I cried. In session.
It wasn’t a full-on ugly cry, but it wasn’t simply tears welling up in my eyes, either.
In nearly 10 years of listening to people’s stories, I’ve never cried in front of a client. I’ve come close. I’ve cried many times after a session. I’ve cried at night, alone, thinking about the suicide, or the cancer diagnosis, or the childhood abuse or the self-injury my clients revealed that day.
But I’ve always held it together during sessions.
My client, a new one, barely said hello and dodged my eyes as I picked him up from the lobby and walked him back to my office. He sat down and began crying before he even spoke. He had cried on the phone setting up the appointment so I knew a little about the backstory. By the time he told me the full story, he was sobbing – the kind of crying that forces you to gasp for air between sobs, and is accompanied by both shaking shoulders and a runny rose.
And I began crying too. His story hit me. Hard.
I apologized right away, of course. Counselors aren’t supposed to cry! We are supposed to be the strong ones, the omniscient sounding boards for everyone else. It’s a lesson I learned in grad school, and was pounded into me during my 3,000 supervised clinical hours from various experienced clinicians: check your own emotions at the door before session.
We. Can’t. Get. Emotional.
When I apologized to him, he thanked me – thanked ME – for being real. And not a robot. I was sure he wasn’t going to come back, sure that I blew it for him. But he has. For many sessions. (And no, I haven’t cried since.)
Like my client reminded me…..counselors are humans…..we are not robots. Let’s be gentler with ourselves. It’s ok to be real and be genuine with our clients, and most of all….to show our own emotions.
A family came to me with their 17-year-old son, who was running – not walking – through every house rule. He wasn’t checking in with his parents as they requested. He was dabbling in substances, coming home high and/or drunk, well past his established curfew. Grades were suffering. The problems were many, the parents had lost control and all three were sitting on my couch, the parents in tears and the son, smirking and visibly high (unbeknownst to the parents).
“Sounds like a good time for a behavior contract,” I told all three.
A tool I use in my practice, and use often, is helping families write and implement behavior contracts. I have used behavior contracts with parents of tweens, teens and adult children (ones living at home as well as those living on their own in a college setting, or ones that have recently returned home after treatment).
Why a behavior contract? There are many reasons:
- It lays out expectations so there is no one saying “I didn’t know” or “You never told me that.” An example of this would be “Curfew on weekday nights is 10:00 p.m.; curfew on weekend nights is 12:00 a.m. sharp.”
- It keeps everyone accountable for both actions and consequences. i.e. failure to comply with stated curfew times will result in an immediate 48-hour phone surrender; there will be no video gaming when any one grade drops lower than a “B.”
- It sets boundaries – in writing for all parties involved to see – whereas prior to the contract boundaries may have been loose, or in some cases, non-existent: “There will be no smoking marijuana, vaping or drinking.”
- It clearly defines anything and everything that needs definition and clarification “you will be allowed to drive the Honda to and from school, and we will provide gas money, but any other driving beyond to and from school needs to be approved by one parent in advance.”
Behavior contracts are not completely punative; they can offer rewards – “six months of clean drug tests and your curfew will change from midnight to 1:00 a.m. on weekends.” or “we would like to host your friends over at least twice a month and we will order the food of your choice.”
The most important point about behavior contract is this: make sure you are willing to follow through with what you put on the document. For example, if you are not willing to drug test your child every month, and implement consequences for a failed test, then don’t put that on the contract.
I have firsthand seen many successes with behavior contracts. They are an excellent way for kids to earn back trust that’s been lost, to prove responsibility and for parents – to rein back control in areas where it’s been lost.
I started writing this “Private Practice Chronicles” series two years ago when I opened my practice. It was a way for me to write about the ups, downs and everything in-between. My chronicles of PP have been some of my most-read blogs, and it’s been fun for me to re-read them to see how far I’ve come in a relatively short period of time.
I’ve written about my mistakes here and here. Looking back over the last two years, though….well, I know I’ve made mistakes but, dang, I’ve also done a lot of things right. So today, I’m sharing six things I feel I’ve done well:
- I don’t try to solve everyone’s problems – When I first started out, I felt immense pressure to fix everyone and everything that walked through the door. That’s what a good counselor does, right? WRONG. I know here are some things that are simply not fixable. The only thing that can change is the level of acceptance in the client, and my job is to help them get there anyway I can.
