Thursday, July 29, 2010


I am not much for labels.

Some of you may know that I am now working two days a week as a psychotherapist, to finish my graduate work, and I hear all sorts of labels there. Sometimes clients borrow them from our profession: My roommate is bipolar. My son has borderline personality disorder. She's a narcissist. He's a nut.

Other times these labels spring from the client's life. My son's girlfriend is a tramp. My daughter is married to an ex-convict. My boss is a control freak. My long-suffering husband is a saint to put up with these rotten kids. Or perhaps worst of all, I am a loser.

If we are honest with ourselves, we see labels as things that helps guide us away from the rocks on the shore of life. Like a speed limit sign or a construction roadblock, they are supposed to lead us away from bad things and toward good things. So we use them as a shorthand to put all of the other people in our lives into neat, little boxes, in hopes of making us safer and happier.

Now, here is why I want you to stop using them:

First, labels aren't what we call "actionable." They do not tell us anything or help us change anything. There is no therapeutic intervention for being married to a "bum" or being a "nut," for example.

Second, they are often wrong. One of the great things about therapy is that we are trained to hear all sides of a story, from all of the players involved. So more often than you might think, the "tramp" daughter is settling down with someone she loves after a couple of conflicted relationships, the "saint" father constantly criticizes his children, and the "rotten" kid is intelligent, sensitive, articulate, and acts very nicely around people who do not constantly put her down.

Third, they do not tell the whole story. Does calling someone "bipolar" also let you know that they are creative, caring, and a faithful partner? Does "ex-convict" accurately reflect the reality of someone who works hard every day and loves his children? Do "saints" ever make their families completely miserable every day by creating an atmosphere of disrespect?

I see just one good use for labels: when they help people understand something that they can fix. So if we diagnose someone's child as having ADHD, for example, they may move from being "bad children" to someone with a treatable medical disorder. Pointing out that a couple is in what we call a "pursuer-distancer" relationship may help them learn to communicate better. And someone who suffers from a severe anxiety disorder may find it liberating to learn their problem has a name, and a way out of it.

So what can we do without our comfortable, familiar labels about people? Talk about specific behaviors and specific reactions. Learn to articulate how you feel and what your boundaries are. And above all, try to understand and respect everyone you cross paths with, including yourself. If you can succeed in doing that, I have a label for it: wonderful.

*P.S. Important disclaimer: the examples in this article are generic and do not reflect my actual clinical cases.

Friday, July 23, 2010

Dear retail store

Here's why I don't buy things from you anymore.

Today I was at a bookstore getting some professional books for my graduate work. Yes, I could have ordered them online, like I usually do. But I read them first in your store, and wanted to be fair about it. So here I was at your checkout counter with about a hundred dollars worth of books.

But instead of simply ringing up my copy of Psychotherapy for Fun and Profit, you started asking me a whole bunch of questions. It went something like this:

"Do you have our membership card?"
"Sorry, I do not"
"Would you like to purchase one? It is only $25."
"No thank you"
"But you would save $14 on your purchase today if you bought one"
"No thank you"
"So tell me, do you live around here?"
"Well, then, you would certainly save money if you purchased this card. You are more than halfway there already with today's purchase."
"No thank you. Really."
"Don't you buy enough books to make this worthwhile?"
"I usually purchase my books online"
"Well, your membership will save you money on our website as well"

For a moment there I honestly wanted to be helpful. I wanted to explain sympathetically that there were too many cards in my life already, and that the thought of netting $7.63 a year didn't really excite me. But then I wondered, philosophically, what has led us to the point where businesses routinely subject their paying customers to interrogations like these? I thought it was their job to serve us, not the other way around.

So I just stood there with a quizzical expression on my face, and you then let out a deep sigh and continued blathering on about how you couldn't understand why I wouldn't want to save money, as you finally rang up my purchase. And I will leave it as an exercise to the reader how anxious I am to return.

Of course, I realize this isn't really your fault. Or the fault of the boss who pressures you to act this way. Or even the corporation that probably makes your job dependent on selling enough of these memberships. It is really the fault of the law of unintended consequences.

You see, once upon a time, some brilliant person at your headquarters discovered that by hassling Every Single Paying Customer to purchase these memberships, their revenue went up. And so upper management probably gave this person a raise, and then ordered you folks on the front line to annoy people as, silly us, we would try to buy your books.

Of course, this makes us buy more online so that we don't have to deal with Dracula behind the counter. Which leads to market declines you blame on everything from the economy to your debenture financing. Which leads you to pressure your staff to sell, sell, sell even more, as we retreat further to cyberspace and develop even less patience for being "sold." See where this is heading?

As a postscript, I had this conversation with nearly *every* store I went into today, each of which wondered why I wasn't using their specific Discount-a-palooza card. I am still not sure why they haven't figured out the idea of just discounting their products and treating me nicely. But while they ponder that, I am heading back to my computer.

Friday, July 02, 2010

Just the facts, ma'am

The biggest surprise about studying to be a marriage and family therapist isn't how often friends want to talk to me about their relationships. Rather, it is how I have completely lost my ability to answer them.

It's not because I am getting more stupid with age. (Please don't all comment at once. :) It is because we do exactly the opposite of what friends do. When you are having a conflict with someone, a friend will normally clasp their head in their hands and say, "Wow! What a horrible person the other person is! And how right you are!"

MFTs, on the other hand, are often accused of being neutral in a conflict. Actually, we are much worse than that: we take everyone's side. The lofty clinical term for this is "multidirected partiality." In plain English, it means that we try to teach everyone how everyone else sees the world – and then leverage that to build new relationships and better ways of problem solving. So a lot of what we do involves helping people see the other person's position and speak to its interests. We do this not to kiss up to people, but rather because, clinically, it is pretty much the only approach that works.

This isn't what friends want to hear, of course. And I certainly understand and respect why. Emotionally, it is much more satisfying to have someone take your side against the bad guy or gal, and that is what friends are expected to do. So while I certainly express lots of empathy for people, the minute I actually start to answer their questions I am on thin ice. Because I am trained to get them thinking about how to engage in dialogue with these dirty, rotten, horrible (fill in your own adjective here) people.

So does this mean that friends can't ever ask me for advice? Really, I don't mind. Just as long as they realize that they probably aren't going to like my answers. (Oh, and while we're at it, you should also never ask a budding psychotherapist how they are doing, because they will probably tell you! That's why we are no fun at parties either.)

Meanwhile if, lucky you, you don't know me well, here is a small example of what we teach people. It is a powerful technique called "reframing." It means that you stop labeling the other person, and start boiling down your interactions with them into cold, hard facts. For example:

• "He is a goof-off" becomes "He is two days later with his projects than most of us."
• "She is a control freak" becomes "She makes sure we finish all of the paperwork"
• "My boss is stabbing me in the back" becomes "My boss feels free to share his opinion of me with others, just like I do"
• "My co-worker is always angry" becomes "When my co-worker says X, this is how I respond"

To try it out for yourself, just stop saying the things on the left, and start saying the things on the right. Then watch what happens. It helps a lot, right? That's what my clients tell me. And do you see why my friends think I've grown three heads when I suggest a heaping helping of it?

But it *is* extraordinarily powerful. Think about it: when a coach tells a team they "choked" or "stunk," those words are not only scary but useless. There is no such thing as an anti-choking procedure or a non-stink drill. What actually happened is that they dropped a critical pop fly in the eighth inning, and that can be dealt with. Move from criticizing people to troubleshooting facts, and you will be amazed at what you can address and resolve. Good luck!