Hands by Carol Kastx

Sitting with Dukkha

– Photograph by Carol Kast – 

I sit day in and day out, year in and year out, with client after client — their pain-anguish-anger-fear-rage. You name it. That’s why they come to me. They’re hurting. They wouldn’t bear their soul and shame to a stranger if it was otherwise. Yes, there are the veterans of therapy who include it as part of their self-help regime, but they are in the minority.

I hold still. Okay, relatively still. Sometimes I fight with my restless legs and restless heart. But I keep my seat, my composure and my interest. Okay, sometimes I restrain my yawns. Though I might have the impulse, I’ve never run out of the room screaming. Instead I know this feeling as counter transference. Most of the time I make a note to myself to later contemplate what is driving my strong reaction. What is from my history, what is the client’s unacknowledged or not yet integrated angst. What is the soup containing each, along with other ingredients? I can’t imagine how I would be able to do this without on-going experience of holding my seat in meditation.

I’m careful with my speech, attempting to state only that which I think will help. Of course, what we think helps depends upon our therapeutic orientation. And varies with how we’re doing that day. Oops, I hope I didn’t reveal something secret? I’d like to believe I’m a consistently good therapist, though my immersion in Buddhist teachings informs me otherwise.

I’ve touched upon the three marks of existence in Buddhism, though not directly. The first mark of existence is that there is pain in this life. No one gets a free pass, though our struggles take many different forms.

We’ve experienced a lifetime of all kinds of personal pain, hurt, trauma and stress, though in our professional role we need to set this off to the side. Sometimes it overlaps or is mirrored by that of the client sitting in front of us. That’s when it gets hard. A lot to watch out for here. The easy tendencies to project or introject our pain can contaminate the therapy. That’s when we need to hold our seats and sometimes our tongues.

Also, when we successfully set aside our own distress, it’s tempting to delude ourselves that we’re above or beyond it, and this presents a different risk. It’ll likely come out the side door. We best later, in a different context, explore our pain, soothe it and heal it.

The next mark of existence is hard to understand and is continually misunderstood. Who I am shifts and changes. There is no consistent me who walks into the the therapy room each Wednesday at 3pm to see Jennifer. Yes, I’m a seasoned therapist, and hopefully somewhat consistent in my perspective and intervention. But underneath that my inner world is shifting and changing.

Herein lies a skill we develop. How to hold both at the same time. Neither rigidify into a therapist role and be unable to meet each new client and each situation creatively. Nor morph into murky boundaries, contradictory interventions and an unreliable relational stance.

“I need to take a pause and look in the mirror to realize what I look like now” says a new friend of mine in her late seventies. It’s like that. How I appear on the outside often doesn’t match how it feels inside. I count on this in my work. Otherwise I’d need to cancel sessions more often than I do. I, too, fluctuate between states of wellness and angst, integration and confusion. I am not only the wise, evolved “know-it-all” professional that some clients project unto me. Nor the incompetent asshole that others imagine me to be, likely to distract themselves from who they fear they are.

That’s the third mark of existence. Things change. Influences outside of ourselves are fluid, dynamic, bleed and blend together. Not just our therapist self, but also our clients. The good news is this is what allows for growth, new understanding and healing.

Potential clients reach out to us because they can’t bear it alone anymore. Sometimes I think of this as the fourth mark of existence. We need one another. Being cared about by another helps. Even when the source of the pain remains.

Nelly Kaufer, LPC

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