Tag Archives: The Hope Chest

The Hope Chest: The writing on the wall

By Kim Johancen-Walt March 16, 2015

Through our traumas, we are often at risk of ingesting our perpetrators, continuing to perpetuate the same cycles of abuse and abandonment on ourselves and on others, and believing the messages of unworthiness communicated through the injuries that were inflicted. Left unchecked, these messages can be fully absorbed like toxins through our skin, and we may not even know we are infected.

It is not enough to help our clients identify the source of their ongoing patterns and propensity to both abuse and abandon. We must also help them reveal how these beliefs continue to affect their relationships with themselves and limit their ability to truly heal.

Powerless to change

“Devin,” 45, had started therapy because of complicated grief associated with having his fiancée leave him several months before our first meeting. Devin was severely depressed and was becoming increasingly suicidal. Early sessions included taking a close look at Devin’s relationships, which revealed a pattern of abuse set in motion by growing up with a mother who had been both physically and sexually abusive to Devin at a young age.

Because of early trauma, Devin had grown up believing he would continue to be victimized. At first, treatment involved uncovering this belief and how it had defined his relationships with others. We unpacked his various traumas and co-created a space in which he could process these events and integrate them differently along the way. Motivated, Devin worked hard to change how he had narrowly defined himself and began broadening his personal identity. Knowing he was making progress, I was not expecting the reemergence of earlier symptoms, dying embers of self-abuse growing once again into a raging fire.

One day, coming in for a session looking simultaneously exhausted and agitated, Devin discussed feeling increasingly hopeless. We revisited the progress he had made up to that point, how he had fostered compassion for himself and his perpetrators, and how he had taken steps toward a bright and meaningful future. But despite these efforts to shine light on his growth, Devin continued to feel both stuck and helpless to move any further. It became obvious that he still believed he was powerless to change his life.

Feeling his frustration, I asked Devin how he could continue his healing while also holding on to a belief that he could not change. Although abrasive, his victim identity had become a comfortable blanket he wrapped tightly around himself throughout his life. We discussed how it was hard to let go and identified the various ways he continued to stay in the shadows. For example, precious time in counseling was still spent focusing on many of the people who had hurt him. It was at these moments of misguided focus that he continued to disappear, abandoning himself in the process of trying to understand and predict the actions of others.

Open to the idea that he had been binding himself, we discussed the true nature of acceptance. Acceptance is not about needing to embrace the events that have happened; it is about embracing the impact of these events. This involves being completely present to our experience (while simultaneously limiting the overwhelm), feeling the fullness of our grief and loss, and acknowledging what we need along the way.

Early on in counseling, time spent dissecting the actions of others may have been valuable in regard to deepening Devin’s understanding that his abuse was not his fault. But at some point, more time needed to be spent acknowledging his personal experience and his needs moving forward. Extinguishing the flames of abandonment involves catching those moments when we abandon ourselves. By focusing only on those who abandoned us, we can slip back into the abyss, feeling powerless with no obvious way out.

As Devin became more proficient at recognizing his own patterns of abandonment, he also became more adept at focusing on his feelings, his passions, his desires and, ultimately, his true identity. Changing how he related to himself and the belief that he had to abandon allowed him the opportunity to let go more fully and ultimately get back on the journey to focusing on what was truly in his control.

Attempting to solve the problem with the problem

“Reece,” 53, was an accomplished career woman. Always impeccably dressed and looking as if she had just stepped out of a salon, Reece maintained a successful business. At the same time, she was also struggling with an alcohol problem and unresolved grief surrounding the recent loss of another meaningful relationship in her life.

Reece had grown up with parents who focused solely on achievement and withheld love from her when she failed to perform at high levels. She discussed, for example, how her father had encouraged her to start dieting at age 12, limiting treats when she didn’t lose weight, and how both parents rarely acknowledged her perfect report cards, stating that her academic achievements were expected and nothing to celebrate. As perfectionism took root at a young age, Reece constantly chased approval from others, believing she was never good enough despite her numerous achievements.

