Van Gogh*Post-Trump Stress Disorder

In therapy, when a disaster strikes it’s usually not my disaster. Usually it’s my patient’s crisis that we address. Usually I exercise my empathic superpowers to identify with them so that they are assured I understand what they’re going through. Therapeutic empathy means identifying feelings in oneself (the therapist) that nurture the working relationship while keeping clear boundaries. Your feelings are yours, not mine. The ‘Not Mine’ part keeps me emotionally detached enough to help you.

In graduate school, professors drilled into us how important it was to keep a proper clinical distance from our patients, the same way a surgeon learns to cut in and muck around in a person’s insides without feeling that person’s pain. If we don’t, our ability to do our best job to help people with their distress is compromised.

This election of 2016 made many of us feel as if we were hit by a huge Mack truck; the same Mack truck many of our patients were hit with. What do we do then?  What does a therapist do when there is little if any distinction between the trauma their patient is experiencing and their own?

First, we do not bring up any Mack truck trauma unless our client does. That’s important. If our client does not suffer from *PTSD and is feeling perfectly comfortable and satisfied with the state of the world we focus on what is important to them. But if they do, and you are having a hard time yourself, try this:

1. Be human. A little self-disclosure can be a gift to the patient, a way of saying I get it because I’m there. The therapist has to be skilled to do this with just the right touch, not too much, not too little; but when does right it can be powerful. After she disclosed her panic, I told one patient that my brain was running away with me, leaping from “this is going to happen, then this, then that, until nuclear holocaust.” She opened her arms to me in a gesture of inclusion and said with a grateful exhale, “Yes! Thank you for saying that! That’s exactly what happens to me.”

2. Compartmentalize. This is where you force the orange-haired genie (sorry, just can’t help myself) back into the bottle long enough to clear a path to healing. Even if it needs some serious effort, like sitting on an over-stuffed suitcase in order to close it, we, the therapists, have to do this. We have to clear our heads enough to think clearly to help our patient through their fog of fear.

3. So that you can re-focus to the patient’s issues and life as soon as possible. Once the clutter in our head is cleared out some, the boundaries set by the therapeutic milieu helps us as well. In the therapy hour we are in a safe zone with our patient, designated by the office itself, walls, furniture, all providing comforting familiarity. Confidentiality and trust are fundamental as well. We use this to focus entirely on our patient. In that place, in that time, nothing else is as important as the person in front of us.

4. Stay in the here and now. Fortune-telling is dysfunctional thinking and catastrophizes. In the example above, as soon as my
patient and I identified the challenge we were both having I could use this CBT model and technique, one we’ve used many times, to reduce her anxiety. Identifying the automatic negative thoughts and reining them in with more reasonable thought. In this case, I couldshare taking a good, clean, deep breath with my patient and say clearly, “It’s not happening now.” Today we are OK.

5. Self-care. To be available to our patients we must take care of ourselves. We must do what we can to get enough sleep, to move, to eat well. During times of stress we all break the rules. Comfort carbs have definitely been on the menu a lot right now, but let’s try to make them the good kind, potatoes and pasta, not too much sugar. I’ve been allowing myself popcorn, chinese foo
d, soda, and a big cocktail in the evening these past nights. Meditation is an excellent centering tool when we feel off balance. Gather close to supportive loved ones who are calming. Turn off the news when it gets to be too much. By taking care of ourselves we give unspoken permission to others to do the same.

Therapists aren’t the only professionals who have the care of others to keep in mind while they work to regain balance themselves. I’ve heard from care givers, parents, professors, teachers, administrators, attorneys and clerics. Let’s support each other!

Any other suggestions for Election 2016 recovery? Please let us hear from you!