On the Failure rate of Therapy

therapyI’ve been back and forth about whether or not I want to continue in the marriage and family therapy field. It can be rewarding sometimes when I see families or couples changing in front of my eyes, but a lot of times, I see them leaving the room no different that when they came in. That’s when my self-doubt and insecurity speak up. “You’re obviously a bad therapist.” “You haven’t done anything to help these people.” “Everyone would be better off if you just quit.”

These types of thoughts take a toll on you, no matter how confident you may have been at the start.  It wasn’t long before I found myself desperately searching for another job, one that had nothing to do with therapy. Now, over three months removed, I’m able to see the situation a little differently. I know that, for a lot of those clients, the lack of movement had little, if anything, to do with me.  I was trained as a therapist, not a magician. There’s no magic wand I can wave to make everything perfect. A lot of the work has to be done by those seeking help, not the helper. And if they’re not prepared to do that, therapeutic success is virtually impossible.  

When someone needs help, they need it sooner rather than later, and in most cases, we understand this concept. If we’re carrying a big load, we ask for help before we drop it. If our houses catch fire, we call the fire fighters before it burns down. But when it comes to our most important personal relationships, our minds seem to go blank. We forget that sooner is better than later. We wait until we’re at our wits end and can’t stand the sight of the other person to seek help. At that point, there’s little that can be done. The window of opportunity is nearly closed.

Other times, people try therapy just for the look, not for the benefit. People in this category already know they want to end the relationship, but agree to therapy just to say they tried. In a case like this, no amount of work done by the therapist or other party can fix the problem. Therapy turns out to be nothing more than a cover up and a set up.  Without truly motivated participants, there is no room for positive change to enter the relationship. This rule applies inside and outside of the therapy room.  No one person can save a relationship, no matter how determined. This can be a hard pill to swallow for gung-ho types that see ending the relationship as a non-option. They, like me, may see the end of the relationship as a failure on their part, a definitive flaw in their being.  

We are so used to being defined by what we can do, that our self esteem often takes a serious hit when we come across something we can’t do, regardless of the fact that relationships are interpersonal and cannot, in any way, be created, maintained or improved by one party alone. Perhaps when we destigmatize the idea of therapy (which doesn’t have to be administered in an office setting) people will be encouraged to act sooner rather than later.

When things are going well, couples tend to be more social, making their easy love visible, but when things get hard, the barriers go up. They disappear into seclusion, shielding themselves during the most vulnerable and fragile time. That is when we should be reaching out the most, when we’re frustrated, angry, hurt and confused. That is when we should be taking advantage of the rich resources we can find within our parents, close friends, therapeutic professionals and religious leaders. But, because of the shame that our egos make us feel, we deny ourselves the very things we need the most. It’s ok not to have all the answers. It’s ok to love someone, but not know how to make it work. You don’t have to do it alone. It doesn’t have to fail.

 ~Nadirah Angail
Like what you’re reading? Leave me and comment and keep up with my latest by clicking the “Entries RSS” link on the right under SUBSCRIBE NOW.

On Drops and Beams

water dropExcluding my own personal hang-ups, I get discouraged for good reason. I’m trying ridiculously hard to put a drop in what seems to be a bottomless bucket; and people wonder why I constantly question my decision to be in the family therapy profession. As rewarding as it is to successfully shine a beam of hope into a far-off, dark tunnel, the many failed tries have their consequences too.

Like many new therapists, I came into this field with big, naïve dreams of helping people and changing the world with my keen insight, positive words of encouragement and discerning eye. I knew that there were tons of people in tough situations, dying to have some change injected into their lives. So there I stood, smile big as ever, therapeutic needle in hand. But little did I realize the army that I’d need to complete the tasks I’d set out to tackle on my own. One person certainly can affect change, but to step into such a static and expansive grid, teeming with obstacles, booby traps, and “flashing lights” (thanks Kanye) and think that you can be the one to turn it all around is unrealistic. And who should be more based in reality than a therapist? Or at least that’s how it seems.

But how it really is is something completely different. Daily, we go to the office or into the homes and discuss various things with various people. No need to go into depth. Just know that our job is to help individuals and, preferably, families to find better ways to get their needs met. That’s all therapy really comes down to. No matter what someone is doing, no matter how destructive, maladaptive, or counterintuitive it may be, know that it serves a purpose and meets some need that was previously unmet. Humans are just wired that way, to survive in the best and only way we know how.

So, then the task of the therapist is to help them discover other options? “Simple enough. Case closed. Let’s all go home, because once I go in there with this long list of options and present them in an appropriate yet inoffensive manner, the job will be done,” thinks an eager and inexperienced therapist. And in a perfect world, every session would end ten minutes to the hour and there would be no such thing as “no shows.” But in the real world—the one we’re all forced to accept sooner or later— sessions can go on for three hours, clients will stand you up, and the problem that brought them into therapy can be just as present in the last session as it was in the first. Now, is that the sign of a bad therapist? I don’t know. (My answer changes with my confidence level). But, it seems to be a sign of an important fact: We’re up against giants, here.

So many families come from environments that scream to them, in surround sound, “How dare you think you’re anything more that what you see around you?!” From the moment they exit the womb, they have neighbors, friends, teachers, family members, complete strangers and even parents chipping away at their innate potential. (And that’s just on a micro level. I didn’t even mention the macro factors of social issues and government.) Needless to say, by the time they get to us, that beautiful potential has oftentimes been whittled down to a mere suggestion of its former self. Not only that, but they’re encased in communities that too have had the very nature carved out of them. And here I am, trying to put a drop in this bottomless bucket.

For some people, we are the only ones even trying to shine beams their way, the only ones trying to throw out a lifeline. That’s 1hr./week of therapy and 167hrs./wk of the indescribably strong magnetic-like pull of the streets. You do the math. I cannot do this alone. We cannot do this alone. The most successful client’s I’ve seen have had their own cheering sections made up of neighbors, friends, teachers, family members, complete strangers and, of course, parents. (Funny how the same people that pull you down can boost you up.) One of my teachers told me, in a perfect world, therapists wouldn’t exist. The families and communities would fill these shoes; but until then, we need all the help we can get. I wish communities would rally around their youth and infuse them with the tools they need to make it in this world. I wish our society would accept and reflect beautiful images of the people that need it. I wish parents would become competent enough to not set their children up for failure. And I wish people in general would care more and take an interest in the people around them, because one beam and one drop is just not enough.

~Nadirah Angail

 ~Nadirah Angail
Like what you’re reading? Leave me and comment and keep up with my latest by clicking the “Entries RSS” link on the right under SUBSCRIBE NOW.

.