Through early stages of counseling, Reece became more aware of her drive for perfection and why it had evolved. We discussed how her need to perform continued to run her life and affect her relationships with others. She routinely chose partners who affirmed the belief that she had to perform or else be punished. Although it was useful information for Reece to realize how perfectionism was part of how she had survived as a child, it became apparent that her growing awareness was not enough to effect change. She became increasingly impatient (both with herself and with me) and progress slowed. She would have occasional bursts of confidence and clarity, but inevitably she would slip back into her depression and grief over the loss of her relationship with her boyfriend. It was during these “slips” that her self-abuse would also become amplified. In addition to other forms of self-injury, she began coming to therapy with scratches on her neck and the backs of her hands.

During one particularly difficult session in which Reece arrived with fresh cuts, I told her that she may be “stuck” because she was attempting to solve the problem with the problem. She had tried to approach healing and recovery the same way she had approached everything else in her life — with perfection, unrealistically high expectations and punishment in various forms when she failed to deliver.

In her push to move quickly through recovery, she routinely minimized her feelings, berating herself for not moving forward and effectively tightening the chokehold of both abuse and abandonment. Acknowledgement is the No. 1 prescription for healing and recovery because it is the exact opposite of what has been done. With traumatic events, our needs have been completely disregarded. Reece’s refusal to acknowledge her grief and despair had simply created more of the same. Her substance abuse and self-injury were two more perpetrators serving to mute and minimize her feelings and needs.

Beginning to recognize that sitting in the mess was also a way to move through it, Reece started to practice patience for her own natural healing process. She began working toward the idea that she was inherently lovable because of who she was, not because of what she did. She began seeking acknowledgment from caring others and received additional messages of worthiness in the process. Increasing her exposure to lovingkindness was the antidote.

Letting go

Letting go is a challenging and difficult practice. It requires commitment, recommitment and tremendous patience. When therapy seems to stagnate and our clients feel as though they are hitting an unmovable wall, it may simply mean that they are getting ready to push through to the other side. Sometimes letting go of our old identities, even the ones born out of abuse and abandonment, can activate both new and old feelings of loss. We might actually hold on more tightly as we feel the old relationships with ourselves slipping through our fingers. The desperation comes because we cannot bare the thought of additional loss. For many of our clients, these relationships with themselves and others, although abusive, are what they have always known, making it difficult to let them go.

Without understanding the pervasiveness of these messages and the terror of potential additional loss, we are at risk of joining our clients in their frustration over a lack of progress. Our frustration and failure to accept our clients unconditionally can tighten the vice grip of self-abuse rather than help free them from it.

We do not want to reinforce messages of abandonment through our work. We simply have to read the writing on the wall that our clients are bumping up against. If we do that, we may be able to help them discover that seemingly slow moments in therapy are actually a necessary part of healing and recovery. It is a signal that they are in the final steps of letting go and it is always darkest before the dawn.

It is not enough to change our patterns with others. We have to first start by changing the patterns with ourselves. What keeps us pushing is the faithful knowing that there is beauty on the other side.

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Kim Johancen-Walt writes “The Hope Chest” column exclusively for CT Online. She is a licensed professional counselor with almost 20 years of experience. Her clinical experience includes working as a therapist for La Plata County Human Services, where she helped develop a treatment model for adolescents in Durango, Colorado. She has presented her clinical work at mental health conferences nationally, including at the annual conference for the International Society for the Study of Self-Injury. Additional clinical experience includes a position as assistant training director and senior counselor in the Counseling Department at Fort Lewis College. She currently operates a full-time private practice in Durango. Contact her at johancenwaltks@gmail.com.

Previous columns:

The Hope Chest: The GIFT of therapy

The Hope Chest: Unpacking the hurt

The Hope Chest: Finding calm within the storm

By Kim Johancen-Walt November 13, 2014

We have all taken seminars, classes and workshops focused on the importance of self-care. These forums generally highlight the importance of taking care of ourselves outside of work. We talk about the importance of finding balance, taking spin classes, kickboxing or engaging in hobbies such as drumming or knitting. But despite our best efforts to make self-care a priority, there are times when many of us still find ourselves feeling fatigued, increasingly irritable and disconnected from our personal relationships.

When we are merely burned out, all of those pickle ball classes we participate in or blankets we crochet can work to rejuvenate our spirits so we can continue engaging with our clients and within our own lives. Sometimes, however, we find ourselves unable to bounce back, stretched beyond our natural elasticity and resilience. Through our daily exposure to trauma, we are at risk of developing tilted vision without even recognizing that it is happening. At these times, our self-care may not be enough to prevent us from doubting our ability to effect real change for the people we are trying to help. Activated and overwhelmed, we can lose our way, maybe even seeing our clients as problems rather than people.

