Reflections on Wellness Series

Therapist in Crisis
Sitting in the emergency room following the dog attack, trying not to feel, it occurred to me how convenient it was for this to happen on a Thursday evening. I had no clients to reschedule the following day. I was grappling with excruciating knee and genital pain amidst the horror of what had just transpired. The physical injuries and trauma were compounded by the dog owner, a psychiatrist, leaving the scene of the incident.

I knew that soon I would have to figure out how to provide my clients with quality care while navigating through my own nightmare. How? Even when life is relatively in sync, at times I wake up and say, "No, not today... I do not want to be a therapist today." Typically, naming my truth, such as momentary resistance to my work, provides enough release to bring me back into focus. In crisis, I found this process to be far more complex.

Presence
I engage in intimate relationships for a living. To honor this gift, my full presence is required throughout the day. I function as a model for interpersonal communication in each unique non-mutual relationship. This job calls for a Wellness column!

During my crisis, the thought of relating on this level was sometimes daunting. I valued my therapeutic presence and intended to maintain that. There was no time or energy for this life disruption. PTSD, however, spoke to me through the language of nightmares, flashbacks and startle responses... the works. I got it: This is happening, make the space for it in order to remain present.

Crisis as Opportunity
I was introduced to the Chinese symbol for crisis two decades ago when I worked as a crisis counselor. A picture I have from that time remains in my office today. The background has shifted from dark to faded pink, but the two black characters remain bold, reminding me of its impact. One symbolizes danger and the other opportunity.

Looking at this symbol did not send me into a flurry anticipating opportunity. My experience and hard-wiring, however, comforted me on a cognitive level. I knew that eventually I would transcend the various aspects of pain I felt. I already walked through the world perceiving experiences as opportunity for spiritual growth; that ought to help. Still, it was a daily nightmare. I encouraged the thinking and feeling centers of my brain to communicate with each other. That went well. It was like the futile "Hello? Hello?" between cell phone users who know they have lost connection. Opportunities mostly crystallized for me toward the latter part of my healing. I am certain that I will discover others over time.

Reasonable Expectations
During the crisis, my "To Do" lists spiraled out of control as rapidly as my hair in humid weather. Semi-manageable lists morphed into scarcely legible scribbles pleading, "Elisa, really, today." Feelings of vulnerability extended to my professional life. I questioned how my practice would be impacted if I could not do enough, but my priority was physical and emotional healing.

So, I stepped up my pre-existing selfcare routine and set limits. I went to doctor and physical therapy appointments, and Eye Movement Desensitization and Reprocessing (EMDR) (which I found to be difficult yet transformative). I consulted about cases to address potential counter-transference, and went to therapy. When necessary, I cancelled client appointments. I put non-priority items into perspective. I informed colleagues to temporarily stop referring trauma and high-anxiety cases. I lost income and risked losing potential future referrals.

I continued to move my body, play, laugh, write and connect with my Jewish spiritual community. Nature remained necessary and so did friendships. My partner had her own crisis and we proactively attended to our relationship.

Despite my losses, I was determined to keep these and other sustaining forces in my life present, even if they could not be uncomplicated. Through the disruption and challenge, I gained clarity and became further grounded in self -care. I believe I transmitted this healing to clients. Keeping my own expectations under scrutiny enabled me to be present for clients to explore their own.

Healthy Surroundings and Clean Air
In order for me to provide a space for clients to heal, I attend to what I breathe in and what I emit, physiologically and energetically. When I encounter judgment or negativity, I metaphorically head for the hills. I conceptualize this as running toward, not away from something, like Maria in the Sound of Music. I like to think that the Castro Movie Theatre sing-along audience, who year after year faithfully shout "Run Maria, Run!" at Julie Andrews, is right there with me with a Jewish spin.

When I began sharing my story, I was reminded that transference is not limited to the therapy room. Projections from others felt as though I was inhaling carbon monoxide. I was given unsolicited advice, void of authentic connection. Some responded with inappropriate jokes, ?What did you do to make that dog attack you?? Others minimized my trauma through the power of language, changing my words ?vicious attack to ?bite. The dog may not have been vicious, but the attack was. The language mattered.

Fortunately my lungs and heart expanded also to receive oxygen. I inhaled supportive words, ?That sounds horrible let me know if you need anything,? and gentle guidance. I breathed in the solid presence of those who sat with me while I sobbed. I opened to\receive protection. In some moments I held compassion for those whose own vulnerabilities blocked them from giving it to me.

I feared I would have less to give my clients, but worked hard to create space for availability. I sat more aware of the gifts of breath, language and presence.

What a Laugh
For me, surviving in this serious field necessitates humor. I cherish my ability to laugh at this work, myself and life in general. Sometimes my partner or I will exclaim, "I’m having Family-of Origin issues," which always invokes laughter. I revel in my trusted relationships with friends, family and colleagues and our comfortable walks along the continuum of gravity and levity. With clients I use humor when appropriate and witness its connective healing power.

I’ll Take It
My life was impacted more than this article contains. Considering the CEU opportunities of life, I would have opted for a different course. Although I did not need this particular experience to deepen my psycho-spiritual process or enhance my clinical insights, I am grateful it did both. I ingest the language and meaning of the bold Chinese symbols. Crisis as opportunity? That, I’ll bite.

Elisa Friedlander, MFT, has a full time practice in downtown Burlingame. She has extensive experience working with children from a very young age up to adolescents, and enjoys balancing youth with her adult client population. Elisa works with parents of children with special needs and disabilities, adults, teens and children with generalized anxiety disorders and OCD, and deaf and hard of hearing individuals. www.ElisaTherapy.com .

Author: Elisa Friedlander, MFT