by Monica Ross

Irving Yalom has a book called The Gift of Therapy in which he talks about his experiences as a psychotherapist and addresses the book to a new generation of people practicing the art. It's in my pending read queue, but not one that I’ve personally read yet.

In fact, I haven’t read any other person’s account of their experiences working as a psychotherapist. I simply wanted to go through the exercise myself of trying to describe what practicing the art of this profession is like.

I guess I can start out by saying that I have spent time on the other side of the couch.

It’s important to start there I think because it means that I have a sense of empathy for those going through their own process of healing. I do not put myself above my clients as though I am some sort of expert or authority on the topic of their lived experience.

I am just someone who has had training and practice in guiding people through the exercise of introspection or contemplation with the use of psychotherapeutic tools and techniques.

In terms of my day to day there are mornings or evenings when I go into work alone. I enter the office, turn on all the lights, and make sure the Keurig has water. Then I turn on the characteristic sound machine and lamps. I do any number of other miscellaneous housekeeping things to the make the actual physical space is ready for my clients.

I try to center myself by listening to music typically.

In those alone moments there is time to write, there is time to read and reflect, and to do research. These are the moments of calm and quiet. And as I am sitting there alone in my office in my chair, I may be thinking about my own life or the lives of those I love.

There is the family member with a substance abuse issue I think about. There are the thoughts of friends and relatives who have long passed. I think about the people that have come in and out of my life.

I also think about what I’m going to eat for my next meal or about whether or not I’ll have time to run an errand that day. There are those mundane thoughts as well.

A million different thoughts might go through my head in those quiet moments of preparation. And then there are those moments when I’m not thinking anything in particular at all and my mind is resting. I’m embracing just the moment of solitude itself--grateful for another day.

Oftentimes one of my officemates will come in at the moment and then there is the opportunity for hurried conversation and shared insights about this work or time to vet consultations about clients.

And then invariably a client themselves walks in--my client maybe, or my colleague’s client, and the conversation with my colleague then gets cut short. There never seems to be enough time for those conversations with colleagues that I treasure so much.

From that moment on, I’m in that space where all those thoughts that I had previously that were so focused on the things going on with me, and my loved ones, and my life—all those thoughts--they take a backseat now.

The moment, space, time, and focus is now on my client.

The client who walks in may be one whom I’m meeting for the first time. If so, one of the first questions I ask is—“What brings you into therapy?”

As part of my training as an intern I learned to embrace whoever enters the room at the moment with little to no prior knowledge about them or what brings them there. This was the style of one of the first clinics that I worked at here in Austin. This has since become part of my ongoing style.

In other words, I do not typically look up my client’s gender, age, ethnicity, particular issues as recorded over the phone, and the like. I see a name on my calendar and when that person enters the room I rely solely on their account of who they are in that moment and what brings them to me in that space and time.

There are many reasons why I choose to operate this way. For one, I don’t want to have any preconceived notions about anyone. My preference is to meet a person face-to-face and hear their story by their own account, not for instance by the account of the court as I have had clients who were court mandated.

The demographics part--it is important as part of my client’s operating in the world in terms of the way the society at large views and treats them. But more important to me is how my clients’ view themselves and how they experience the world around them and that I get by their own account not an document official or otherwise describing them.

Being a psychotherapist is humbling. Because here I have been entrusted with some of my client’s most deepest and pressing concerns. They have come seeking a neutral third party and someone who has training and experience in dealing with similar issues.

And for that reason I think of the actual therapy space that I hold as a sacred space. I would imagine a bodyworker or massage therapist might get the same sensation in a way in the work that they do with their clients.

Physicians and other healthcare workers I would assume also get the same feeling. They too are being entrusted and they too are engaged in the process of facilitating healing.

I find that some clients have predetermined notions of what therapy is about having experienced it before and then there are those who have never been in therapy. And so sometimes I answer questions about the process itself in session and sometimes clients find the answers themselves through the experiencing of it.

What I find time and time again though is that all those concerns that I may have had walking into the office are no longer there when I am with that client because I find myself so absorbed in how best to listen and how best to attend to their needs.

Some see the role of the therapist as a passive role. They view a therapist as a person who just sits and listens without saying much at all. Some therapists may work this way. I find myself more active.

I do the work of how best to make connections between my client’s thoughts using the information they present me with. I search for how best to throw out ideas and alternative ways of looking at things to assist them in their process.

I do the work of listening most of the time, sure. But I also track my client’s dialogue and offer ideas about things that occur to me based on my education and training and personal knowledge and experience and tools at my disposal.

The process is relational and collaborative. We are there as a team to find the point or points of pain and suffering and to find ways of alleviating them.

I told someone once that I see my role as a psychotherapist as a spiritual practice in a way. By that I simply mean that there are periods of alone time as part of my work, as I mentioned. There are daily rituals I engage in that are part of the work.

I often have to step outside of my comfort zone and am challenged by this work. For example when someone comes into my office and triggers issues that I too may have had or have had to deal with.

There are moments when I am tired and have to push through. There are distracting thoughts that try to enter from time and time and there is always a coming back to this moment in time in the room with this person before me.

When I do this work I feel connected to a higher purpose and to a collective energy. I assist people with transformation and I find myself transformed in the process. I go in with the intention for healing to take place, always. And it often does.

And when that happens I’m not the one that takes credit for it. All of that credit goes to my clients who show up with consistency to do the work.