Bret Hofstein, MA/MFT

PSYCHOTHERAPY

Emotional Sherpa, Part III

Bret HofsteinComment

Toward a Relationship of Trust

My client, Alex, had told me early on in therapy that he had a secret. As we progressed and climbed higher and higher in his therapeutic journey, we realized that certain revelations needed adjustment time. Once we could sit with a new level of disclosure, though, we were able to continue on as Emotional Sherpa and mountaineer.

One session, Alex was enjoying telling me about favorite things from his hometown. From certain hole-in-the-wall eateries, to museums, to the ballpark that he used to go to with his father as a young boy, my client gushed about his city with pride. In many ways he had taken me back to where I had found him and began to see things differently. It seemed that he had adjusted to the rarefied air and was now beginning to make better sense of things, of his life, and of where he came from. And during that session, he reminded me that he had “secrets.” I told him that I had not forgotten. He was telling me in that moment that he was getting ready to climb higher, but he was also wondering if I was ready for the climb ahead. I wondered with Alex if he thought that he could trust me with the messy stuff sitting at the bottom of his emotional backpack — parts of himself that he’s been too afraid to touch or understand. He didn’t know for sure. A part of him was concerned that it might be too much for me to handle or too much for me to hold. If it was too much for me, he would be unable to continue on up the mountain.

In his book “On Becoming a Person,” renowned psychologist Carl Rogers writes, “I would like to go with him on the fearful journey into himself, into the buried fear, and hate, and love which he has never been able to flow in him.” Rogers highlights this desire of the therapist, the Emotional Sherpa, to move with and into the tortured parts of the client’s psyche. Unafraid, without judgment, the therapist is eager to get out the picks and shovels and excavate with the client and move closer and deeper toward their more realized and understood self. But before any of this can begin, before a word of real significance is spoken, trust between client and the Emotional Sherpa must be established. And this, of course, does not come easy.

Carl Rogers writes about his client’s struggle to let go and trust the therapist, but his client has fear and reluctance to do so. By meting out a morsel or two to keep the therapist satisfied and engaged, the client tests the Emotional Sherpa’s patience and strength, as if to say, “I know what I’m capable of doing. I know that I can climb a bit higher but I’m not sure you can catch me if I fall.” So this cat-and-mouse game between client and therapist persists.

Then, perhaps there is a breakthrough. After months, and sometimes years, of gaining trust not only in the Emotional Sherpa but also in himself or herself, the client takes a chance and, with it, a big step. And with this big step comes a revelation that “maybe, just maybe, I can ascend higher.” Rogers writes about his client’s desires: “It makes me feel that I want to go further, exploring me, perhaps expressing more of myself.” And with this new sudden courage to move higher, to challenge oneself to dig deeper into the psyche, comes fear — a sudden recognition that the client is no longer thinking of delving to deeper awareness but is now there, at the highest peak he or she has ever reached. Looking down can be terrifying. Vulnerability starts to take effect. Doubt starts to creep in. Anger and fear make way for eventual forgiveness, and the client senses there has been a change. The client has begun to push through prior resistance and with this rebirth, a fright of the new heights. But there is also the recognition that someone is there for the client. Hence, a trusting relationship has been established.

“I don’t want to scare you away,” Alex said to me that night. Scare me away, I thought to myself. I had recalled when I was in Yosemite on a family vacation and, not being too fond of heights, looked down from the ledge into the deep canyon below and noticed how I was completely consumed by my body’s reaction. I was so aware of the shortness of my breath, the tightness in my chest, and the quiver in my legs that I had moved away from my rational mind. For a moment I felt quite unsafe, like I could at any moment fall over the side. But then I reminded myself that I was safe. My client’s words, “I don’t want to scare you away,” were in many ways his version of the deep canyon inside him not wanting to scare me away. In that moment Alex had an intention of wanting me to peer down, but also an awareness that the depths might be frightening for me, and perhaps for him. And if I was frightened by what I might see, and perhaps terrified of falling in, how could I lead us higher? So I simply said to him, “I’m not going anywhere. I’m right here.” Alex thought about that for a moment and then said, “What if you’re not strong enough to catch me?”

Faced with the contradiction of wanting to push himself toward the unknown, but being afraid of taking that first crucial step, Alex is stuck for a moment. Clearly there is a desire to take the risk, an aching to test the limits, but there is also an uncertainty that I will be able to tolerate the weight that might befall me and, therefore, hurt him. The Emotional Sherpa’s job and responsibility in that moment is to assess where the client is on the mountain. Are we about to make a major climb out of a comfortable and safe area, an area to which we’ve allowed time and space to acclimate? Or do we need more time to stay put and think about the strength and readiness of the client? “I don’t want to scare you away” and “What if you’re not strong enough to catch me?” clearly signify to me that Alex is ready to climb higher. This has now become about the Emotional Sherpa’s strength and conditioning in this moment. Alex has moved away from fear of himself and moved toward questioning the therapist’s ability to stay strong in the face of this significant move toward unseen vulnerabilities.

