The Tough Love Therapist

Merely Me Health Guide
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    When I was in graduate school, going for my Master's degree in Social Work, I had to do an internship at an outpatient day program for treating people who were dually diagnosed with addictions and mental illness.  I am not going to lie to you.  It was a tough crowd.  Many of the people were hard core and more than street wise.  Some of them were no strangers to the court system and had been in and out of jail.  When I asked the program's psychiatrist what the goal of the program was he told me quite frankly, that our only goal was to keep this population out of the hospital and jail for as long as we could. 

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    All of the therapists and even the psychiatrist on board were recovering addicts or alcoholics.  I felt conspicuously out of place as I did not suffer from any addictions.  All the therapists had vastly different styles of conducting therapy.  One therapist was very gentle and empathic during her group sessions.  Another therapist seemed a throw back to the sixties with his way of leading the group by not leading.  And then there was the new therapist who came fully equipped with attitude.  She was an older woman, who had been there and done that.  Her style was to be very concrete and to the point, almost to the point of being abrasive.  I was very curious to see how she would fare with the program participants who were used to a more subtle and laissez faire approach. 

     

    I will call her the beehive lady because she wore her hair in this outdated style even for fifteen years ago.  Needless to say, the beehive lady was not liked by all.  Although over some time, she did grow to earn a certain respect from most of the people there.  I dare say that respect is sometimes a lot more important than being liked when it comes to helping others.  The beehive lady earned my respect one day for a simple thing she said. 

     

    I was observing a group session where one lady would come in each and every time, crying and talking about wanting to get her kids back.  They had been taken away because she was on crack and was now living in a crack house.  It was a horrific story and my heart went out to her and her children.  Empathy only goes so far, however, and sometimes it is time for action. Once this session began, the woman started up with crying and telling her story when the beehive lady put up her hand to stop her.  She then told this woman, "You will not be allowed to cry and tell your story here anymore until you can tell us one thing you did this week to help yourself."  The whole room was silent.  Nobody had said such things before.  It was certainly a risk for the beehive therapist to do what she did.  The crying woman might not come back because of this new expectation.  But she did. 

     

    I wish I could tell you that this tough love approach was the most effective one.  I will never know because my internship ended before I could fully evaluate the results.  And too, treating addictions is a multi-faceted approach.  Let's face it; talk therapy is only going to do so much.  I do know, though, that the beehive lady helped me without even knowing it.  When you suffer from depression you sometimes get into this mode of pushing away any help you might receive even when you are asking for it.  I have definitely been there when I have been at the bottom of my emotional well.  It is easy to get stuck and feel trapped with nowhere to go.  But the truth of the matter is, we all have choices, we just may not like the choices.  The beehive lady reminded me that ultimately I am accountable for the direction of my life.

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    There was a friend of mine who also suffered from depression and was always eager to ask for advice.  But whenever you gave it, she would quickly turn it into a sparring match where each thing you said would be rebuffed.  Either she had done everything before or the ideas just would never work and I just wasn't getting how bleak of a picture it all was.  What I think she wanted in the end was for me to validate her beliefs rooted in depression that everything sucks and that there is no hope.  When I refused to do that she grew angry and kept baiting me.  At one point, I just told her, "Look...you keep asking for help and advice but you never want to hear it.  I am not going to do this anymore.  You are going to have to come up with your own solutions."  She was shocked but later thanked me for my honesty.  She just had no idea how she was coming across.  And believe me, in a lot of ways it was like looking in the mirror.  When I am at my depressed worst, I am not one to be so accepting of help. 

     

    I have never been fond of the "tough love" approach but sometimes in modest doses it has its merits.  There is a time for emoting and empathy but there is also a time to get unstuck and get moving.  There are no pills, no therapy, no treatment, no friends, no loved ones who can cure your depression.  Despite the depression we have to keep living our lives the best way we can.  One day I wrote a note to myself to remind me of what is most important throughout all of this.  I wrote the words, "I AM RESPONSIBLE FOR MY LIFE."  I cannot sit around either blaming others for all my misfortunes or waiting for the magic elixir to solve everything for me.  Despite my genes, my chemical imbalance, my unfortunate upbringing, and so forth...I am still responsible for my life. 

     

    We fork over our personal power everyday to anyone who looks like they have the answer.  Treatments, medications, therapists, doctors, friends and family can help us on our journey but we are the ones who have to take that first step.  Nobody is going to do it for you.   And so I ask the question posed by the beehive therapist so many years ago, "What have you done lately to help yourself?" 

     

    It is a good question to ask oneself when caught in the seemingly endless quagmire of hopelessness and helplessness which by any other name is depression.

     

     

Published On: October 22, 2008