The Lonely Italian

No, I haven't been watching too many episodes of The Real Housewives of New Jersey (RHNJ). I've been too busy working on my self-torture project known as graduate school qualifying exam. What these two things, RHNJ and grad school in clinical psychology, have in common is that they are excellent examples of the how culture often shapes our thoughts and behaviors. Is this a MacArthur Genius Award-worthy idea? Most definitely not. It just helped me make sense of the fact that I am the only person of Italian decent in my program.

One day in our group supervision, a few classmates of mine were discussing a family case they were working with. They showed the session video, which had captured a mother and teen-aged daughter speaking loudly at the same time while waving their hands around. Our wonderfully insightful and incredibly supportive supervisor made a keen observation: this family talks very loudly and often over each other. Other families, apparently, were more quiet and subdued, often sitting in silence and taking turns to insult each other rather than interrupt, all of which is totally odd, in my opinion (Why? You'll see.) Then, my classmate says: Well, they're Greek. Aha! That's the diagnosis for poor communication skills, being Greek. Then said supervisor asks: Is this cultural? It's like Italians. Do we have any Italians here? All eyes turn to me, the daughter of Italian (pop) and Ecuadorian (mama) parents. Also, what makes me even more of an authority on all things Italian is that I'm a native New Yorker. I'm practically the Dhali Llama of Italian-American culture.*

What could I have done with this? At first, I sat there stunned with eyes wide open (not unlike those flashed by Dina or Caroline when there's been an "attack" on the famiglia). This is when I realized that I was the only person in the room with any sort of Italian descent. One could imagine this being a very strange moment for someone who grew up in a predominantly Italian/Irish area of New York where it was weird if you weren't Italian--instead of Smiths and Williamses, we had Cusomanos, Pagliucas and DiFazios. I also realized that I don't know any other Italian-American in Los Angeles, except for my husband's friend who's a self-identified "pizza-bagel," an Italian-Jewish hybrid from Boston. That doesn't count.

I asked myself: Are Italians loud? Some do of course speak at elevated volumes, myself and my immediate family included. My Italian immigrant family in Brooklyn is not loud, in fact, they are Mario-Puzo's-The-Godfather quite. All you'll hear from them is a low, scratchy whisper, at best. Unless you piss them off, then watch out. OK, so we're loud. Fine.

So, I responded: Did you just ask me if Italians are loud? (laughing) I suppose some are. Let's face it, I'm a little loud, for a therapist at least. How is this relevant to Greeks? Actually, what I think we should be asking ourselves is how this style of communication, marked by conflicting shows of power, interferes with their relationship? For one thing, this Italian (pointing to myself) often feels like it's so hard to be heard in this context, that you have to ramp up the volume. (Yeah, nice, right? Well, I could have just flipped the table on them.)

After this, I started to think about my therapeutic style: tons of empathy punctuated with playful challenging that I fondly refer to as "gentle-tough-love." I find that this approach help me build rapport quickly and gets my clients to let their guard down. Do I get this from my Italian culture? Maybe. Then there's the volume issue. I am louder than other colleagues, who have a distinct "therapy voice." It's softer that the "indoor voice" and much more annoying. Frankly, I hate when I'm spoken to that way in therapy. As a friend once told me: You like to keep it real. And I do.

My clinical evaluations from supervisors often say that clients appear to feel heard and comfortable with me. Maybe, because of my history of decibel-driven power struggles growing up, I know how important that can be for someone. I also don't let my clients off easy. I'm also like this with my classmates, albeit with much less tough love. I just think it's interesting how culture can shape my therapeutic style. Culturally-matching therapist and clients have been debated in the field and it's kind of a mixed bag of findings with regards to it's benefits or costs. What's interesting to me is that I often get contacted by other therapists trying to refer difficult clients. Maybe, the true "culture" here is just that neither the client or I take BS lightly. If that's a cultural match, so be it!
Now, geddouta hea!

*This just happen to be the PhDini being minister of all things Italian. Most other days, I'm the minister of all things "Latino." I'm very important and influencial.

What a therapist thinks about....

I've noticed that people are often curious about what therapists think about during sessions...or outside of sessions, for that matter. To sate this craving, I'll start posting random therapists' thoughts...enjoy.

Facing the music...

OK, I lied about writing regularly. I admit it. I'm a dirty liar. I sit in an over-sized arm chair of lies. In the spirit of forgiveness and acceptance, here I am.

