What do you like most about your job?
As a harm reduction psychotherapist at The Center, I’m grateful to work within a therapeutic framework that I feel connected to, and that simply makes sense. Every client arrives at The Center with his/her/their own story, and through Integrative Harm Reduction Psychotherapy we can create individualized treatment plans to increase the likelihood of clients meeting their own goals. Additionally, being a part of an interdisciplinary team with intelligent, compassionate, and like-minded individuals allows for rich discussions and continued growth, which ultimately benefits our clients.
How do aspects of your “self” factor into your psychotherapy practice?
As therapists, we are often communicating things about ourselves both verbally and nonverbally, and always allow room for exploration of these disclosures. I’d say that my comfort with using myself in the room varies with each client, and in each session, depending on how useful I believe it would be for my client’s progress. There have been times where I have been ill or had a visible injury that required me to acknowledge that something was different. These are moments when my humanness comes out in a different way, which can often increase the connection between my client and me. While the focus of treatment remains on my client, I believe that wounds that were created relationally must be healed relationally. In order for this to occur, there must be authentic communication and intimacy, which allows both my clients and me to take greater risks in the treatment.
Do you have a mantra? Or daily practice?
I maintain regular mindfulness practices, such as meditation and yoga, which help me remain calm and focused throughout the day. Sometimes this just means sitting quietly with a cup (or two!) of coffee in the morning, setting an intention for the day. I also use a lot of mindfulness techniques with my clients to help them remain clear in difficult moments. Whether it’s riding the subway during rush hour or tolerating an intense urge or craving, these practices can be useful. Mindfulness techniques help me negotiate balance between acceptance and change in different areas, which really fits into the Harm Reduction model.
How do you think about space? How do you arrange your physical space or don’t you?
Because I have worked in many treatment settings and with different populations, I have learned to be comfortable doing therapeutic work in many different environments. I find that working with some clients in smaller spaces can be more intimate and containing, allowing for a rich clinical experience. Larger spaces, however, can also allow clients both literal and figurative space to explore difficult emotions and physical sensations. As long as the space is somewhat comfortable for the client, I find that if the therapeutic alliance is strong then the space becomes less important. I don’t like to have a lot of stimulation in the therapy room, but I’ve had clients discuss how they benefit from having multiple things to look at to mitigate moments of intensity of the relationship. I’ve also had client’s request a change in lighting or some other environmental detail, and even if I am unable to accommodate, I appreciate the strength it takes to verbalize one’s needs around space.
Can you talk about a satisfying professional experience?
I’ve done a lot of harm reduction work around suicidality and exploring ambivalence about living. When shifts occur, these cases stand out as being the most satisfying, as I strive to create a space where really difficult, scary thoughts and feelings can be explored. I recently successfully ended treatment with a client who came to me feeling depressed, suicidal, and had a problematic relationship with alcohol. We took time to create a strong alliance, and openly discussed his thoughts of suicide and my concerns about his risk. He believed that he could not move forward until he no longer had suicidal thoughts, and struggled with his competing desires to live and die. Using mindfulness techniques, along with regular risk assessments and safety planning, this man began to accept that he might always have fleeting thoughts of suicide, but they did not have to be all consuming. These thoughts, like other difficult thoughts, could come and go, without getting stuck. As he began to work with this idea and introduce new skills to support it, he was able to increase his quality of life in other areas, such as business, romantic relationships, and personal growth. He worked hard to increase his strengths and skills, which had a positive effect on his depressive symptoms and alcohol use. While he continued to have occasional suicidal thoughts, after a few years they had decreased in frequency and intensity, and he felt confident that he could manage them safely.
Can you share a favorite (or recently enjoyed) video, photo, cartoon, movie, song, etc.?