Thursday, October 30, 2014

The Supervision of Tears

I had an incredible internship at Elmcrest Psychiatric Institute.  I learned about people, psychotherapy and myself.   We learn about ourselves through our interaction with other people.  As a result, the place emphasized groups.  Everything was done in groups.  There was group therapy, family therapy, community meetings and multifamily therapy.  You couldn’t get your loved one into Elmcrest unless you agreed to attend family therapy and multifamily therapy weekly.  I tried to capture the spectacle of the community meeting in my novel Bedlam
The training I experienced was perfect for who I was at that time in my life.  I had been studying behavior modification in college and graduate school.  Behavior modification didn’t speak to me.  At Elmcrest, I was trained to look at the big picture, Systems Theory.  My mind wanted to think in the big picture and this gave me permission.  
Weekly, we participated in a psychotherapy seminar with Leo Berman, M.D.  Leo had originally trained as an M.S.W.  Then he went back and completed his medical degree.  He was a wise man.  In my blog Great Marriage Advice, the psychiatrist I refer to was Leo.  During the seminars our therapy was scutinized.  In addition, monthly, we were invited to the Medical Director’s Office.  Lou Fierman, M.D. was a brilliant psychiatrist.  He had studied with Helmuth Kaiser, M.D., who was a student of Sigmund Freud.  Since I found that out, I have always felt a legacy sent down to me from Freud.  This is purely fantasy, but I love thinking it.  We had amazing discussions with Lou about psychotherapy.  
Then there were the monthly workshops.  As an intern, I had the opportunity to attend workshops with Sal Minuchin, Virginia Satir, Alexander Lowen (the bioenergeticist), Bandler & Grindler (The Neurolinguistic Programming exponents) and Carl Whitaker.  Carl Whitaker later became my mentor.  These workshops had a huge impact on me and my psychotherapy.  
I had lots of supervision at Elmcrest.  My supervision is representative of some of the craziness of the place.  I started by being supervised by Steve.  Steve was down to earth and a terrific therapist.  However, half way through the internship, he stopped coming to work.  He eventually went into a substance abuse rehab.  It would be Wednesday morning and 15 minutes before clinical rounds and I would find out that Steve, the team leader wasn’t showing up.  As a totally green intern, it fell to me to discuss all eight cases with the team and the psychiatrist.  
The first psychiatrist I ever worked with was Joan.  It was like working with the earth-mother.  She was strong, intelligent, beautiful and a terrific shrink.  She was the most nurturing psychiatrist I have ever known.  I remember one time, receiving a call from my mother, just before the meeting started.  I don’t think I have ever felt safer as an adult.  I had my mother on the phone and the earth-mother sitting across from me.  
The second supervisor I had was from the admission service.  I had to meet with him, because he was the head of psychology.  Half way through the year, he stopped coming to work.  We found out that he had been admitted to a sister hospital for depression.  
The third supervisor I had was the director of the adolescent service.  Richard was often described as a big teddy bear.  He was a wonderful therapist and a great man.  He was amazing with adolescents.  But one morning when we were just starting the unit community meeting, I looked over at Richard and he was sobbing.  Again I had to take over the team and the meeting.  Later we found out that his wife had attempted suicide the night before. 
My fourth supervisor made up for the rest.  E. Bruce Bynum was a Doctoral Psychology Intern and I was a pre-Doctoral Psychology Intern.  As part of Bruce’s training, he was to supervise an intern:  me!  I met him the second day and when we shook hands, he smiled and asked: “So, Thursday night you want to split spaghetti?”  Then he winked.  From that moment on, he has been my brother, my best friend and my confidant.  Next to my wife, he has been my greatest support and I have done the same for him.  He is one of the great blessings of my life.  
The administrator of the hospital was a fascinating character.  He had been a New York City Policeman.  After that, he got his Masters in Social Work.  Finally, he had finished his Masters in Public Health.  He was smart, loud, bossy and a great therapist.  It is his supervision that I want to discuss. 
I was still new to the internship, maybe it was January.  I was working on the adolescent service.  One of the 17 year old patients was running out of insurance and being forced to leave.  He was still not ready to go to the community, so he was being transferred to the state psychiatric hospital.  From the perspective of working at Elmcrest, this was like being thrown into the snake pit.  Everyone on the unit was feeling very sad the day he was leaving.  I was not alone to have tears in my eyes.  At one of these moments, the administrator of the hospital walked by me.  
The next day I was summoned to his office.  “What was that about yesterday?  I saw you crying on the unit.”  I explained the effect of the boys situation.  “That’s ridiculous.  You are going to be a psychotherapist, a clinician.  You can’t be crying in front of your patients.  You need to be stronger than that.  That’s all.”  With that I was dismissed.  
I wrestled with that for years.  Something about what he said didn’t ring true for me.  Eventually, I realized he was wrong.  I wasn’t crying, I was tearing.  I hope that if I am a psychotherapist for 60 years, I’ll still be able to feel sadness in my office.  One of the worst things you can do as a psychotherapist is be a fake, or not connect.  
Now there is a difference between crying and tearing.  When I am in my office, I sometimes tear.  But I am in control of myself when I tear.  I can continue the discussion, react to what people are saying and be there with them.  Crying is not for my office.  When I cry, I let go, I fall into the sadness and am absorbed by it.  I relish these moments as a cleansing of my soul, but I don’t do it in my office.  
I have had tremendous supervision throughout my professional career.  I wouldn’t have accomplished what I have accomplished without all of them.  There lessons were invaluable.  But with each one of them, there reached a moment when I realized that what was right for them, wasn’t right for me.  Usually supervisors are right, but that doesn’t take the responsibility away from the therapist to make their own decision about what is right for them.  