Vicarious trauma is like a slow-moving virus that weakens our muscles and compromises our immune system. The reality is that we are all at risk. As a therapist in the field for many years, I understand the weight of trauma both personally and professionally. I engage routinely in self-care, take mental health days as needed, strive to find balance and do my best to resist the urge to isolate when I feel particularly stretched. But it is important to remember that distraction alone is not enough to help us heal from the impact of trauma, whether that trauma is direct or vicarious. Sometimes, no matter what we do outside of work to protect ourselves, we still can’t stop the disease from spreading; we merely slow it down. We have to find a way to stop the poison from permanently impairing our system.

We can find openings with our clients to build our own resiliencies along with theirs. By reflecting on these sacred conversations, we can learn valuable lessons that allow us opportunities to heal within the storm. Longevity as a therapist comes from using (rather than avoiding) our exposure as a way to build immunity and ultimately to become even better healers. On-the-job resiliency training involves deepening our understanding of the value of human connection for ourselves, remembering that pain and discomfort are an essential part of living fully and that helping others is a direct pathway to helping ourselves.

Powerful connection

“Patricia,” 36, lived alone and had come to therapy for issues related to the loss of relationships in her life, including a long-term boyfriend and the unexpected death of her mother several years earlier. Patricia was motivated to heal and live a fuller life. Her motivation was evident not only in her regular visits to my office but also in her diligence to practice various techniques and strategies in between sessions. She was also dedicated to other healing practices, including her work as an artist, seeing an acupuncturist and attending yoga on a regular basis. But despite all of these efforts, Patricia continued to talk about feeling stuck in the abyss and unable to find her way out.

She started coming to therapy frustrated, telling me over and over again that she was doing everything she was supposed to do to take care of herself, yet nothing seemed to be working to stop the pain. After acknowledging her incredible efforts along with her frustration, I reminded her that although she was engaging in several meaningful practices, she was doing all of these things by herself. We discussed how as human beings we absolutely cannot heal in isolation. We need each other. Rumi’s teachings remind us that it is the relationship that hurts, but it is also the relationship that heals. After exploring this concept, we discussed how Patricia could begin cultivating more meaningful relationships in her life moving forward despite a fear of further rejection and abandonment.

When the constant exposure to trauma begins to cloud our vision, our connections to peers, friends and family members are threatened as we begin to show the same symptoms of numbing and constriction that our clients exhibit. Whether we see our own therapists or choose to spread it around to our existing support network, others remind us that we are good, that we have experienced success in many areas of our lives and that we make a difference. In other words, we are reminded that it is not all bad. In graduate school, we are taught that the relationship with our clients is paramount to any therapies, skills or strategies we offer. Connection (or reconnection) is the most powerful medicine available to heal the isolation that comes from trauma.

Painful experience

As Patricia began to accept that building relationship outside of therapy was essential to her healing, we began to work with the rawness of her past through a broader lens of human experience. As she discussed moments when the emotional pain was so intense it threatened to split her open, I encouraged her to remember that her pain was not uniquely hers. Although experiences of loss may differ greatly from person to person, it is something we all have in common. Embracing the painful experience is an essential part of what it means to live fully. Through this practice, Patricia began to connect to others more deeply, growing in awareness that there were people everywhere who knew the pain of loss, the feeling of heart-crushing grief and the ache of abandonment.

As therapists, we remind ourselves — as we remind our clients — that the inevitability of change ensures us that pain, just like joy, will not last indefinitely. It is with this knowledge that we remind others to keep moving, to keep breathing and to not give up. It is the not giving up that is most essential. Remembering (or experiencing) the universality of pain can be incredibly humbling for us as healers. No one is immune, and life does not pick and choose who gets clobbered. It is through this knowing that we find humility and the sweetness of shared experience. We find our way and the courage needed to withstand the violent storm raging around us.

Tasting our words

Patricia eventually decided to take her painting to the next level by becoming an art instructor at a local studio. She discussed how it brought her happiness to know she could help others through creative expression and also by helping her students build confidence in their abilities to create beautiful paintings. We discussed her decision to help others as part of her healing because it allowed her an opportunity to reap the benefits of receiving what she gave away. Patricia’s choice to become a teacher helped her cultivate purpose, connection and success.

