My own therapist emphasized to me that underlying feelings of shame, coming from a damaging childhood, colored my psychology enormously. We all have shame, but some of us may be drowning in it. Growing up with a sense of inner defectiveness is excruciating and people usually have no choice but to cover over those feelings both to themselves and to others, so as to to “look good.” Part of the work of therapy is encouraging a client to turn towards these buried feelings of shame and find a better place of acceptance in relation to them so that that person isn’t stuck in a costume of always “looking good” at the expense of feeling fraudulent or empty.
In preparing for a course to professionals on the importance of shame, I began reading Sylvan Tomkins’ work which makes a connection between shame, joy and excitement. It works like this: If you run up to someone, happy to see him, and he doesn’t respond excitedly, you will immediately feel foolish (shame). Without thinking, you might blush, your eyes will turn downcast, and your shoulders will slump. That’s shame.
Think of the way babies are always smiling and laughing and how toddlers run up to parents excitedly. Then think of how the child must feel when a parent doesn’t respond to that excitement or joy. The child must repeatedly endure the precipitous drop from joy or excitement into shame. Over time, this becomes internalized as a state of being. I wonder how many of you reading this grew up in homes with a parent or parents who didn’t respond to states of joy/excitement. The more I’ve thought about this and done research on the importance of joy and excitement in development, the more I’ve begun to notice that most of my clients were undersupplied with the nourishment of joy and excitement in childhood.
When I’m in session, I pay attention to my clients’ eyes and when I see them light up, mine do too. It’s exciting! It’s fascinating! I unabashedly enjoy revving up a good feeling in my client. I like my work; I like the clients I work with, and it helps both me and my client get through some of the tougher times in therapy and in life to know this. Without the leavening of joy and excitement, life is unbearable. I’ve come to feel that it’s vital that therapy include these lively experiences! I guess that means that at times I’m having a great time being a therapist! I can’t help it! If you’re looking for a somber therapist a la “The Sopranos” and come to me, you may be disappointed!
While I take a very serious approach to therapy and don’t shy away from helping a client confront and manage painful experience, I’ve also come to feel that amplifying joy and excitement in session is equally important. Joy and sorrow are kindred emotions of great value in responding to life’s ups and downs.
For about sixteen years, I’ve been a “Preferred Provider” with large health insurance companies in Washington, which means I’ve agreed to diagnose, bill and provide other information, according to their terms. The insurance company has paid the majority of the psychotherapy bill to me directly, while the client has paid me a smaller amount. The advantage for a provider in this agreement is that she receives many more referrals from a larger client base than she would have otherwise. The advantage for the client is that he doesn’t have to pay as much for his therapy as he would have otherwise. Up until very recently, Continue reading “Going Off Insurance Panels”