Moving Along

While on the elliptical (yes, I was at the gym...a miracle in and of itself), I nearly had an emotional melt down when my "Workout or Die" playlist reached a silly song that had no business pushing me over the edge. Despite how embarrassing this is, I will let you in on the tune...(wait for it, wait for it)...The All-American Rejects Moving Along. There it is, for everyone to see. Now, this isn't what I typically "rock out" to. A while back, when I fancied myself a runner, I downloaded the "Lance Armstrong Run Longer Coaching Mix," a training playlist full of boppy and thumping tunes with the added bonus of Lance, himself, telling you to run faster...and faster...and faster! To which I reply, "You run faster, Lance." Anyway, that's how I ended up with this song on my iPod. Why did this diddy touch a nerve, you may be asking yourself?

Well, the answer to this question explains my recent, loooong, hiatus. My husband and I went through one of the most difficult times of our lives. Without getting into specifics, the ordeal involved mystery symptoms, neurosurgery, and a lot of risks. The kind of risks that found us jotting down advanced directives in a notebook I just happen to keep in my purse for those "oh, let me write that down" moments, right before he went under the knife. Needless to say, I never expected to be jotting anything like this down. Yes, we're too young to be dealing with such things. Unfortunately, there are a lot of things that we're too young for in the deck life has handed us. But this was the worst, for me anyway. The next 12 hours I would spend in agony. Will he make it? In what state will he be in? Am I strong enough to be there for him? I was in my absolute most vulnerable state. No amount of self-therapy could bring me back.

Everything, in time, occurred as well as it possibly could. We were displaced for a month in New York, recovering. In many ways, I felt like we were recovering from both the surgery and our tormented lives up until this point. We were stuck in a limbo of sorts. In our East-side sublet, we saw a lot of friends and family, who we realized we missed terribly. I also did a lot of soul searching. That old cliche about it taking something akin to hell to help you make sense of life, what you want your life to be, turned out to be my reality. Which is why I'm here now, writing. And why I was at the gym on the elliptical sobbing over that ridiculous song. It was hearing these lyrics that did it: Move along, move along like I know you do, And even when your hope is gone, Move along, move along just to make it through...

I feel like this is all very vague and overly expository, and not to mention a total cheese factory, but in order to truly move on with this experience, to make sense of my being MIA, and stay true to what I want my life to be, it feels necessary. So here I am,back from the war, with a renewed spirit and clarity that have managed to seep into just about every nook and cranny of my life. I'm living healthier, working harder, and, most important of all, thinking better (in my humble opinion). This last bit has really reshaped my work with clients...making me a better therapist. This is why I'm sharing all of this with you. I've taken the cases I've been working on in completely different directions. This is all a part of the budding psychologists' development. Life happens, even to therapists.

So, what to expect? Well, this is the last of these Barbra Walter posts about life epiphanies...at least I sure as hell hope it is. What I'd like to do includes sharing my adventures with my current client, cutting out a stale case, and sharing my experiences taking on a few more new clients. I'll also be sharing the typical grad school hijinks that I manage to get myself in. I'm also celebrating my 30th birthday next week, so I'm sure there will be the occasional post on the psychology of aging. It'll be fun, I promise. OK, let's go!

Stop, drop, & roll: Encountering Clients in Public

I had one of those days where if the sequence of events that happened on this day were depicted in a movie or a novel, you would never believe it. Totally unrealistic, you'd say, so far fetched! Well, I feel compelled to share what happened with you for two reasons: (1) it has relevance to my life as a burgeoning clinical psychologist and (2) I think it will help me with getting over how strange the day was--like exposure therapy. Here goes...

