Last week I had the privilege of spending my first week on-site in what my graduate program terms “Residency 1”. It was a really great experience that was validating, satisfying, educational, enlightening, and very challenging all at once. I can’t ask for more than that!
I was exposed to many different personalities, backgrounds, world views, and life experiences. I made friends, learned from experienced, respected clinicians, and was confronted with questions that I never even know were questions. I’d like to share one of the more interesting issues that came up during the week because it illustrates an important point about the client/therapist dynamic.
If I am your therapist and you begin to cry in a session, what would you think if I handed you a tissue?
I had no idea that this is a debated issue in the therapy and counseling world. Some clinicians will say that offering a tissue is part of creating a safe, accepting space for emotional expression. Others argue that offering a tissue is a signal that says, “Please stop crying now.” This interpretation varies based on cultural and social norms, lived experiences, and even geography. One professor from Oklahoma stated simply, “I’m from Oklahoma. We’re gonna hand you a tissue. It’s what we do!”
There were other questions and issues like this that popped up as we did the work last week. We talked about eye contact, body language, use of profanity, seating arrangements in a therapy session, the use of touch in a therapeutic setting, and a few other really interesting ideas that I had generally not considered before.
In all cases, there are no hard and fast rules, nor right and wrong answers. So much of what happens between a therapist and a client is based on cultural commonality or differences, socioeconomic status, geography, faith, and lived experiences. Both therapist and client are people. People come in all kinds of different and amazing flavors and we’re not always sure how they’re going to mix. Of course there are ethical and professional guidelines in place to ensure that therapy is a safe place and that the rights of a client are always protected, but many of “rules” governing micro-exchanges between client and therapist are fluid, based on context, and may change through implied or specific negotiation as the relationship grows and evolves.
As a therapist in training, I’m handed phrases like “Meet the client where they are” and “The client is in charge”. These make perfect sense, but until you actually practice being in that one-on-one setting with other human beings and dig into the nuances of how things really work in real life, you just can’t appreciate the richness of the experience for both parties and how it can be enhanced by paying attention to these small details.
On the Internet, I can pass along knowledge and relay my lived experiences with panic, anxiety, intrusive thoughts, and recovery. But generally speaking our relationship when it comes to the content I create is one-to-many. There is one of me, and many of you. I love this thing that we do together, but last week really highlighted some of the differences between being a mental health content creator and being well trained and qualified to provide assistance on a one-to-one basis.
The more I go down these roads, the more I feel privileged to be in the position I’m in.
So tell me. Would you appreciate the tissue, or would you interpret that as a request to calm down and stop crying? I’m genuinely curious to hear what everyone has to say on this.
It’s July 4 in the US - a national holiday - so there is no Recovery Monday live stream today. You can find all the old Recovery Monday videos on my YouTube channel here.
131. If I Give You A Tissue ...