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Online Therapy

Times change. When I’m at my best I adjust. When I resist change I can feel myself getting older. I’m 45 and I’ve been a therapist for 11 years. I’ve watched my field struggle to embrace emerging technologies while maintaining confidentiality and high standards of care. We’re at a point where therapy via webcam, email, and even chat are now widely practiced and accepted.

I resisted blogging about what I do for years. The reasons for my resistance are absurd in retrospect. This past weekend I had yet another opportunity to laugh at myself because while I’ve always thought email to be a ridiculous medium for practicing therapy…I realize I’ve been doing it for a long time.

What I love most about blogging is that it connects me to people all over the world that I’d never otherwise encounter. Folks email me, tell me their stories and ask for guidance. Somehow I never thought of these exchanges as constituting any therapeutic exchange and well, duh, that’s exactly what they are.

Those who write me get the benefit of sharing their problems with a stranger who happens to know a lot about solutions. There’s very little emotional risk because they get an objective viewpoint from someone who they will never meet face to face.

So while I’ll never prefer online forms of therapy to face to face…I get it. It’s good and it has its place.

Reflecting is a therapy term – it means that I’m repeating the highlights of what people say to me. It’s funny but things can sound very different when you hear them from someone else than when you speak them  The most effective way for me to reflect is to summarize and get to the heart of the matter.

To do this in an email is little more than cutting and pasting – which is what I did with an email this weekend.  The recipient experienced it as helpful because lengthy emails are the same as venting – when you get done there’s a lot that’s been said and while all of it has value; only the key points need to be addressed.

The risk in reflecting is that it can seem patronizing or condescending. Normally I am loathe to preface myself but email communication leaves us vulnerable to being misunderstood. I explained to her what I say to many of my clients, “You’re not confused. You hate the truth. You know the answers, and you’re looking for truth that doesn’t require you to change or hurt.”

She asks: Why am I still in so much pain after a whole year has passed? What is wrong with me?

Her comments below are quotes from her email and they seem to answer that question very well:

  1. I feel so alone and frustrated and disgusted with myself.

  2. I don’t believe that anyone, including my therapist, can understand how I feel.

  3. What I’m mad at and hurt by is how insensitively she handled everything and where it has left me.

  4. I guess I was stupid to believe that she really cared about me beyond being some mental patient.

  5. I know I just can’t allow myself to really trust again. No way will I let myself get burned again.

  6. I feel so alone and frustrated and disgusted with myself.

  7. I don’t believe that anyone, including my therapist, can understand how I feel.

Here’s my feedback:

C.S. Lewis said, “Love anyone and you give them the power to hurt you.” If you choose not to trust, you have minimized the risk of being hurt  but you have also eliminated any potential gain of feeling truly connected, accepted and loved. You have left yourself more or less an island that no one can reach, touch, or understand.

For you to be disgusted with yourself is familiar – it’s known and relatively comfortable to live this way. For you to live as though you are completely acceptable is foreign and therefore uncomfortable.

You are unique and so are your experiences. Yet to make a leap that no one can understand how you feel is to deny that others have similar experiences.

Being rejected by (a loved one) left you rejecting you all over again. It’s like ripping the scab off of a wound and then you wonder a year later why you’re not better. Well, it would be healthy if you were feeling very angry, hurt, betrayed as your email indicates that you are. I wonder what you’re doing to externalize that and release it?Blaming yourself means holding on to it and that’s the opposite of letting go.

If you stop blaming you then you’re faced with powerlessness – someone hurt you and you are left to heal that wound. You can’t let go as long as you’re willing to punish yourself for being hurt and you can’t have the life you want if you’re going to be alone.

You deserve more than this but only you can allow you to have it.

Choose you.


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