After experiences like these, how do I go back to my work routine back home, seeing client after client in 50-minute time slots in my carefully organized work day and teaching restless, distracted students in large lecture classrooms? Even though I've spent half the previous year traveling around the world working on service projects in a half-dozen countries, I've spent much of my life telling myself I could never afford to do something like this. When I was a much younger man, I met a woman who told me she was taking a year off to travel around the world. When I remarked how lucky she was to do that she became furious. "Are you freaking kidding me?" she said. "Do you know what I used to do for a living? I was a secretary barely making minimum wage. But I quit my job, sold all my stuff, and invested all my savings in this adventure. Anyone can do this if they're willing to pay the price."
That conversation has haunted me ever since. Although I've never had much interest in travel for its own sake, I've always fantasized about what it would be like to "buy out" some of my time so I could work in regions of the world where they need help the most. Many of us got into therapy in the first place because we wanted to change the world. My initial plan was to work with those who are most neglected, whom nobody else would help. Yet my interest in earning a comfortable living and enjoying the luxuries of life led me to work in a university, seeing comfortably middle-class clients. Granted that most of my students are from disadvantaged groups, and many of my clients are pro bono, I still feel as if I could easily be replaced. If I wasn't doing this work, someone else could step into my role with little difficulty.
It's been just a few months since I returned from Nepal. I've lost so much weight that none of my clothes fit and I've been walking around in a daze for a while. I'm haunted by what I've witnessed, and sometimes burst into tears for reasons I don't understand. I think about the girl in the turquoise scarf and wonder how she's doing. I think about all the other girls we support, and feel so helpless that we can't help more of them. But there's nothing I've ever done that feels more satisfying--and more challenging.
The most important part for me is that I know I'm making a difference. Each year, I see these girls grow into poised young women who have dreams and opportunities for education and professional careers. They want to be teachers and doctors and engineers. They're the first girls in their villages to receive a higher education. As a therapist, I may not always know and appreciate the impact of my work with clients, but when working in the field, it seems as though we're indeed changing a small part of the world.
I wonder why it's necessary to travel halfway around the world to make such a difference. Why can't I remain content with helping my students and clients back home, where there's also much need? My heart pounds when I admit to myself that it doesn't make me feel special enough; any decent therapist can do that. I want to reach out to those whom nobody would ever think of helping. I want to be in a position where I know that if we don't do this work, nobody else will. I could easily work within my own community, where many important things remain to be done, but I hunger for the exotic, even as I complain about the petty hardships of life in this unfamiliar world. I feel better about myself when I encounter people who have so much less than even the poorest people I encounter in my life back home.
When I honestly examine my personal motives for doing work in such a remote region, I must admit I enjoy feeling like a martyr, escaping from the mundane aspects of my life, hiding from issues I'd rather avoid, having an excuse to travel, and having access to an exotic world that few outsiders have ever witnessed. But most of all, at the core of what I'm seeking, is the intimacy and caring I experience with my team members, the parenting role with the hundreds of children, the close relationships that develop over time. It's almost fun to commiserate with our team members about the difficulties we face, bitch and moan about the annoyances we encounter (squat toilets, limited food choices, armed Maoist rebels, traffic jams, fuel and electricity shortages, garbage strikes, unfamiliar cultural rituals). I love what I learn about the world--and what I learn about myself.
So I keep trying to reinvent myself, not so much to have some measurable impact in the world, but to satisfy some deep need within. I crave creative expression and opportunities to do things differently in situations I've never encountered before. I see some of my clients making all sorts of exciting changes in their lives, and I want some of that too! Then there are clients who sometimes don't return, and I wonder what really happened. The clients I see with the most intractable, chronic problems, who need help the most, often take such a long time to achieve observable results. I love that I can work on a project in which it takes so little money and effort to actually save a girl's life!
In the end, I keep wrestling with the ultimate question of what really makes a difference in the lives of those we help. There are all kinds of answers to this, depending on your orientation, professional context, and personal style. But what keeps driving me is the experience of deep connection with the people I'm trying to help, whether clients in my practice, students in my classroom, or young girls in Nepal. They're my teachers.
I'm deeply grateful that I've chosen a profession that allows me to learn so much--requires me to grow so much--every day. Yet, however remarkable the benefits of being a psychotherapist, I find the experience of helping and connecting magnified tenfold when I move outside the framework of the normal therapy transaction--and when I'm not even being paid for my efforts. At those moments, it can be hard to tell who truly is the helper, and the gesture of giving becomes indistinguishable from an act of love.
Jeffrey Kottler is professor of counseling at California State University, Fullerton, and president of Empower Nepali Girls (www.EmpowerNepaliGirls.org). He's the author of more than 80 books, including On Being a Therapist and Changing People's Lives while Transforming Your Own. Contact: firstname.lastname@example.org. Tell us what you think about this article by e-mail at email@example.com, or at www.psychotherapynetworker.org. Log in and you'll find the comment section on every page of the online Magazine.