As part of a long held Sunday ritual, my husband and I set out for breakfast at one of our favorite local breakfast/lunch joints, let's call it Sallie's. Sallie's has been a locals' haunt that has recently enjoyed the patronage of newbies who became hip to it from some good ole Food Network exposure. Thankfully, its dive charm didn't lend itself to be totally overrun by tourists and bored outsiders. It's edgy-hipster appeal melds well with the urban charm of the rough-around-the-edges location in a way that speaks to most of the artists, rockers, and DIY-millionaires who like keepin' it real in the hood (creatives as Deet would say). As we make our way to Sallie's, crossing the street like two Froggers dodgeing traffic, I see this guy who looks familiar sitting at one of the outdoor tables. Hmm, I think to myself, where do I know him. Usually, when I feel that way, the person is an extra or supporting character on TV or in some movie. Nope, not this guy. Finally, when my neural networks made a data match somewhere in my memory bank, I realized this was a former client. Actually, he was half of a couples case my colleague and I saw for a summer. A sense of dread, anxiety, and a little nausea spread over me like a thick smoothie. I try to see who he's with without them noticing. Ah, it's definitely her, I know that profile from anywhere. Ugh, I thought, why them, why now, and why at Sallie's?! My Sallie's?! They live across town...way, way, way, across town. The server, who knows us by now, gets ready to seat us at our usual table outside. "No, we're doing inside today, pal, INside," I say emphatically. He's surprised but chuckles and obliges. Whew.

This couples case was a tough one. There was a lot of--ahem--sensitive issues going on. After some time it was clear that one person wanted to be in therapy while the other didn't. What complicated things even more was that the one who wanted therapy was originally seeking out sex therapy... but refused to talk about sex. We were not allowed to discuss sex, which, as you can imagine, makes sex therapy a little difficult. We ended up doing a lot of couples communication counseling. Eventually, there was a lot of frustration on our end with missed/canceled appointments and they felt like we were being to pushy. There were a number of angry outbursts, crying, and unpredictable reactions to topics we brought up. Right before my colleague and I were about to call it quits, they dumped us. Though they admitted that the one person wasn't interested in therapy, it just wasn't working for them. Fine with us!

Now my husband and I were seated on the other side of a window facing this couple's table. Joy. What does one do in this unfortunate situation? Part of the confidentiality agreement is that I cannot disclose the nature of our relationship in public without the client's approval. Therefore, when I see a client in public I cannot acknowledge that I know them, lest whoever they're with asks, "Who's that?: They need to initiate contact for me to acknowledge them. So that gets me off the hook. I had a feeling that this couple wouldn't initiate any contact, but you never know. They had a flair for the dramatic.

While I start meticulously looking at every item on the menu, something I rarely do since I have a usual order, I can keep track of where the couple is in my periphery. My husband has no idea what's going on this whole time but senses that something's up. "What'cha gonna order, hun?" I ask him. "The same thing I always order, you?" he says. "Oh, I don't know...might switch it up today...switchin' things up!" I responded, sounding a touch insane. Meanwhile, the man of the couple gets up and walks past my table to the bathroom. This is odd because no one uses the bathroom at Sallie's. It's way far back in the restaurant and you have to walk through the kitchen...and, honestly, it's gross. I sense that they're totally onto me. My eyes stay glued to the menu. I see him, in my periphery, leaving the restroom as he heads outside, again passing my table. Then the woman goes to the bathroom, passing my table on the way. WHAT GIVES?!?! How typical! They are trying to make me uncomfortable, my paranoia leads me to believe. Finally, she comes out and they leave. I put my menu down and let out a big sigh. "What the hell is going on with you?" my husband asks. I tell him that clients were sitting there and he laughs. He laughs even harder when I describe my theory that they were purposefully making me uncomfortable. "Maybe they just needed to go to the bathroom," he says, still laughing. "Maybe," I say, "but maybe not." I laugh and finally order my usual.

As we enjoy our meal, a group sits at the table next to us. As their conversation develops, I over hear a guy talking about his studies in psychology and seeing clients. At one point he says, "So yeah, I've got my Masters which basically makes me a clinical psychologist." I nearly vomit all over my half empty plate. My husband, who also heard this, starts to laugh a little. A master's degree does not a clinical psychologist make. It can make you a therapist in a number of different areas, but not a clinical psychologist. I don't spend years of my life tortured and stressed, working my self into the ground to get a Ph.D. to have idiots like this calling themselves clinical psychologists. The man continues, "Oh yeah, I'll be seeing clients on my own pretty soon, which is great. You know, big bucks. And I believe in it to, you know, therapy, it sort of works." Oh yea, sure, therapy sorta works. Why not try it out? The guy doesn't even believe in the work!! I'm livid and shaking at this point. Then the group's conversation shifts to the topic of awkward moments when people run into their therapists outside therapy. Can you believe that? Can you BELIEVE that? Thankfully, we were done with breakfast. "You ready to go?" hubby asks me. "You bet your ass I am!"