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Last June, I posted a diary about testing inaccurate thoughts that define, what for me, had become a personal narrative that pointed to incompetence. I wished I hadn't posted it and felt it was my worst diary. I just reread it and now feel a little differently about it; it's actually an interesting study of working through anxiety as both a therapist and a patient.

I've been wanting to write about a young woman I've worked with because I was so moved by her sensitivity and sense of internal conflict that manifested in self harm behaviors. When I wrote the previous diary, I was certain I was a poor fit for those souls lost in the identity crisis years of teenage land. But, I was wrong. In fact, the voice I hear coming out of me, full of concern and respect, with a touch of maternal love and wisdom, is just what is needed. I continue in my awareness that there is so much I don't know, but at this point, there is more that I do know that is helpful. The internal fight within the anxious therapist treating the anxious and depressed kid is dissipating while the therapist who is a mother, daughter, friend, wife and writer is sitting rather comfortably in a cushy chair not having a secondary dialogue in her head about WTF she's doing in the cushy therapist's chair. Perhaps this integration process had been interrupted by cancer.

I met with the parents of the young lady I mentioned above. My job was to explain to them why their daughter was self harming and how they can support her in a way that elicits their trust in me, because without their trust, therapy may be largely unsuccessful. No one wants to be sitting on the couch as those parents who are being told that their kid's therapist is acting as a bridge to their daughter's world because they are having difficulty accessing it.

No parent wants to hear their child harms themself as a way to make sense of conflict and emotional pain...

...because it's easier to understand the manifestation of physical pain than it is to understand the illusiveness of emotional pain.

…because she is hurting so deeply with little respite for calm.

...or recognize the ritual which serves a function they could provide if they only knew.

No one wants to be sitting on the couch across from their child's therapist asking them to become part of that ritual in order to break it by acknowledging and validating their child's pain.

There is no way I could have had that conversation without some level of competence. Teasing out the function of self harm takes some level of skill and intuition. Serving it in small doses to two aching hearts takes assertiveness and compassion.

What ever I lack in clinical understanding, which is tremendous, is offset by confidence and genuine care for these individuals, and the pain that brings these kids to our offices. What my friends, family, and colleagues could not get me to see, I now do because I learned it first hand:

Competence is not the act of knowing, it is the act of being.

And then there's always this from the comment section of the worst diary I ever wrote:

Interesting subject, remembrance. (14+ / 0-)
To me, incompetence is best described as what you get when you're real old, or if you've had prostate surgery, or if you say something that makes me piss myself.

by cactusgal on Thu Jun 05, 2014 at 05:39:29 PM PDT

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