Therapists with potentially compromised systems are at risk of abandoning ship by closing their offices temporarily or, in some cases, leaving the field altogether. And although there is value in taking a self-appointed sabbatical, a radically different choice would be to continue showing up in the chair. The fact is, we cannot do the work we do as counselors without compassion, however difficult it may be to find at times. By keeping our hearts open so that we can be there for others, we effectively resist the urge to disconnect from ourselves and from the people that matter most in our lives. We are either open or we are not. By tasting our words, we offer comfort and reassurance to ourselves as we offer comfort and reassurance to others.

No one is immune to the impact of trauma, the devastation of loss and the activation that reminds us that although we are therapists, we are also carriers of the virus. Through our connections to the

caring others in our lives, we are able to integrate our own trauma stories while keeping a larger perspective. By helping our clients work through painful feelings, we are humbled, remembering that the experience of loss is an essential part of what it means to live fully. Furthermore, by helping others we can remain open, resisting the urge to close ourselves off from relationships and from our own lives. It is the work itself that helps us heal.

Perhaps over time we can treat ourselves with greater compassion and gentleness, not waiting to seek support but rather asking for it when we need it most. Perhaps by remembering our shared experience, we can hold steady in the storm. Maya Angelou spoke about how the universe continues to present us with opportunities to learn valuable lessons over and over again until we finally “get it.” Whether trauma comes in the form of personal experience or from the ongoing exposure to the trauma of others, this is an important concept for the wounded healer.

What is the universe trying to teach you?

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Previous columns:

The Hope Chest: The GIFT of therapy

The Hope Chest: Unpacking the hurt

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The Hope Chest: Unpacking the hurt

By Kim Johancen-Walt August 19, 2014

When I first met Ally, 17, she surveyed the seating arrangement in my office and chose the chair closest to my door. Obviously guarded, she sat with both arms and legs crossed looking at me with green eyes slightly camouflaged by blond wispy bangs. Ally’s mother had been trying to get her to come to therapy in recent months because of Ally’s deepening depression. Her mother believed Ally’s depression was due to an abortion Ally had had several months prior to our first meeting. The mother had only insisted on therapy after reading a journal entry in which Ally had made it clear she was thinking about suicide.

As I began to ask Ally some questions during our initial visit, she stated that she did not need therapy and expressed anger at her mother for forcing her to come to my office. Although Ally knew I was aware of the journal entry and the abortion, I honored her resistance by staying in shallow waters, asking only about things such as hobbies, school and friends. I purposefully avoided the topic of loss. At first she answered questions but became increasingly quiet and then stopped talking all together. Counselors working with teens dread these moments, wondering how we will get through the hour when our young clients refuse to talk to us despite our best efforts to connect, create safety and begin the therapeutic process.

By the time many kids get to my office, they have come to believe that most of the adults in their lives cannot help them. They feel misunderstood, sometimes blamed, and tend to find their own emotion overshadowed by the emotion of others. They are also desperate for relief. I strive to educate these kids about the connections between unresolved grief, loss and suicidal behavior, about how therapy can help them manage pain differently and how to cultivate hope and resiliency along the way.

Sitting in silence, I explained to Ally that I actually did not need to know much about her to know that she was in incredible pain due to her suicidal thoughts. I told her that I knew I was looking at the tip of a very large iceberg. It is important to communicate to kids our knowledge of what may fuel suicide, that we take it seriously but are comfortable talking about it, and that we do not judge them for their thoughts and actions. I told Ally I knew she was doing the best she could to take care of herself as she dealt with unbearable pain.

Not believing that they can (or should) seek support and care from others, many kids come to believe that they must be fully self-reliant. Otherwise, they think they will risk more injury to themselves or become even more burdensome to those around them. Add to this the developmental (and oftentimes skewed) belief about the need to seek independence, and many teens retreat completely into themselves. Affected deeply by the things that happen in their lives, these teens believe they are mainly (if not solely) responsible for their losses, their pain and their inability to cope. Rather than asking for help, many of these teens become increasingly desperate as they find themselves drowning, with little or no ability to swim to the surface.