By not overreacting to Alex’s questions and concerns about me I allow the room necessary to be patient, knowing he, through months or years of exploration before, has the capacity to trust. With time, my patience and reverence for my client’s journey up the mountain, and his own recognition of the potential within him, he will continue to climb the mountain of his life. By helping him with his climb higher, and gathering the emotional tools necessary to move higher, Alex will become his own Emotional Sherpa.

My client has a secret. In time he might tell me. Until then, we continue up.

Emotional Sherpa, Part II

Bret HofsteinComment

Adjusting to New Altitudes of Self-Disclosure

Previously in this series, I introduced a client of mine, Alex, who was seeking therapy for depression and panic. He indicated that he had a secret, and I had likened his emotional journey to that of climbers in the Himalayas, who enlist the aid of the Sherpa people to help them navigate the treacherous terrain.

Before Sherpas are hired to aid their clients up a mountain, they have to be sure they themselves are ready for the climb. If they were to fall victim to altitude sickness, they would be little use to their clients and would risk harming their clients in the voyage. Years and years of training, as well as years and years of self- exploration, are expected and necessary for Sherpas. The more time spent on the mountain, the better understanding the Sherpa would have later on when worked called. Any clients can trust that they are in the hands of a professional. They could assume correctly that the Sherpa had been there and back hundreds of times, and that if trouble did arise the Sherpa would know from his own experience what to do, how to navigate through it, and how to survive.

My clients should have the same expectations.  They should assume that I’ve traversed similar peaks and valleys; I’ve gone to the depths and back again. Perhaps I have not walked the same exact paths, but I know the topography. From years of my own work with similar guides, my own Emotional Sherpas, these kinds of journeys that I speak of are familiar ones. For me to simply pretend that I know pain, sorrow, stress, or tension would risk further trauma for my client. When lives are at stake, physically or emotionally, pretending to know is left back in the classroom. Empirical knowledge is the only thing that can be truly trusted out on the mountain.

My client Alex and I uncovered and discovered pounds and pounds of self-doubt, low self-esteem, and depression while rummaging through Alex’s emotional backpack. From years of emotional abuse and lack of parental attunement, Alex’s emotional toolkit was ill equipped to handle the vicissitudes of life’s peaks and valleys. So, we continued to pour out its contents. I held them with reverence, as they represented his inner struggle. To discard them and leave them on the side of the mountain and continue on would be akin to leaving trash behind for someone else to tend to. My job as his therapist was to bring it with us and find ways of using it later in a more meaningful, satisfactory way. I held his emotional life in my hands. From the benign to the malignant, all of it, every piece, told his story.

After many more months of discovery in his journey, Alex came in for his session one evening very depressed.  He expressed to me that he had a secret life that no one knew about. When I asked if he was doing anything illegal or hurting himself in some way, either physically with drugs or other means, or intending to hurt anyone else, he said he wasn’t, but he didn’t offer any other information regarding this secret part of him. And I didn’t press him for it.

So we sat in my office that night for the remaining 45 minutes or so of his session and Alex’s depression eased. He had gone higher on the mountain and needed time and patience to acclimate himself to the new altitude, lest he get sick and need to come down. Because I was allowing the space and time to sit with this new information about a “secret life” and not pressuring him to know the details, we could now resume the climb. He trusted me enough to give me more of himself, to unburden his emotional backpack and give it to me to hold for a while.

Perhaps his depression rested in this question about another’s strength to hold his things for awhile, without question, without judgment, and with reverence. In that moment he tested my strength. Would I buckle? Would I want more to prove how strong I thought I was? Or would I meet him where he was and be thankful for what he was giving me and not ask for more but instead allow the space and time for both of us to digest the moment, metabolize it, and sit with it for a time? This was the path that I chose.

Though my journey around Annapurna was met with certain physical challenges, aches and pains, and a hyperextended knee, I found out more about myself during that three week odyssey than any other time in my life. Yes there were times when I wished I had a Sherpa carrying my backpack for me. Thirty-five pounds for 21 days can and will take a toll on you physically, as well as emotionally. There were times when I hated that backpack. I cursed that backpack. I didn’t want to look at that backpack. But I had no choice. It was mine, it was necessary, and it went with me regardless of any other intentions. I couldn’t escape from it. Therefore, I had no choice but to embrace it.

