I really liked this! I don't think it's written for the general public, but more for therapists themselves. Not necessarily in a clinical way, just that I don't think you'll enjoy it if you're not a therapist. There wasn't a ton of novel ideas or words in here, but it was just so refreshing to be completely validated in every aspect of my career: the good, the bad, and the ugly! I found myself putting off listening to it because I didn't want to finish it. It got a little slow at the end, but I think that had to do with the reader I was listening to. Some quotes:
"It is not what the therapist does that is necessarily important, whether she interprets, reflects, confronts, disputes, or role plays, but rather who she is as a person. A therapist who is vibrant, inspirational, and charismatic, who is sincere, loving, and nurturing, and who is wise, confident, and self-disciplined will often have an impact through the sheer force and power of her essence regardless of her theoretical allegiance. The first and foremost element of change then, is the therapist's presence. Her excitement and enthusiasm, and the power of her personality."
"It is the client's perception of the quality of the alliance that best predicts positive outcomes."
"Human beings have an intense craving, often unfulfilled, to be understood by someone else."
"Whatever we do, it is hardly business as usual in the sense that we can never truly expect to help those who are most needy, until we learn to customize and adapt everything we do, regardless of our attraction to a favorite model. This is both humbling, and endlessly fascinating, making it virtually impossible for us to reach a place where we can ever be certain about the therapeutic path we are taking."
"When a person gives attention to unresolved issues of the past, she often must work through resistance and apprehensions to dismantle rigid defenses, interpret unconscious motives, or reflect on unexplored feelings, we must sometimes push the client to the brink of her patience and endurance. . . In order to attain real growth, the clients must often be willing to experience intense confusion, disorientation, and discomfort. She leaves behind an obsolete image of herself. One that was once comfortable and familiar. And she risks not liking the person she will become. She will lose a part of herself that will never be recovered. She risks all of this for the possibility of a better existence, and all she has to go on is the therapist's word."
"Each of us is privy to so many tragic, powerful stories that are shared with us by our clients. We hold these stories. Take them in with our minds and hearts wide open. All the while doing our best to protect ourselves from the collateral impact and side effects that penetrate our own defenses. But far more than that, we also help to restructure, reframe, and co-author the stories in more constructive and heroic forms that honor the lessons learned. This is the essence of narrative and constructivist therapies, but is also a part of any therapeutic approach regardless of the particular names ascribed to the process."
"We experience the world as a series of stories."
"Stories are so much a part of individual and cultural identity. Rachel Carson's Silent Spring, for example helped to spark the environmental activist movement. Upton Sinclair's The Jungle was instrumental in creating the worker's rights and union movement. Harriot Beecher Stowe's Uncle Tom's Cabin may have actually been one of the sparks that launched the American Civil War, just as Thomas Paine's Common Sense did the American Revolution. St. Augustine's Confessions, Machiavelli's The Prince, and Henry David Thoreau's On Civil Disobedience were all powerful forces for change in their times. Then there are all the influential sacred stories that have formed the basis for the world's religions. It's pretty clear that particular stories can lead not only to wars, political calamities, and societal destabilizations, but also to breakthroughs in therapy and every day life."
"The experience of any practitioner would attest to the emotional and intellectual strains of living constantly with client's crises, confusion, and intense suffering. We sit in a sacred vault, completely isolated from the rest of the world and all other intrusions, accompanied only by those who have lost hope, who live with excruciating agony, who sometimes try to make others lives as miserable as their own. Even with the best defenses and clinical detachment, we are still sometimes polluted by this pain."
"We know clients at their best, and at their worst. And as a function of spending so many intense hours together, our clients come to know us as well. We aren't nearly as inscrutable as we think. Clients can read the nuances of our behavior, and study our must subtle "tells" or micro expressions."
"There is remarkable resilience and hardiness of people to tolerate such excruciating pain and yet still keep fighting to regain some kind of equilibrium and reasonable functioning."
"We can't pretend that things are simple. We know too much about what happens when people deceive themselves. All day long we listen to people lying to us. Lying to themselves, and trying to find a way to cope. Our job is to confront this deceit. When the day ends, we are left to face our own self-deceit, which is one reason why it is so critical for us to honestly and scrupulously assess early signs and symptoms for potential difficulties."
"Our clients only come to us when they are desperately in the throws of dysfunctional behavior. We constantly sort through the presenting complaints, narratives, life histories, and presentations by clients in order to identify problems and disorders in need of attention. Moreover it is very, very difficult to turn off this pathological filter when we aren't in session. It is all too easy for us to become psychological hypochondriacs, constantly aware of every nuance of possible problems in our own functioning, or those close to us. We are taught to become increasingly self-aware for purposes of honing our clinical skills and working through counter transference reactions. We are admonished to continually work on our own stuff so that it doesn't pollute our work."
"These people populate our world. We see them more frequently and regularly than we see most of our friends. No matter how much we work to preserve our professional detachment, no matter how hard we discipline ourselves to push them out of our minds when they walk out the door, we still carry them around inside us. How could these people not be significant in our lives and loom in our minds when we spend week after week discussing the sacred details of their lives? I feel exhausted. My energy is depleted just thinking about the burdens we routinely carry. It is strange to consider that we work so hard while sitting perfectly still. Maybe it is because must remain immobile and attentive that the job is so tiring. If only we could separate ourselves from the chair. If only our existence outside the chair could be as meaningful as the time we spend enveloped within it."
"Failures are hardly ever the result of one person in a relationship, but involve interactive effects that play out between participants."
"With anything we do, or have ever done personally and professionally, it is only after we've already exhausted everything we know how to do that we are willing to experiment and improvise with something else. Something that often leads to the unexpected and unanticipated."
"It is precisely our own ability at emotional regulation and self-talk that leads to a deeper understanding of our mistakes and misjudgments. As well as the opportunity to fix them."
"Squirrels can't find 80% of the acorns they bury. Even though this is how they spend most of their time, they lose more than three quarters of their valuable food sources. But the lesson here is that, I assume, they just accept this consistent failure and loss as part of the job, and move on with a shrug. If squirrels can shrug. It is rash, if not downright irrational for a therapist to believe that they can be successful with all of their clients all the time. It is beyond our means to help everybody."
"Incremental stages and other forms of stress reactions: secondary trauma (close proximity to someone in despair), vicarious trauma (contagious affects of being a witness to or intimate with someone who is decompensating), and compassion fatigue (prolonged exposure to someone's suffering with a corresponding collapse of boundaries. Burnout can encompass all of these in some form."