Learning to Tolerate Shame
Shame sucks. It's the easiest way to put it, the least emotive perhaps, which keeps me at a safe distance from the mess I feel at the pit of my stomach.
Shame is a difficult emotion. It can bring up a lot of painful ideas about yourself and your worth. It can be so powerful, it has been described as an emotion that can lead to a state of "cognitive shock," or the inability to think, when experienced intensely enough.
Many clients feel shame, and I suspect many therapists do as well. This week was my turn. I felt such incredible currents of shame at watching clients' pain and feeling that my caring exceeded my current skill level. Feeling like I don't know what to do, moment to moment, I don't know whether I'm doing or saying the right thing, I don't know if it's helping, or whether I'm coming across as condescending -- too logical -- when their emotions are so strong.
Of course, these are things you bring to your supervisors as a trainee. Right? Right. Except this week I felt so much shame, I didn't. I was afraid of what it would mean. Maybe they would think I can't handle this. They would change their minds about having me here, training. They would wish they had picked someone else, someone more competent. They would be disappointed, which would bring on more shame. And I had had enough.
Marsha Linehan, creator of DBT, says that when you feel shame, the treatment is to do the opposite of what shame tells you to do. Every emotion comes with an "action urge" -- an urge to act in a certain way. With anger, for example, the associated urge is to attack. With shame, it's to hide. So the treatment of shame is to do the opposite of what it tells you to do. Not to hide but to come forward and talk about it. (Assuming shame is unjustified, and it's unjustified when you won't get kicked out of your community for feeling it. And so in this case, I think it is unjustified -- I won't get kicked out of my training, and I won't be rejected by friends or family for admitting it.) But I feel so much shame at even thinking of bringing it up. I don't want to talk about it. I don't want to engage in its treatment.
OK, fine, fine. I can feel like not doing it and do it anyway. so I'm taking the first step of Opposite Action here. Talking about it here.
So ...
Shame sucks. I felt it because I felt I could not help my clients. I felt it because I felt I could not tell my supervisors what exactly went wrong and get help because I could not formulate the problems well enough to know what questions to ask.
I felt it when they suggested we could record the sessions to help me ... I felt it when I had an accompanying thought that perhaps we would then all see how awful I am at all of this, and that I have no future in it, and the fact that I thought maybe I did was a silly idea.
Of course, I recognize that voice. It isn't my voice. It's impostor syndrome. Also comes with shame.
Feeling shame won't kill me, no. But as I talk about this now, it is very, very uncomfortable. I don't want to feel it. I don't want to talk about it. And so I keep talking about it ...
The thing is, I AM training. I am NOT going to have all the answers. I am not going to be able to deliver perfect interventions when they are needed. I am allowed to make mistakes. And when I make them, I give my supervisors a chance to help me, to teach me, to guide me better.
Writing this now feels a little better ... I sense the first seed of relief ... the benefits of talking about shame, seeing what I have to accept here and what I do not ...
I feel ashamed because I am afraid that maybe I can't help them. It's a terrible feeling to watch someone suffer and feel that you can't do anything. To want to help them so much. Of course we want to. That's why we go into this kind of career. But the catch, if you want this career, is that you have to sit through this very uncomfortable beginning stage. The stage called learning. The stage that likely never stops but perhaps gets easier with time because the steep learning curve stops being so steep.
But right now ... right now, here I am. In this part. I need to accept that I am not perfect, I will not do things perfectly. In fact, I will probably fail several more times. I will likely have sessions that were not that helpful. And I will need to tolerate the discomfort of that experience. Because it's the only way. The only way out is through. The only way out is to tolerate the discomfort, worth doing to get to a better place, where you've learned more and you know more of what to do and what not to do.
And in the meantime, you rest on what you do now. The theories, the ideas of what might work right now, the super-strengths of listening and empathy.
When I am present, and I listen there in the room, and don't get caught up in my head about "can i help?! i don't know!" and just trust that the words will come, because some learning has already been programmed in there, everything tends to go so smoothly. Because even now, when I am drowning in shame, now that I have started talking about it, what I want most is someone to listen. A safe space to explore my feelings.
Perhaps I wasn't ready to tell my supervisors yet before about all this shame. Maybe I won't be next week. Maybe it's someone else I'll tell. That's my right. I deserve to choose.
I need to tolerate my discomfort and allow shame in. It won't kill me. I just cried about the feeling, and you know what? I noticed in the middle of that, that experiencing heartbreak, although highly uncomfortable, was not dangerous. I could do it. I could tolerate heartbreak ... and the fear that I won't be able to help, and the shame at not being able to do things well every single time. I can tolerate these things enough to keep going and keep reading and keep showing up and keep trying and keep going to supervision and asking questions. I can feel shame AND keep going. There, some dialectical thinking.