The overflow

When working with suicidal teens, I have found it useful to tell them about the invisible box that we each carry. It is a place where we store the painful events or losses in our lives, packaging them tightly to avoid the feelings associated with those events. Although this process of stuffing may work for a while, over time our boxes can begin to fill up, leaving us little room or tolerance for added stressors. I remember vividly the reaction of one of my 16-year-old male clients who, after I explained the box metaphor, stated, “If that is true, then I have a field of boxes buried in the ground.”

Once full, we find ourselves frantically trying to keep the lid on the box tightly sealed. But regardless of how hard we try, it is at this point of distress that painful content may begin to leak over the sides. When there is no room left in the box, many teens find themselves spilling over into what I term the “Overflow.” Desperate, they may turn to self-injury, substance abuse or suicidal behavior. After using this metaphor to explain the connections between my clients’ feelings and behaviors, most begin to understand the importance of making room so they can stay out of the Overflow. They become primed for therapy and ready to cautiously explore methods of healing and more effective ways of coping.

Although the unpacking is necessary, it is also a tender process. After a few sessions spent building both trust and safety, Ally started discussing the details of the abrupt and painful breakup with her boyfriend that occurred soon after her pregnancy. She cried quietly as she talked about his cruelty, along with how her mother had also abandoned her, “forcing” her to have an abortion and telling her she was irresponsible and an embarrassment to the family.

Ally believed she was fully to blame for the pregnancy, for having disappointed her parents through her reckless behavior and for her boyfriend leaving. Furthermore, she believed that her inability to cope and “just get over it” were signs of a flawed character. She believed she was weak and selfish for having aborted her baby. She continued talking about what happened, looking into the deep well of grief over having lost a child.

Throughout her process, I seized every opportunity to listen, understand and treat her with love and compassion. We discussed how her coping was outstripped trying to deal with complicated grief and that her suicidal feelings were the result of what had happened. In other words, I told her that her depression and increasing suicidal thoughts made sense.

Many of my clients have dealt with multiple losses and are unaware that each new wound can awaken others that are tucked away in dark corners. Overwhelmed with grief, most of these clients do not realize that the only way to make room is to unpack their losses one by one. And, sometimes, one explosion can be followed by several other mini blasts. For example, if our clients are not met with love, support or compassion after the initial bomb goes off, then their injuries can deepen, their framework distorted by multiple losses. They come to expect loss, perhaps blaming themselves and losing hope. Ally not only lost her child, but she also felt abandoned by some of the most important people in her life. She couldn’t stop the bleeding despite her best efforts to avoid stepping on additional land mines.

Handle contents with care

When I discuss the box metaphor with teens, I assure them that they are in charge of what content they choose to remove. Not wanting these young clients to feel further overwhelmed, it is critical to move forward at a gentle pace and to focus on the importance of making room rather than what is actually emptied. After explaining the therapeutic process in this way, many kids naturally begin looking at what is taking up the most space in their containers, knowing that the bigger objects are what contribute to their inability to handle added stressors.

We do not want our clients to empty everything at once, and each container must be handled with care. I want kids to know they are in control of their therapy, but I also want them to be aware that the unpacking is necessary if they are going to make room, build tolerance and effectively stay out of the Overflow. Throughout therapy, we assess safety and coping constantly, knowing that without careful attention to the process, speed and wounds touched, we may inadvertently push our young clients closer to the edge rather than away from it. We find ourselves dipping in and out of raw material.

Through our conversations, Ally slowly began building confidence in her ability to handle painful feelings. Gradually, we were ready to invite her mother into session to discuss what had happened. Both women cried together as Ally’s mother discussed feeling deep remorse for how she had handled the situation and for not considering Ally’s feelings surrounding the abortion. Through her own accountability, Ally’s mother opened the door to begin repairing the cherished relationship between mother and daughter. And in addition to cultivating compassion for herself, Ally was able to begin finding compassion for her mother. She came to realize that her mother had also done the best she could at the time and acted in what she believed to be the best interests of her daughter.

Through therapy, we help our young clients to uncover new pathways that were previously out of their view. We celebrate their victories and watch them gain confidence not only in their ability to cope but also in their ability to heal. And as we end therapy, we remain aware that they may have more work to do. Whether they collect new losses over time or whether older losses begin to reemerge, we know that future excavation may be needed — although that process may not happen with us.

