How Can I Help You?

How can I Help You? Finding and using your best self  Psychology Today Post published 10/27/14

selfieI do not make my bed every morning. In fact, at the risk of alienating a large majority of my clients and colleagues, I admit I hate to make my bed unless I’m having company over. Even then, I resent it a bit. I resent that every so often I feel pushed by the inconsequentiality of worrying about what others think of me. I’m almost over that.

I do not believe in Botox. While I certainly understand the appeal, and confess I am secretly jealous of my peers who look 10 years younger than me, frankly, it skeeves me out. On a couple of levels. First and foremost, I’m not a fan of injecting poison into my face. It scares me. Secondly, I try diligently to remain true to my family’s legacy of aging gracefully. Without pretense. Without judgment. It’s not easy, but I have stunning role models.

I choose not to follow recipes. Too many instructions, I suppose. Too precise. A little bit of this, or too much of that, has always made more sense to my brain than whatever a teaspoon actually represents. It has always felt so arbitrary to me. There is too much sugar, for my taste. Never enough salt. After all, what really matters is how I want it, right? Fortunately I trust my instincts. I try hard to be true to myself and what I want or feel like I need. Whether I am creating in the kitchen, or afraid to get on that roller coaster, or feeling obliged to take a stand and voice an opinion. I can’t say I don’t push myself past my comfort zone, I’ve been known to do that. But generally speaking I tend to be comfortable with my choices, even when they are unpopular or anxiety-driven.  I am, simultaneously (depending on the context), both an agitator and a follower, outspoken and deferential, self-confident and apprehensive, enlightened and traditional, content yet hungry for more. Often, it is these very paradoxes that unsettle a postpartum woman who is grappling with her fragile self-esteem. This is when I remind her that it is, indeed, these absurd contradictions that make all of us interesting and dynamic. And that you can, in fact, be both competent and symptomatic at the same time. This phrase can be life altering for some postpartum women trying to reconcile the incongruity.

I do not work well with deadlines. I cannot stand the pressure. In order to avoid that, I was always the student who finished the 10 page paper a week early.  While my classmates were cramming for an exam, I was one of those nerds who spent the weekend in the library preparing for it so I could shun the last minute pre-test panic. Honestly, I still panicked, and never felt quite prepared, but always convinced myself that earlier was somehow, better. Now, when I have a book deadline for March, I’m done in January. I push and push at the outset, in order to avoid the last minute crunch, which I imagine would create incomprehensible cognitive and emotional disintegration. So I steer clear by racing ferociously against my own random cut-off date.

I am not a fan of research data.  First of all, it is hard for me to understand. It’s the wrong side of my brain, I say, when I am too lazy to try to make sense out of it. Abstracts always remind me of Cliff Notes, which always felt like cheating, so I do my best to find the article in full. Then, I am ridiculously lost and remind myself that it’s okay to be totally inept in this area.  In the end, I do not believe that rigorous research is as rigorous as sharing the space with a woman enslaved by shame and hopelessness. While I understand they have a place in both the academic and clinical world, I do not think statistics should influence our work as much as they do. Rather, the words that are uttered and the stories which unfold should have authority as we move forward in treatment. We need to pay close attention, always.

You may be wondering how this string of seemingly unrelated tidbits about me relates to our work? Therapy with postpartum women is not precise science. There are no hard and fast rules in therapy. Of course there are guidelines, constructs and theories that substantiate our good intuition . But when it’s just her and her therapist in that room, it comes down to this: Do you know who you are?

With me, what you see is indeed what you get. Whether or not it is an asset or a burden, I know of no other way to be. Therapists have heard me say, over and over, that the best tool we have to release a postpartum woman from the clutches of depression is for us to offer our own best self. If we can sit in her mess, if we are comfortable with her most gruesome thoughts, if we can hold the grievances that gush from within her and provide a safe place for her to fall, we are doing our part in creating the environment that will nurture her back to herself.

As for me, I will break the rules if I think they are getting in the way of a healthy choice that needs to be made. I will not be afraid to tell someone what I think if I believe it will be worthy and beneficial.  It is about being authentic; being present; being emotionally accessible. And it’s about being vulnerable. Still, these states only work within the context of being the expert and knowing how to balance the range of earnest emotions, both hers and mine.

Working with postpartum woman is challenging and spectacular. For each of us.

Here’s why:

It’s about learning to live within a reasonable amount of “mess” just enough to keep the pangs of perfectionism at bay, so you can understand it and model it.

It’s about learning to live with who you are, trying hard not to compare yourself to the others that look like they are having an easier job than you are, because they are not, and forgiving yourself along the way, so you can understand it and model it.

It’s about using the structure of a theory or protocol, and then creating a path that resonates for you and works best for your client.

It’s about learning to live with the paradoxes that bring energy and life to our selves and to our work, so you can understand it and model it.

It’s about working well and constantly, even when, and especially when, you are sitting quietly together.

It’s about reading the research and learning what it means to you and your clinical practice, while never forgetting that the conclusion of that body of work may not even remotely apply to the woman sitting in front of you.

It’s about remembering that the within the context of treating postpartum women, wisdom is the balance between the knowledge you have and who you are.


copyright 2014 Karen Kleiman, MSW, LCSW

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