Elaine Waller-Rose, LICSW

Competent and Compassionate Psychotheraphy


Psychotherapy and Change: A change is gonna come

Most people enter therapy seeking change in some area of their lives. We all want things to change for the better. We want pain and difficulty to be eliminated, obliterated, outta here, especially when we’ve had more than our share for extended periods of time. We may think that the changes we desire in relationships, mental or physical health can’t happen soon enough. However, the demand to “fix” things now can create problems of its own. Negative thoughts about lacking willpower, not being serious enough or wanting to fail can have their root in our strong desire mixed with impatience.

When our sense of urgency is intense, it’s easy to forget that change is always happening. Change permeates everything, from the laws of physics to the facts of life. The simple reality is that no situation, relationship, behavior or emotion remains static. The kaleidoscopic movement of every part of our lives can work in our favor. We’re constantly having new experiences. Different people enter our lives and we learn from them. Even the bodies we live in are constantly changing. An unexpected shift in our circumstances may allow us to see the “same old same old” from a new and different perspective. We may find ourselves ready to take on a problematic trait or behavior that we tolerated or even protected in the past. The objective in therapy, as well as in life, is to increase the likelihood that the changes we make are the ones we actually want.

When sitting in the middle of a frustrating dilemma, we may be prone to feel confused or hopeless, like avoiding the problem is the best we can do. A key part of making change involves remembering and reflecting on what we have already done. We made our way through difficult circumstances in the past. Sure, we made some classic mistakes but we tolerated the stress, often learned from our mess-ups and lived to tell the tale. In these tales we can find what we don’t want to do and ideas to reinforce what we do want to do, we may also notice states of mind that helped us persevere.

Sometimes, we want to make a change but seem unable or even unwilling to. Some of us are quick to assume we are consciously blocking positive change due to laziness, stubbornness or obstinacy. Actually fear, anxiety and even difficulty imagining that things can be different are the more likely obstacles. It takes mental and emotional preparation to give ourselves over to an unknown and unfamiliar way of being. Trust in others, the new methods we are trying and especially ourselves, may take time and practice to develop.

Another crucial support needed is compassion. It sounds easy enough, but using it skillfully and lovingly with ourselves (or others) may not be our first response. Society, religions, educational institutions and family experiences can add to the tendency to respond to difficulty, emotional vulnerability and mistakes with reactions that are punitive, blaming or belittling. In response to an embarrassing blunder we may be more likely to think “how stupid” thoughts than supportive thoughts that acknowledge our intention and encourage us to adapt and keep at it.

With the subject of change comes another reality spoken of clearly in the Serenity Prayer, that relating to “things I cannot change”. While nothing stays static, some things are not amenable to “fixing”, such as the death of a loved one or the loss of a limb. Others are less finite but still involve realities that cannot be wished or strategized away and demand to be dealt with. A major physical or mental condition may not go away but may be handled more successfully with a combination of adaptations, attitudinal shifts and audacious courage that can surprise even its owner. Situations in home life, on the job and among people you know may not be set in stone, but changes in them usually necessitate commitment and action from others as well as yourself. Frustration, bitterness and useless effort may be spent trying to make others do or be as we think they should. Changing the “things we can” often means accepting that others are piloting their ships and figuring out what you need to keep your own on course.

Perhaps the greatest changes we make in life are invisible to the naked eye. Yet we notice when someone we know no longer seems as angry, depressed, critical or morose. We can learn to change focus, put mental distance between aggravating thoughts and situations, both those in life and in our minds. We can develop the ability to give less attention to our complaints and rants about others and give more air time to thoughts and feelings we want to have and actually enjoy. And when learning, focusing or giving more attention is a struggle, we can treat ourselves warmly and with encouragement. Missing the mark is not a mistake. It’s an excellent opportunity to practice compassion for ourselves. Each effort we make is gradually changing our outcomes, expectations and even our brains! We may not need every obstacle obliterated to experience change at its most profound and satisfying.

Psychotherapy and Spirituality

In American culture, talking about spirituality can be tricky. In some ways it seems strange that a dimension of life so important to so many, so central to how people think, feel and understand life can lead to conflict and misunderstanding so easily. From very early in life we get different messages about bringing up the subject. Some are encouraged to talk about it whenever possible, while others learn to avoid it altogether.

One of the most valuable experiences I’ve had was participating in and facilitating interreligious dialogue many years ago. Ironically, speaking honestly about the very different ways we are inspired shed light on much of what connected us all. I was surprised by how hard it was to discuss what I’d experienced and still make sense. The response of a friend said it all: “You mean Baptists, Methodists and Catholics sat in a room talking and not trying to kill each other. No way.” I saw her point. I’d seen enough arguments, damning of people to hell and ruined acquaintences to know strange I must have sounded. You can imagine her shock to hear that the spectrum of difference was even wider. Add Muslims, Mormons, Jews and Buddhists to that room and you’re getting closer to how diverse we were.

Before it began, I wondered how such heartfelt and intimate conversations would be possible without conflict or attempts at conversion. It became possible because we weren’t there to discuss doctrine, positions, what one believes or who is right. What was discussed was how each person’s faith supported them in their life and helped them during difficult times. All faith traditions give guidance on living and loving, how to treat strangers, friends and family, why we are here and what is important about being here. As we shared our stories it became clear that, though we saw the world differently, our struggles and journeys toward resolution were often strikingly similar. Regardless of background, many people said their experience there led to even stronger conviction in their own path, along with greater understanding of people on other spiritual paths. There were very few discordant moments but lots of sighs of relief and eyes flashing with surprise and recognition. Lots of recognition.