Monday, October 6, 2014

Boylin/Surette Wedding Sermon - October 4, 2014: "The Heart transcends life's difficulties"

I believe there is a difference between getting married and having a wedding.  Marriage is a legal union.   Whereas, the wedding blesses the union.  Do you know what bless means?  It means, “to invoke divine care for...”  What we are doing today is asking for divine care for this relationship.  We are asking for a blessing for this couple.  
I ask you, of what value is marriage?   The first 6-12 months is the really fun stuff,  the discovery, the passion and the heat of the relationship.  If this is the most exciting time in the relationship, why get married for life?
Occasionally, I become aware of a movement to institute time limited marriage licenses. You get married for 2 years, or 5 years, and then the license expires.  You can renew your current license, or move on to more fertile pastures.  I don’t know.  Do you think that would work?  I’m skeptical.   I can imagine little Suzy asking mommy what happened to Daddy?   Then Mommy answering, “I’m sorry Suzy, Daddy’s license expired.”   
If the best part of marriage is the beginning, of what value is the lasting marriage commitment?  I have heard many responses to this question over the years, but rarely have I heard a  good one.   We will come back to this question.  

Today, you are looking at the luckiest man in the world.  Today, I get to bless the marriage of Kelly & Kris.  This is an incredible honor for me.   When Kelly first asked me if I would marry them, I was flattered.  Then, I got scared.  I realized what a profound responsibility I was facing.  I did not know if I could pull it off.  I did not know what I would say.   Further, I didn’t know if New Hampshire would give me permission.  So, I did what I always do when I’m in trouble.  I asked for divine help and I received it.  
First, it finally sunk in what a great opportunity it is for me to marry them.  This is one of the greatest experiences of my life.  I can’t begin to tell you how blessed I feel right at this moment.  
Then I had another thought.   Just think, my daughter will have to listen to every word I say for 15 minutes or so.  I can’t remember the last time that happened.  That alone is a blessing. 
Next, the State of New Hampshire gave me permission to marry these two people, on this day, in this place.  My fear grew again.  
Then I remembered that with me today would be people that love me, and love these two.  I knew you would all be rooting for us.  
When I thought about what a great gift they were giving me,  it made me think about other gifts I have received.
Kelly is one of the greatest gifts of my life.  Through the years we have laughed, cried, worried and generally watched her grow into a phenomenal young woman.   I remember crying out of poor joy when she was born.  I remember crying with her when I dropped her off at college the first time.  I remember watching an entire audience be moved to tears from the power of her singing  “On My Own” from Les Mis.  
She is intelligent, creative, passionate, fun loving and giving.  She is only beginning to realize how intelligent she is.  She has incredible power in her personality which she is discovering.  However, she is also emotional and sensitive.  Her feelings can take over and drive her.  Over the years she has filled me with love, pride, joy and terror.  
That led me to thinking about Kris’ gifts.  I think we can all agree that they are much different than Kelly’s.  Kris is intelligent, but it is a different type of intelligence from Kelly.  He is handsome, loyal and successful.  Kris has a soft gentle heart.  Yet, he’s logical and rational.   He is conscientious and a hard worker.  He is mature and grounded.  He is kind and respectful.  Most importantly, he is a tender partner to Kelly.    He treats her like a princess.    I am honored to have him join our family.  
Shakespeare said, “The course of true love never did run smooth.”  I quote Shakespeare so that when you leave here, you can say you heard a truely intellectual sermon at the wedding. 
Kris and Kelly have many things in common but there are profound differences between them.  That is the nature of relationships.  To understand their relationship, you have to see how they fit together.     
These two balance each other.   For example, Kris can bring Kelly back down to earth when her emotions take over.  On the other hand, Kelly offers spontaneity and creativity that bring Kris out of his shell.  Kris appreciates and benefits from her playfulness.  Kelly benefits and appreciates his being so grounded.  This is why the relationship succeeds but also why it is tumultuous.  Maintaining the balance between their commonality and their differences is why marriage takes work.  What is the work of marriage?  
I remember a student calling and asking me for advice.  This young man was an eligible bachelor.  He was intelligent, handsome, funny and had success written all over him.  He also had a fantastic personality.  He told me that he was dating lots of girls, and looking for the right one, but not finding her.  I don’t know what possesed me to say this, but I told him that it may not be about finding the right one, but about becoming the right one.  
After I told him this, he was quiet.  I didn’t hear from him for almost a year.  During this time, he worked toward becoming the right one.  Today, he is happily married with two beautiful kids. 
The Key to Marriage is to become the right spouse.    Schnarch, America’s foremost marriage expert says: “nobody is ready for marriage when they get married; marriage gets you ready for marriage.”  The work of marriage is being true to your own self, and not losing yourself, while being close to your spouse.  Most of us lose ourselves when we enter into a relationship.
When I was young and I would start a relationship, I was all about what she wanted, what movie she wanted to see, what restaurant she wanted to go to.  I would lose myself.  As I grew, and started to know who I was, I could speak up for myself.  Within marriage, we each need to learn how to be true to ourselves while negotiating with our spouse.  
The next devine intervention came from my wife.  My wife told me I had to include something in today’s message about how we can support this union.  This is the proof that I always do what my wife tells me to do.  