We have done our job if we have given our young clients a new framework to work through the inevitable human experience of grief and loss, if we have taught them the importance of seeking help from caring others and if we have helped them learn how to effectively stay out of the Overflow. Through our work, these teens leave therapy with a new definition of healthy independence rather than one that finds them overwhelmed and in dependence. Through our connections with caring others, we are reminded that even in times when things are not OK, we will be OK.

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Read her previous column, “The Hope Chest: The GIFT of therapy,” here: ct.counseling.org/2014/06/the-hope-chest-the-gift-of-therapy

The Hope Chest: The GIFT of therapy

By Kim Johancen-Walt June 2, 2014

No apologies

What we think makes an effective counselor may evolve over time, but in the end it is the willingness to evolve itself that offers the most reward and sustainability throughout our careers. As counselors, we know that our growth is equally as important as the growth of our clients. And although we receive countless contributions along the way from teachers, mentors and peers, the gifts we receive from our clients offer us the most reward and the best opportunity to progress as counselors.

Marcie, a young adult, started coming to therapy after developing debilitating anxiety that interfered with her ability to manage a new career as a dance instructor. Although she had worked hard and been on stage her entire life, she had begun to doubt herself after other dancers told her she did not deserve the coveted position. In addition to reviewing other sources of self-doubt during our counseling sessions, Marcie identified and practiced a set of beliefs that produced a very different emotional response for her. After several conversations, Marcie’s anxiety disappeared almost entirely as it became clear to her that she was indeed the best candidate for the job based on her experience. She repeatedly told herself, “I deserve to be here … no apologies.” Courage and support are powerful allies when it comes to growth.

My hope in creating The Hope Chest column for CT Online is to pass on valuable tokens that I have collected in my career as a counselor. I will present various case studies and highlight what I have found essential in my own evolution as a counselor. I hope to offer strategies that other counselors can easily integrate, while also sharing new ideas to help promote effective change for clients. We evolve by staying open to our own process and by tolerating the discomfort involved with self-doubt and risk. It is within this discomfort that we grow as counselors, craft our own therapeutic style and stand strongly in the belief that we have a right to be here. No apologies.

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As counselors, we want our clients to feel safe, understood and loved for who they are, regardless of their mistakes, habits and blemishes. It is from that place we may even reveal some of our own humanness. We strive to understand each unique experience, and we support our clients’ progress by pointing out inherent strengths and resiliencies session after session. The relationships with our clients provide the rich soil that promotes growth, but once a strong foundation has been created, then what? What can we look for consistently when assessing whether treatment is effective?

Successful treatment lies in our ability to help clients identify and work toward their goals, while also learning the importance of awareness or intention as they move toward creating new habits. Effectiveness is also measured by our client’s ability to maintain flexibility and to tolerate painful feelings while moving toward beliefs and practices that create positive emotion. These therapeutic tasks, remembered through the acronym GIFT, can happen simultaneously and may indicate that treatment has been effective as well as when it may be nearing its end.

When I first met Jenny in her 60s, she was timid and small. She leaned heavily toward one side of the love seat in my office, as if something else was taking up all the space beside her. My sofa had never seemed large until that moment. In those first sessions, I listened to how Jenny’s experiences of growing up with an absent father and a mother who was severely mentally ill had affected her, how she had survived chronic abuse starting when she was still in utero and her mother had tried to terminate her pregnancy. Jenny provided most of the caretaking for her three younger siblings when she was still a young girl herself, and she endured years of psychological abuse.

Jenny described a childhood in which she had subsisted by vacillating between perfectionism and invisibility but never truly succeeding at either. She was never good enough to avoid an incident of harsh criticism, and she could never completely disappear. Her mother would always find her eventually. Although Jenny had long ago escaped her chaotic childhood she had lived her life grappling with the belief that she was deeply flawed, while also feeling continually disconnected from those around her.

Throughout treatment, Jenny’s goals became clearer, endlessly polished by her statement, “I want to live a life for me.” She said this a little more boldly each time. She also began to detach from the side of my couch as we discussed what it would be like to live a life for her, how she would feel when she reached her goals and what steps she would take to get there. She gradually grew into a solid presence as she talked about all the things she enjoyed, including daily walks, reading and taking the necessary steps to feed her love of learning by enrolling in classes at a nearby school. She scheduled additional trips throughout the year to see her adult children and was particularly excited about her gardening, saying she always felt happier with her fingers raking the dirt.