While these discussions didn’t include avowed atheists or agnostics, I believe they could have. All of us have some source of guidelines and principles that we believe are the driving forces in our lives and life in general. Many atheists would say theirs are rationality or the scientific method. Many agnostics would say theirs is a belief in the good of humanity, that people can have high ethics and respect for each other without belief in God. Though these ideas are very different from those of believers, agnostics and atheists experience the same trials of life and relationships we all do. I would feel priviledged to hear their stories of how the overcame, found inspiration and ways to live and love when doing so seemed almost impossible.

People and cultures throughout time have looked for answers to similar questions—the Big Ones like the hows and whys of existence, the world, people and the reasons for it all. People did and do ask for guidance about how to live, treat each other and ourselves. We’ve wanted to know about the nature of right and wrong and looked for ways to correctly determine it. We’ve sought ways to relate to that which is greater than ourselves: God, a divine creative being, higher power or other valued ideal.

Psychotherapy is also a place where spirituality, and especially religion are often missing in the conversation. Here I’m defining spirituality broadly to include beliefs and practices of people devoted to specific religions, those committed to a spiritual life outside of organized religions and those who reject ideas of spirituality but are guided by other positive beliefs and values. The last group would include non-religious people and atheists.

Some therapists are taught or later choose not to broach a subject many see as controversial. Some clients assume that therapists are likely to be anti-religious due to their education or other factors. Others may worry that the therapist might try to influence or convert the client to their religion or beliefs. This concern may cause some devout people to avoid therapy altogether. Reluctance to “go there” on either party’s part could shut the door on the client’s ability to express a cherished part of themselves and a major way many people view their lives and challenges.

Why would a person’s spiritual beliefs be relevant to what goes on in therapy? The topic may or may not be but questions they seek to clarify will definitely come up, even if the words God, faith or worship are never spoken. “Why” and “how” are questions fundamental to both spiritual understanding and psychotherapy. Why did this happen? Why do I feel this way? How can we save this relationship? How will I survive this loss?” “What’s wrong with me?” The process of therapy is one of exploring these to illuminate what the person has experienced and what they think and feel about it.

Our understanding of what such experiences mean influence what we come to believe about our self and what we can expect in life. ”What do I deserve?” ”Am I being punished?” “Should I be forgiven?” “Am I lovable?” “Can I trust anyone?” “Will I be heard?” There can be great benefit in a discussion that looks deeply at questions like these, whether the topic is labeled “spiritual” or not. Addressing one’s spiritual and ethical world may allow a client to tap into therapeutic sources she or he has had a long relationship with.

It can’t be automatically assumed that a person’s spiritual experience has been a positive one. The actual role it has played would be important for me to be attentive to. It could be a great relief for a person to be able to speak or their experience, reservations, anger or fear—to be heard without fear of judgment. Sometimes clients have beliefs that might pose a barrier to healing, such as believing God requires them to suffer from guilt or to reject a loved one. Such beliefs pose a delicate issue. I cannot tell a client what to believe but I can be with them in their dilemma. I can wonder with them about the role of compassion and mercy attributed to the Divine in most religions.

These are the considerations I would make in discussing spirituality with a client. I’d make my best effort to be sensitive about how I brought up the issue and what the client communicated to me about willingness or interest in exploring it. I’d listen and look for cues as to how our conversation was going. I would listen and speak in ways that acknowledged the client’s beliefs and help to identify new ways he or she could use them to support change, healing and wellbeing. I would be open to discussing whatever seemed important. If it was clear to me that a person considered themselves agnostic or atheist, I’d look for ways to talk about what ideas and ideals they have found support and inspiration from and how they might be helpful in the present situation.

I’d especially make sure my own spiritual beliefs didn’t interfere with the client’s process of and my ability to support them. In some religious traditions, discussion naturally involves affirming the truth of one’s faith and trying to convert others. I understand and respect this. Spirituality discussed in therapy is all about the client. My own experiences have given me a basic understanding, respect and even love for many spiritual traditions. Still, I would not engage in discussing principles or dogma unrelated to the client’s concerns.

Sometimes people want to know what my spiritual orientation is, something I don’t really discuss in therapy. People who have seen my internet presence might have seen me associated with Buddhism. I have practiced meditation for many years and have connections in that tradition as well as the faiths of my parents and family. For me to be true to my own spiritual ways, I support and respect others in theirs. Persons who feel they can only work with a person of their own religion often find it easier and more comforting to work with a person who professes that faith as a central part of their therapy practice.

If we meet, perhaps we will touch on this subject. Meanwhile, here are some thoughts you can ponder on your own, in an intimate moment with a friend or even in an intimate moment with The Friend.

  1. A circumstance you have longed for and tried to make happen finally happens. What are the first five thoughts you have about what has happened?
  2. A children’s story is being written about the time when you triumphed over a difficult challenge. What would that story be?
  3. Think of the wisest people you know. What are the qualities that make them so admirable?
  4. Your emotional self is temporarily stuck on a desert isle. Your basic needs are met, like fire and food. Name 5 things you wouldn’t want to live without?