As time went on and other sessions came and went, Alex and I did not discuss his “secret life.” He didn’t mention it, but he knew that I knew of it. That seemed to be enough for the time being. Instead we needed to be in this space for awhile. We had reached a new altitude and needed to be patient. I remember reading Jon Krakauer’s book “Into Thin Air” about the devastating events on Mount Everest in 1996, and how when they reached base camp during their climb to the summit, they needed time to adjust to the heights and thinning air. Each leg higher during their ascent required more time spent at each new phase of the journey to gain their strength, get the proper nourishment, breathe more thoughtfully, and respect and honor where they were. Alex and I were on the same emotional journey. To push ahead prematurely could result in a massive setback emotionally. Or, worse, it could result in complete abandonment of the move higher – which in turn would mean we would be stuck on the mountain, stuck in a depression, and too afraid to move again. Alex needed time to adjust, to sit and be patient, and then, with recognition by his Emotional Sherpa, we could both move higher.

Emotional Sherpa, Part I

Bret HofsteinComment

My Client Has a Secret

I’ve been working with a 30-year-old person, “Alex,” for over two years now. When Alex came into my office he struggled with a debilitating combination of panic attacks anddepression. Alex was stuck on the mountain of his life, afraid of moving in any direction. He was paralyzed. So when he finally arrived in my office and sat down on the couch in front of me one evening, I started slowly. After making so many “wrong” choices in his life, Alex didn’t know how to proceed with his journey. He didn’t trust his instincts any longer and he questioned his existence. He was in the midst of an existential crisis and was losing rational thought. As I sat with Alex in my office that night I honored where he came from and moved patiently.

As a psychotherapist working in private practice in Los Angeles I’ve come to think of myself as a Sherpa for people in therapy with me—an emotional Sherpa. I carry the backpacks of their lives with them, sometimes for them, as we set out on their journeys of understanding and discovery. Hopefully, this results in a better sense of self and, therefore, a more fulfilling and meaningful life for them. I too have had to explore the depths of my own psyche.

On New Year’s Eve in 1994, I set out on a journey around the world. With no real road map and no thought of an end date or a city in mind for the culmination of my travels, I left my home in Los Angeles to explore the world with a 35 pound backpack strapped to my shoulders.  Filled to capacity without an ounce of room to spare, this backpack contained all that would be needed during my adventures. Clothes to accommodate cold and warm climates, essential toiletries, a journal to document the journey, a sleeping bag harnessed on top of the pack—this bag would come to represent my life; if it were to be lost, compromised, or damaged, I would become more vulnerable. It was important to recognize the significance and importance of this backpack and to treat it with the utmost respect and care. To not hold it in reverence would be foolish and costly.

As my trip progressed through Thailand, Singapore, and Malaysia, to the tiny village of Pokhara in Nepal, I readied myself for a three week trek around Annapurna, the Himalayan range in the north central part of the country. I once again strapped my trusted, yet somewhat frayed, backpack to my shoulders and began what would be a monumental trek through the tough terrain of the Annapurna circuit.

There, I encountered the Tibetan Sherpa people, who live in the extreme altitudes of the Himalayas. Sherpas are known for their ability to navigate this terrain, and they often transport and guide mountaineers up and down the mountains. Having been raised in and around the region, they are experts at traveling in the extreme altitudes of Mount Everest, Annapurna, and Kangchenjunga, to name a few. Sir Edmund Hillary, the first man to summit Mount Everest, used the services of Tenzing Norgay, a Sherpa, because he knew Norgay understood the challenges ahead and shrewdly recognized the importance of and need for someone who knew how to climb effectively and prudently. Today many would-be mountaineers take advantage of the Sherpa’s services to make their climbing and trekking experiences more enjoyable and less taxing, both physically and emotionally.

I likened my experiences and my knowledge of the Sherpa people to my work with Alex. As Alex gave me bits and bits of information, bits and bits of his past, I stored them with me. He unfolded his fears, his questions, and his shame, and I allowed the room necessary for Alex to unburden himself and trust that I could hold onto his precious cargo. It had become too heavy and too toxic to hold any longer. The more he shared and the more we were able to process and make sense of his concerns, the calmer he became. Movement had begun.

After a few months of seeing me a couple times a week, Alex was stable and free of panic attacks. In many ways we sat at a certain elevation and allowed the time to acclimate to the extreme altitude and learn to breathe a new way. He needed to adjust to the unfamiliar air and wait for it to become more familiar and less feared. Then he was ready to resume his journey on his trail leading up the mountain with stronger lungs, less anxiety, and a trust in me. And up we went.

But the journey was not over, and Alex still had a secret.