Perhaps shame in this form is a good thing. Its presence signals honest caring, a genuine desire to learn and be the best I can be. Not the best ever. But the best I can be, good enough to be able to sit there in that little room and skillfully help people in pain. That's why I'm making a choice to tolerate discomfort. Each time I tolerate it and I talk about it, I am making a choice. To keep working toward that dream there in the distance. I could suppress it and not talk about it and distract myself instead, but then we know that suppression leads to the fueling of the shame which promotes depression and anxiety, and if I choose that route, that would hurt my efforts in learning how to be a competent clinician.
So I keep going this way. Talking about shame. And reminding myself these things:...
---
Shame is a difficult emotion. It can bring up a lot of painful ideas about yourself and your worth. It can be so powerful, it has been described as an emotion that can lead to a state of "cognitive shock," or the inability to think, when experienced intensely enough.
Many clients feel shame, and I suspect many therapists do as well. This week was my turn. I felt such incredible currents of shame at watching clients' pain and feeling that my caring exceeded my current skill level. Feeling like I don't know what to do, moment to moment, I don't know whether I'm doing or saying the right thing, I don't know if it's helping, or whether I'm coming across as condescending -- too logical -- when their emotions are so strong.
Of course, these are things you bring to your supervisors as a trainee. Right? Right. Except this week I felt so much shame, I didn't. I was afraid of what it would mean. Maybe they would think I can't handle this. They would change their minds about having me here, training. They would wish they had picked someone else, someone more competent. They would be disappointed, which would bring on more shame. And I had had enough.
---
OK, fine, fine. I can feel like not doing it and do it anyway. so I'm taking the first step of Opposite Action here. Talking about it here.
So ...
Shame sucks. I felt it because I felt I could not help my clients. I felt it because I felt I could not tell my supervisors what exactly went wrong and get help because I could not formulate the problems well enough to know what questions to ask.
I felt it when they suggested we could record the sessions to help me ... I felt it when I had an accompanying thought that perhaps we would then all see how awful I am at all of this, and that I have no future in it, and the fact that I thought maybe I did was a silly idea.
Of course, I recognize that voice. It isn't my voice. It's impostor syndrome. Also comes with shame.
Feeling shame won't kill me, no. But as I talk about this now, it is very, very uncomfortable. I don't want to feel it. I don't want to talk about it. And so I keep talking about it ...
The thing is, I AM training. I am NOT going to have all the answers. I am not going to be able to deliver perfect interventions when they are needed. I am allowed to make mistakes. And when I make them, I give my supervisors a chance to help me, to teach me, to guide me better.
Writing this now feels a little better ... I sense the first seed of relief ... the benefits of talking about shame, seeing what I have to accept here and what I do not ...
I feel ashamed because I am afraid that maybe I can't help them. It's a terrible feeling to watch someone suffer and feel that you can't do anything. To want to help them so much. Of course we want to. That's why we go into this kind of career. But the catch, if you want this career, is that you have to sit through this very uncomfortable beginning stage. The stage called learning. The stage that likely never stops but perhaps gets easier with time because the steep learning curve stops being so steep.
But right now ... right now, here I am. In this part. I need to accept that I am not perfect, I will not do things perfectly. In fact, I will probably fail several more times. I will likely have sessions that were not that helpful. And I will need to tolerate the discomfort of that experience. Because it's the only way. The only way out is through. The only way out is to tolerate the discomfort, worth doing to get to a better place, where you've learned more and you know more of what to do and what not to do.
And in the meantime, you rest on what you do now. The theories, the ideas of what might work right now, the super-strengths of listening and empathy.
When I am present, and I listen there in the room, and don't get caught up in my head about "can i help?! i don't know!" and just trust that the words will come, because some learning has already been programmed in there, everything tends to go so smoothly. Because even now, when I am drowning in shame, now that I have started talking about it, what I want most is someone to listen. A safe space to explore my feelings.
Perhaps I wasn't ready to tell my supervisors yet before about all this shame. Maybe I won't be next week. Maybe it's someone else I'll tell. That's my right. I deserve to choose.
I need to tolerate my discomfort and allow shame in. It won't kill me. I just cried about the feeling, and you know what? I noticed in the middle of that, that experiencing heartbreak, although highly uncomfortable, was not dangerous. I could do it. I could tolerate heartbreak ... and the fear that I won't be able to help, and the shame at not being able to do things well every single time. I can tolerate these things enough to keep going and keep reading and keep showing up and keep trying and keep going to supervision and asking questions. I can feel shame AND keep going. There, some dialectical thinking.