What can you do to support this marriage?   If they ever come to you for marriage advice tell them to work on themselves.  The work of marriage is working on yourself.  Let me tell you what that looks like.  
If you are going to be married for any length of time you need to become a forgiver.
Second, learn to fight with love.  Men are notoriously terrible at fighting with words.  In marriage you need to learn to fight clean.  This means to leave out the nasty words.  I often tell couples to talk nicely to each other.  After several years of marriage, following a fight, Catherine and I decided that in the future we would leave the “d” word (divorce) out of our fights.  Neither of us wanted to leave so we realized that using the word “divorce” in the fight was just another club we used to hit each other.  Since then our fights have been cleaner and more effective.
Third, work on being less selfish.  Catherine insists that she taught me to be less selfish, but I had to teach myself.  Having children helped.  When there is one last piece of bacon and you have a child, you wouldn’t consider taking it.  
Fourth, continue to grow and encourage your partner’s growth.
Fifth, take care of your health and insist that your spouse take care of their health.
Sixth, do things out of love.  It would be ten o’clock at night.  The children and my wife would be in bed.  I still needed to do the dishes, bring up wood for the stove, set the stove, feed the cats, turn of the lights, etc.  I resented it.  Eventually, I got sick and I think that came out of the anger.  I decided that in the future, I would only do jobs if I could do them with love.  If I was going to resent doing them, I would leave them.  To this day, I only do them if I can do them out of love.  I find I do the dishes now more than ever.  
Finally, my mentor, Carl Whitaker, one of the original family therapists, told me just before I was to marry:  “You shouldn’t get married unless you can tolerate being all alone.”  I didn’t know what he meant until I was married.  The aloneness can be felt even more deeply when you are married.  
    In August, I was given the last devine message for this wedding.  I was sent, or I should say reminded of a message for you.  It came to me in a strange way.  It was only recently that I realized why I had this experience.  It occured at a funeral.  Something happened to me there that was very special. 
    Last fall, we attended the wake of Kris’ Grandmother, Lydia.   We had already fallen in love with Kris and we wanted to show him support.  Kris was very close to his grandparents.  We went through the receiving line and met all the relatives.  I met Kris’ Grandfather, Walter, for the first time.  He had spent the last few years taking care of his wife as she faded away.  Shortly after we sat down, there was a lull in the receiving line.  Kris’s Grandfather came over and sat with me.  The first thing he said was:  “You’re a therapist aren’t you?”
    I must add that this question often fills me with terror.  I never know what will follow.  
    He then proceeded to talk to me about his life.  He briefly told me the highlights of his life story.  People tried to talk to him as they came through the line.  He was always courteous, but he would be brief with them, then return to talking to me. What he told me was very beautiful.  He talked about when he was a young man.  He told me a story about a superior who helped him out when he was young.  He told me about the funeral business.   He told me about his career.  He told me about life, and love.  Finally, he started telling me about his wife and their marriage.
    When he and his wife first met and fell in love, nobody approved.  She was Russian Orthodox and he was Polish Catholic.  This was a match that was unheard of at that time.  That didn’t stop them.   
    They believed that the heart transcends life’s difficulties.
    Their parents didn’t approve of their union.   Their extended families didn’t approve.  They told them that they had nothing in common.  They were from different cultures, different religions.  It would never work!  That didn’t stop them.   
     They believed that the heart transcends life’s difficulties. 
    They went to the Catholic Priest.   He refused to marry them.  He told them it couldn’t work.  They were different religions, different cultures.  The families had nothing in common.   That didn’t stop them. 
    They believed that the heart transcends life’s difficulties.   
    Finally, they appealed to the Bishop.  The Bishop was impressed with their perseverence, which was reflective of their love.  The Bishop ordered the Priest to marry them.  They went ahead against the odds.  Walter told me he was deeply blessed by that decision.  He had a wonderful life with your Grandmother.  The love brought him great happiness and made him stronger and more confident.  
    They took care of each other until she got sick.  When she got sick, he took care of her until the day she died.  Then, like the gentleman that he was, he let her go ahead of him to heaven, and then he followed her a few days later.  
    It was an odd experience for me to be singled out by Walter.  At the time, I didn’t know why it happened. Only a few weeks ago I realized why I had that experience.  I think he knew he wouldn’t be here.  So, he gave me the message he wanted you two to hear.   It’s almost like he handed this to me to bring to you today. 
    We now go back to our initial question, “Of What Value is Marriage?”  “Why be Married?”  I think Walter has already answered the question.  
    But I will give you my answer.   I am more because of my wife.  She gives me confidence.  She believes in me.  When we got married, it was like one and one equals three.  We each were bigger, stronger and more effective because we had each other. 
Of What Value is Marriage?  It provides a deep root into the ground.  It anchors you.  It supports you.  It gives you strength, courage, confidence and love.  If you both work on being the best spouse you can be, nothing can stop you.  
    The heart transcends life’s difficulties.  
    These final words capture for me the true meaning of marriage.  I quote from my favorite play, Les Miserable:    
“To love another person is to see the face of God.”

