Real World Clinical Social Work Blog: Stinging Stoicism

by Dr. Danna R. Bodenheimer, LCSW, author of Real World Clinical Social Work: Find Your Voice and Find Your Way  

     I have a client I have been working with for about five or six years. I have watched her make all sorts of life decisions that haven’t seemed to really fit her authentic desires. I watched her marry a man that she was unsure about, pursue several jobs that she was not a good fit for, enable her very drug addicted mother, refuse to get a handle on her financial life. At all of these twists and turns, I barely said anything. There were times when I wanted to scream, and there were times when I wanted to whisper. But every time, I waited for her to arrive at her own truths and her own conclusions, while I sat across from her watching.

     In the middle of a session a few months ago, I got a sudden and horrible pain in my arm. I had no idea what it was. It was downright startling. I wanted to whisper that I was scared. I wanted to scream that I was in pain. I didn’t do either. A few minutes later, we saw a bug buzzing around, making a distractingly irritating buzz. My client wondered aloud, “What is that?” I said that I had no idea. She then looked a bit closer as the bug flew by her and said, “Oh my god, that is an enormous wasp!” She grabbed my tissue box and said, “Let’s kill it!” and handed me the box of tissues. I stood on my chair with my shoes on, took the tissue box, and slammed the bug into the window, murdering it, proudly. I was self conscious, but still I found my way to killing the bug. She said, sweetly, “Aw, my hero.” I said, “Actually, it stung me a few minutes ago," and raised the sleeve on my shirt. It was the first time that I let myself look at the source of the pain, which was now pink and swollen. She then said, “Wow, why didn’t you say anything? Actually, how didn’t you say anything?”

     Perhaps I was not her hero after all.

     Those were the two essential questions of our treatment. Why don’t I say anything? How do I manage to continuously say nothing? I want to say that the problem was co-created, that it was the by-product of our relationship. But that answer would be both untrue and unfair. The truth is that there is a way in which I have internalized theory about how we should practice in ways that have felt both toxic and paralyzing. I get confused about my role.  I know that we “shouldn’t” give advice. And I know that we are ultimately gentle guides, not sages on a stage. But should this leave us tongue tied as we watch a car veering off the road? Oftentimes, it does. But no, it shouldn’t.

     I think that we become so afraid of our own power and influence that we hold ourselves still and we hold ourselves back. We ask a lot of questions. Sometimes we offer reflections. And at our most aggressive or active, we offer interpretations. We rarely say, though, “I am scared for you,” or “This doesn’t sound right to ME.” We seek some sort of objectivity, hoping that we can move our clients to their own realizations with techniques that will escort them there somehow. But, typically, what truly moves someone forward is the power of a relationship that both parties are uniquely and powerfully present in.

     While I certainly have no affection for wasps, I am so grateful for the one that stung me. It made me realize how deadened I can be in treatment. It made me realize just how easy it is for me to stay silent, even in the face of panic and pain. The truth is that there have been many times when I have felt stung in the presence of this client. There have been many times when I have wanted to scream: “Don’t do it,” “Protect yourself,” and “I love you and I care about you and I don’t want to see you hurt.” But she didn’t hear the buzzing, so she didn’t know.

     I know that the murder of the wasp represented a deeper death between us, the death of a fantasy objectivity, the death of technique and silence. It also represented a birth. A birth of collaboration, presence, and a shared willingness to risk the pain of intimacy.

     For Thanksgiving, I received a text from her. It said, “Happy Thanksgiving Danna! I feel so grateful for having you in my life J. Enjoy the day.” My first internal responses were all pre-sting like. I worried about boundaries, about how I could “professionally” respond, about what another therapist would do. I thought for a while about not responding at all, as if I never heard the buzz on the phone. A few hours later, I wrote, instead, “I feel grateful for having you in my life too!” I wrote that because it is the whole, subjective truth, and anything other than that would have stung.

Dr. Danna R. Bodenheimer, LCSW, is in private practice at Walnut Psychotherapy Center in Philadelphia, PA, and teaches at Bryn Mawr College Graduate School of Social Work and Social Research. She is the author of Real World Clinical Social Work: Find Your Voice and Find Your Way.