again, responding to the anger cues until our fight/flight/freeze response kicks in. I'll dig in, and he'll freeze out. Once calmed down, we'll likely repair the situation, but become increasingly more frustrated that we can't break the pattern.

We're both locked in the anger cycle and continuously triggering the other person into their own.

This idea, that we relate to the people we are close to in cyclical patterns, is not just represented in the anger cycle.

Created by CZ Therapy Group

This example is an illustration on how couples fight from the lens of EFT, or Emotionally Focused Therapy. It suggests that when an "alarm bell" goes off, or you feel as if you are disconnected from your partner, we all react with protective, reactive, or defensive behaviors.

While I might be yelling "Hey! Do you even care?"

He may be thinking, "I can never do anything right."

And thus, the cycle continues.

Lastly, this example suggests that the entire relationship itself follows a cyclical pattern, having seasons of hot, intense love that moves on to eventual conflict, and back again.

The point here is: there is no straight line of cause and effect when it comes to how we relate to other people.

"We split because he was narcissistic."

"I'm mad because she never listens to me."

"I cheated because she doesn't have sex with me anymore."

These are all one-way viewpoints that are valid in their own right, but are never going to be the whole story.

What you receive, and how you react, can set off a chain of events that look and feel like this:

I invite you to start considering your relationships with others as a constant feedback loop. Every action and reaction can help unravel the mess, or tangle it further.

Our Silent Goodbyes

Strangely enough, in the social circles of the therapy world, there are taboo subjects that therapists are hesitant to discuss. Setting fees, taking insurance, the validity of certain training, methods of practice, and even where you work can be touchy subjects in this field. It seems absurd that a collective body of highly trained and emotionally intelligent professionals still sometimes fail at the one thing we are supposed to excel at- effective communication.

But alas, therapists are in fact human beings.

We are simultaneously flawed in our human-ness and highly effective at communication in a way that no other being can be (looking at you, AI).

Which brings me to one taboo subject that you often won't hear therapists talking about openly:

How we experience the loss of a client who has terminated therapy.

Let me set the scene from a therapist's POV:

You walked into my office around 2 years ago, in distress and needing some things in your life to change.

Slowly, week by week, we get to know each other. I learn your strengths, your pain points, your family members' names, you childhood dog, your crushes, and your dreams.

We eventually develop a working relationship in which I know you well enough to encourage you, challenge you, and empathize with your pain.

We share laughs, you show me photos of your cats, and I rejoice with you when you land a new job.

You're doing better, you're feeling confident, and you've changed in ways that are immeasurable.

Slowly we space out our sessions. We know that our time together is winding down.

And then, one day, you cancel an appointment. And you don't reschedule.

Pause:

This is where I'm bound by my conscience to say- the client didn't do anything wrong here. They paid for my time, they did the work, they got what they needed from therapy.

And yet, as a human-

I do still think about you.

I wonder how your job is going.

I wonder if you ever broke up with that awful boyfriend.

I wonder if your mom beat cancer.

I wonder how much your niece has grown.

I wonder if you're doing ok.

Unlike that ex-boyfriend, I'm ethically bound to never find your socials, never look you up. I don't know how you are and amidst that silent goodbye, I have to set my mind with the intention of serving the next client.

As a therapist, it is my job to hold space for you, to be locked in and attuned to your needs, to help you process your trauma, and then (sometimes without notice) accept that I will never know the end of your story.

In my feelings of loss, I sometimes think:

“There is no other career where you have to be at peace with being a pivotal person in someone’s life and then never hearing from them again.”

But I am wrong in that, too.

Nurses care for your body and then send you home.

Teachers nurture children and then start anew every year.

Medics see you at your worst and get you to the medical team.

Performers form powerful bonds and then the show wraps.

Our silent goodbye may not carry the joy or finality of a curtain call, but I’m honored to have been on stage with you, and now both our shows will go on.

Oklahoma! The Musical, 2015

Your "Sorry" is a Burden

You read that title right, and damn if that isn't a hard pill to swallow.

Despite my enormous amount of wit and charm, I routinely make observations in the therapy space that are downright painful to say, hear, and bear witness to. Recently, I was working with a couple where one partner's medical disability was wreaking havoc in their daily life.

The procedures, hospital visits, medication side effects, caretaking tasks, and general crankiness that comes with a medical disability are not exactly easy hurdles for a couple to weather through. From both sides, the level of guilt, shame, and stress that are created with any illness can create patterns of communication that are less than ideal.

Just imagine: you're hungry, tired, in pain, financially stressed, and having an identity crisis all at once. Then, sit down and try to have a normal conversation about going to the grocery store with your spouse. You forget for a minute they hate onions, and when you suggest a dish with onions, your spouse (who is also at 0% capacity) freaks out.

THAT is what couplehood is like amongst chronic or acute illness.

It's something I have to normalize for my clients, and myself.

In the same way that the illness is no one's fault, it can also be expected that the medically disabled spouse will take full undue responsibility for it.

Cue: I'm sorry.

I'm sorry our life is like this.

I'm sorry I'm making you so stressed.

I'm sorry I can't be the partner I want to be right now.

I'm sorry, I know this isn't what you signed up for.

Spoiler: I have said all these things to my husband. Yikes.

And this week, I witnessed a very powerful message from the other side of the coin. As painful as it is, the reality is:

Sometimes, hearing I'm sorry is just another burden.

What is the healthy spouse supposed to say to an unwarranted apology?

Yeah dude, how dare you get sick?

I accept your apology for the thing completely out of your control?

Saying I'm sorry when you're dealing with illness is just another way to punish yourself. It's another way to put people at arm's length because it cements your position as a burden. Saying I'm sorry for things out of your control is a trap of your own design, and both of you get ensnared in it.

The reality is that your spouse is already watching you physically suffer. Imagine the helplessness they feel when your mental health and self confidence wither as well.

Here's my new commitment, and I hope it inspires you to make your own.

I am no longer sorry. I am thankful.

Thank you for being here.