Thursday, October 2, 2014

Telling Kelly We Were Pregnant

We didn’t know if we could have a second child.  We were older and pushing it.  We stopped using birth control in the hope that we might get pregnant.  One day my wife came to me with a physical concern.  The symptoms she was having suggested she might be starting menopause.  She decided to see the doctor in case she needed hormones or something.  As the examination continued the doctor finally started laughing.  “Lady, your not entering menopause.  You’re pregnant.” 
That was great news, but still scary, psychologically, financially and physically.  They ordered all kinds of tests for her.  We had to wait until the end of the first trimester to know if everything was okay.  The tests finally indicated that we were going to have a healthy baby boy.  With that assurance, we could now tell people.  
The first person to tell was our seven year old daughter, Kelly.  We couldn’t wait to tell her.  She had been asking for a little brother or sister.  When she came in off the school bus, we sat her down and told her the news.  She could barely contain herself.  She hugged both of us, kissed us, hugged us again.  Then she hugged my wife’s belly.  Throughout this she was crying tears of joy.  She asked for some of the details and then went back to hugging and kissing us.  This entire scene continued for several minutes.  
Then a look came across her face.  You could see the change of expression, it was so drastic.  You could see she was thinking.  Then she stood up to her full height, she put her hands on her hips and looked at us.  Finally, she looked her mother in the eye and asked: “Does this mean you two have been having sex?”  We laughed for 10 minutes.