Perhaps shame in this form is a good thing. Its presence signals honest caring, a genuine desire to learn and be the best I can be. Not the best ever. But the best I can be, good enough to be able to sit there in that little room and skillfully help people in pain. That's why I'm making a choice to tolerate discomfort. Each time I tolerate it and I talk about it, I am making a choice. To keep working toward that dream there in the distance. I could suppress it and not talk about it and distract myself instead, but then we know that suppression leads to the fueling of the shame which promotes depression and anxiety, and if I choose that route, that would hurt my efforts in learning how to be a competent clinician.
So I keep going this way. Talking about shame. And reminding myself these things:...
- I accept that I am learning. Learning comes with being unsure, with sometimes not being able to help right there in the moment as much as you would be if you had had much more time learning, not just 3 months as I currently have.
- I accept that learning requires committing to tolerating discomfort. I choose to tolerate this discomfort as I go. I do not want to let it hold me back.
- I keep choosing to keep trying. Even if I don't get it right, week after week, the therapy meeting or the part of asking the right questions in supervision.
- I also choose to build myself up. To trust my instincts a little more. To make room for believing my supervisors when they tell me I have good instincts. To believe a little more that maybe I can be great at this one day, and maybe I am good at it for my level right now. Maybe there are moments and sessions that are excellent. There are. I've seen them. I've felt them.
I notice something else arise as I write that ... I am afraid that if I come to believe I am good at this, it will be equivalent to arrogance and that would hurt me because maybe it would fool me into thinking that I don't need to try anymore or that I know everything already or that I am something I am not. I don't want any of this. I want to stay humble because this is how you learn.
But maybe this is where some more dialectical thinking might benefit me. The question is: Can I acknowledge that maybe I have potential, that maybe I do many things well, that maybe the effort I put in to learning and growing is fantastic, that maybe I have good instincts AND that I still have ways to go before I am excellent at this? Can I accept each side of that "and?" Can I accept that both sides can co-exist equally strongly, at the same time?
Can I be good along the way without it meaning that I am arrogant? Can those two things, competence and experience, not be perfectly correlated? Maybe I can be competent even without a ton of experience and without being able to find the perfect words to say each time yet. Maybe I can be competent even if something takes me two sessions to accomplish instead of one.
But maybe this is where some more dialectical thinking might benefit me. The question is: Can I acknowledge that maybe I have potential, that maybe I do many things well, that maybe the effort I put in to learning and growing is fantastic, that maybe I have good instincts AND that I still have ways to go before I am excellent at this? Can I accept each side of that "and?" Can I accept that both sides can co-exist equally strongly, at the same time?
Can I be good along the way without it meaning that I am arrogant? Can those two things, competence and experience, not be perfectly correlated? Maybe I can be competent even without a ton of experience and without being able to find the perfect words to say each time yet. Maybe I can be competent even if something takes me two sessions to accomplish instead of one.
As I said that, I felt the shame arise again. At the fact that "some things take me two sessions to accomplish instead of one." I heard a number of thoughts flash through my mind: "You are ripping off your clients. You are doing them a disservice. A lot of them have financial struggles, and you're working inefficiently?!"
My internal voice is harsh right now. A consequence of a weeklong journey into shame. Alas, I'm here for me. We can pull through.
I keep talking about it ...
I keep talking about it ...
The thing about clients and the idea of "ripping them off" each time I'm inefficient ... the thing is, just like I am choosing, always, to keep learning and showing up, they also are choosing, always, to keep showing up to therapy. If they decide one day they can't afford it, they will let me know. They pay a much lower rate to see me than anyone else at the practice. AND it's not like I'm doing this alone ... I am supervised by seasoned clinicians behind the scenes -- something the clients also know and are told before treatment begins. So they enter into this relationship fully knowing its boundaries. They choose to keep coming because they are getting something out of it. So I'm not ripping them off. I am not taking advantage of them. What we have is a relationship that is based on a number of agreements, including the one about more affordable care from someone with less experience who is nevertheless much more competent than the average supportive listener and also not acting alone but with an expert behind the scenes. Clients agree to keep coming because this agreement has many advantages for them, including the fact that some wouldn't be able to afford therapy otherwise and also that some probably find many aspects of it helpful -- otherwise, they'd stop coming.
---
One day, I WILL be a seasoned clinician, able to work much more skillfully than I often am now. In order to get there, I need to go through this period, and to tolerate all of its discomfort. I choose to keep going through this period, to keep tolerating discomfort, to keep talking about shame. Even on days or weeks when it's not easy. I choose to keep doing it, because I care and because this work is meaningful, and because I love doing it, even when it's hard.
There is no requirement to be great yet. Only to keep trying and keep tolerating, doing yourself what you ask clients to do, if you truly want to get from here to there.
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