Sunday, September 5, 2010

Discovering Our Strengths

Margaret was a 73 year old woman who was my counseling client for several years. Her diagnosis was chronic depression for which she had been on medication and in therapy for over 10 years. As a child she had been mildly depressed off and on, but her depression got dramatically worse as an adult after her husband died.
During the nearly two years I worked with her, she had recurring suicidal thoughts, but never made any serious attempts. We weren't  making much progress in therapy. Each week I questioned her about her medication and assumed our weekly visits were somehow helping her to “maintain”.
In the community mental health center the push was to help each client return to their highest level of functioning as quickly as possible. When brief therapy models came on the scene, the therapists were encouraged to take workshops to learn all about it. I was somewhat resistant to this type of therapy. I believed therapy was about helping the client see more clearly why they thought and behaved the way they did by uncovering primary experiences from their past and seeing how the dysfunctional themes manifest in their current life. This takes time.
The first brief therapy workshop I attended was presented by In Soo Kim Berg. She and her husband developed Solution Focused Brief Therapy in the 70’s. My resistance broke down quickly after listening to Ms. Berg. She was a dynamic speaker who passionately believed in what she presented. I knew I would never become a complete convert to the brief model, especially for long term deep seated problems. I was comfortably rooted in a more Existential-Humanistic approach. But I left the workshop with one major idea that changed the way I did therapy.
In brief therapy the counselor does not focus on the history of the problem. There is almost no probing into the past to find its origins. The focus instead is on the client’s history of finding their own solutions to life’s problems. The solutions come out of their own past successes, what they did right, instead of what they did wrong.
Margaret came in one day very distraught. She said she had received a letter from the Department of Social and Health Services saying that they had paid her too much over the past year and she now owed them $800. The letter went on to say that DSHS would take legal action if she didn’t pay them back within a short period of time. Margaret lived in subsidized housing and was on a fixed income. Her medications were expensive and she only got partial help paying for them. She had no money to spare. She was in an agitated state over this and at risk for plunging back into deep depression.
Influenced by the workshop, I decided not to focus on the problem, but to work on uncovering Margaret’s strengths. I remembered her telling me during an earlier session that when she was a young woman, after graduating from engineering school, she got a job working in the fledgling aerospace industry. She was one of few women in a male dominated field and was proud of this. She said she felt like “one of the guys” and that she “could hold my own with the best of ‘em.”
As she droned on about her miserable life, how everybody took advantage of her and how she was again a victim of the “system”, I interrupted. I asked her to tell me more about her time in the aerospace industry. She didn’t see how this was relevant, but she reluctantly agreed. I kept up the questioning in my best “Colombo” style until she started getting into it and began spontaneously recounting experiences from that period. As the session progressed, I witnessed her transformation. The powerless, depressed woman that initially came in to the session had straightened up and become more animated and alive. In her once cloudy eyes, I now saw fire and clarity. I never once mentioned the letter from DSHS and when the session ended, I knew she was infused with a forgotten part of her self, a part that was confident, assertive and capable of handling whatever came her way.
At the following week’s session, Margaret didn’t mention the letter. Finally I asked her about it. “Margaret, what happened concerning the money DSHS said you owed them?” “Oh that!” she replied in a rather nonchalant way. “When I got home after our last session, I called my state representative and gave him a piece of my mind. He was very nice and finally said ‘Margaret, don’t worry about it, I’ll take care of everything’. A few days later I received another letter from DSHS saying I didn’t owe them anything”.
I never became a brief therapy convert, but it is my belief that we all have many parts that make up our personality. Some of these parts are dysfunctional and some are highly functional. When we are stuck in one of life’s dilemmas, we sometimes forget to draw on the more capable parts. Margaret had temporarily forgotten the part that “held her own with the best of ‘em” and over a number of years had come to identify with being a depressed, powerless victim.
That one session did not cure her depression, but it changed how we worked together. She was eventually able to get off medication altogether and rarely felt depressed. My therapy with other clients changed as well. We spent more time discovering and developing  strengths and less time focusing on problems.

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