Jenny moved in a different direction while still believing she would be punished if she made her needs a priority. Although uncomfortable, she continued to take the necessary steps to change her reality, and she built emotional tolerance along the way. I talked repeatedly about how she deserved to have her needs met and her dreams realized, and I encouraged her to continue visualizing a life of self-love both in therapy and outside of it. As counselors, we may find ourselves repeating the same reassurances over and over, but it is through this repetition that we help to carve the new streambed that gives the water a different direction to flow over time.

As is the case with many of our clients, there were moments when Jenny would slip back into old habits, becoming activated and inflexible. For example, during our time together, one of Jenny’s good friends experienced a car accident that left her severely disabled. With great compassion for her friend, Jenny discussed how this incident had left her shaken, doubting her ability to change her course in life. It is at such tenuous moments that we remind our clients of their intention, the bigger picture and the importance of sticking to the path regardless of where they top out in the end. With Jenny, it involved reminding her that the purpose she had created for herself involved living a life for herself NOW — regardless of how much time she had left.

It is through these activating events that our clients may become rigid as they recoil from fresh pain. They may feel overwhelmed, helpless and alone. By bringing our clients back to their goals and intention, we have an opportunity to offer them a corrective experience. Without judgment, we help them regain both footing and perspective. We encourage our clients to cultivate flexibility by reminding them that challenges are an opportunity to integrate new beliefs and habits, to work through raw material and to return to the path regardless of the various twists and turns. We accept them through all of it by matching their pace rather than imposing our own.

Although many clients will report that their relationships outside of therapy have grown stronger, sometimes clients experience an increase in relationship discord instead. In Jenny’s case, growing relationship struggles were a sure sign that she was making progress — her husband struggled to catch up to the changes she was actively making. Although Jenny’s husband eventually started accepting her new independence and greater presence, this is not the case for some of our clients, and relationships end. The weeding process is an essential part of active growth. Change can be hard for our clients and for those around them.

Within the safety of the therapeutic relationship, our clients find the freedom to explore their goals, the changes they want to make and what it is that makes life worth living. If we have tended the soil properly, providing both nutrient and light, at some point we begin to sense expansion breaking through the surface. Our client’s ability to transcend doubt and fear depends on the environment we have provided for them to promote such growth.

When considering therapeutic effectiveness, we need to ask ourselves (and our clients) the following questions:

• Have we helped them create a clearer vision of what they want?

• Are they able to practice awareness and intention, focusing on the bigger picture through all of the inevitable distractions?

• Do they have the flexibility needed to stay the course regardless of unforeseen challenges?

• Can they tolerate the discomfort involved with exploring new terrain and the uneasiness involved with doing things differently?

Lasting change happens through the support of caring others. It is here that we can safely resist the urge to flee and where we learn to tolerate anxiety, staying present long enough to be acknowledged and to allow ourselves to feel loved.

I know therapy is beginning to wind down when I feel my own grief begin to emerge. I feel deeply for my clients, and I am sad when they leave. I do not hide this sadness but rather consider it another opportunity for my client (and perhaps me) to experience the richness of real connection and the unfiltered emotion that goes along with it. Upon one of our final visits, I noticed the dirt underneath Jenny’s fingernails and how she sat directly on the couch — fear was no longer taking up all the space beside her. We reflected on our time together, shared gratitude and discussed the connection we would always share.

Through our presence, we teach our clients that they deserve to have their needs met simply because they exist on this earth. When our clients tell us they want to change something, we point out that they will only bind themselves if they want greater happiness but do not actually believe they deserve it. We start with the deserving, tending soil and watching for signs that growth is happening throughout our weekly conversations. That is the true gift of therapy.

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Kim Johancen-Walt is a licensed professional counselor with almost 20 years of experience. Her clinical experience includes working as a therapist for La Plata County Human Services, where she helped develop a treatment model for adolescents in Durango, Colorado. She has presented her clinical work at mental health conferences nationally, including the annual conferences for the International Society for the Study of Self-Injury. Additional clinical experience includes a position as assistant training director and senior counselor in the Counseling Department at Fort Lewis College, where Kim helped train and supervise graduate-level interns in addition to working with college students. She currently operates a full-time private practice in Durango. Contact her at johancenwaltks@gmail.com.