- I set boundaries – Of course, I’m admittedly still a work in progress on this one, but I’m getting much, much better. I’m not answering every email or phone call or text that comes through on the weekends (or all hours, for that matter), and I end my last appointment of the day at 7:00 p.m. (I used to take 9:00 pm appointments, even on a Friday)!
- I keep the hustle up – Just because your practice starts taking off doesn’t mean you can sit back and rest on your laurels. I am constantly marketing myself and thinking of new ways to get new business in the door.
- I screw up – and own it. Double-booked clients? Been there. Called a client by another client’s name? Done that. Completely forgot about a business meeting I set up with someone I admire who squeezed me into his busy schedule? Yup, that’s me. I’m a human being. I’m imperfect. I never make excuses for my mistakes, I can only own them, apologize, then do my damndest not to repeat them.
- I stick to my guns – People told me to take insurance (I don’t). People told me to see everyone that walks through me door to grow my business (I don’t). People told me to take on a partner (I haven’t). People advised me to take on business contracts that, while lucrative…..would be the only reason why I was doing it. People told me to do lots of thing that, in my gut, I knew weren’t right for me or my business. It’s your practice, to run your way – not anyone else’s.
- Listen to others – Contrary to my previous point, there have been times where I have sought out advice from older and more experienced clinicians in private practice. Something a colleague said to me has resonated with me since my early days. We were talking about marketing and he told me he doesn’t spend a lot of time or money on it. Why not? I asked him, almost incredulous at his answer. He said this: “I spend my time reading and learning and just trying to be the best therapist I can be for my clients, and when I do that, I find that my business grows itself.” He has a successful practice, and this statement of his is true on many levels.
So there you have it, the six things I’ve done well. I’d love to hear from you and what you do well in your practice. Keep going and keep growing.
Dear Addiction Client,
I am writing to tell you a few things that were on my mind after our last session – actually, things that have been on my mind since the first time you walked through my door.
I can always tell when you are lying to me. Believe me, I’ve heard it all. You’ve been lying to yourself for so long that I know at this point, even you may believe the stories you tell. But I don’t. And the people around you that know you even better than I do better don’t believe you either. Beginning with the truth is a first and crucial step on your journey to recovery.
Show up for your appointments. You are wasting money if you don’t show up. And show up consistently, and on time. The only way you are going to get better is with consistent and continual therapy. Showing up for appointments holds you accountable, and forces you to be responsible.
Oh, and besides the importance of showing up for appointments……don’t show up high. Truly. Just don’t. It’s not funny, or cute or anything else. It is disrespectful to me and my time. And it is disrespectful to you and your time. You’ll never get anything done in that session – anything that you remember. Plus, I’m not going to let you drive home so besides the money you waste on the hour of therapy….you’ll also have to have an Uber to drive you home, or someone come pick you up.
If you were voluntold to come to therapy, that’s ok. Don’t be angry about that. Someone in your life loves you and is desperately trying to get you the help you need. Be glad there is someone that still cares enough about you at this point to try and get you some help. Because trust me: soon, if you don’t get serious about your recovery, they will get to the point where you will lose them forever. And they’ll be gone. Think about that while you complain about them to me. Picture your life without them for a
No one is going to do the work for your recovery. That comes from you. Not me, not your mom, dad, grandma, grandpa, aunt, uncle, daughter, son, girlfriend, boyfriend, cousin, neighbor, Pastor, Rabbi, partner, friend or spouse. You will most likely have the support of one or more of those people I just named, but you and only you are responsible to do the actual work. Period.
Do I sound like I’m being hard on you? I am. I want to help you, and I want you to get better. I wouldn’t be doing my job if I don’t call you out from time to time. I know you are hurting. I know addiction is a beast to overcome. But you can fight it. I’ve seen people fight tooth and nail for their recovery. It’s possible. Anything, anything you want….it’s possible if you want it bad enough.
Recovery can happen. It can. I know you don’t think that now, and it feels like everyone is against you and the world is a hopeless place…..but stick with me. I believe in you. I know you can do it, you just gotta dig down deep and do the work. I have seen nothing short of many miracles in the time I have been working with people in addiction. I’ve seen people hit rock bottom and come back stronger and better and totally opposite of how they were before.
I can’t wait for you to re-read this letter once you’re in recovery. Do me a favor, and let’s read it together. It will be the biggest gift to me as a therapist, to see how far you’ve come.
Thanks for listening. You mean a lot to me, and I know you mean so much to the people in your life. We all want the best for you. Nothing more, nothing less. Just the best.
I’ll see you next session.
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