Vanessa explained that her whole family was in the healthcare field, and, although she loved sports and had thought about working with athletes, what she really wanted was to help people overcome tragedy. Her face beamed and she gestured excitedly as she told me about a few of the clients she’d helped learn to walk again in her training, but soon she buried her head in her hands, crying, “I’m afraid I won’t be able to do this now because I’m such a nervous wreck. I can’t pass my exit exam like this! When I try to study, all I can think about are the people I saw bleeding and screaming in the movie theater parking lot, and that I didn’t know how to help them. Why did God put me there? Why did I survive? What does it all mean?”
In the past, I’d have compassionately listened to her subsequent litany of maladaptive meanings her mind had attached to the traumatic event, and I’d have gently and logically tried to help her challenge their validity. Now I knew it was far more effective to bypass those arguments completely and find a way to spark her emotional brain—to move her mind toward a useful meaning for her with a bit of creativity and provocation. So in my best motivational-speaker voice, I leaned forward, looked directly into her eyes, and said with conviction, “I don’t know what the heck it means. We live in a crazy world, where horrific things randomly blow into people’s lives—natural disasters like tornados, hurricanes, and this guy. Who knows what screwed up his thinking and caused him to do this? Who knows why a hurricane hit Dick’s town instead of Jane’s? But that’s not the point. The point is that a few minutes ago, I saw your face light up as you passionately talked about how you helped those people learn how to walk again after events turned their lives upside down. So, while I hate that you found yourself in the middle of that tragic situation, I think you’re going to be one hell of a physical therapist, because on a deep level, you now get what it means when someone has an experience that’s completely life altering. I know this isn’t the way you wanted to get that awareness, but now you’ve got it. Your clients will sense that you understand their suffering and are still 100 percent committed to seeing them through to recovery and finding significance in their lives in spite of what happened. That depth of understanding will cause you to be 10 times as effective as your colleague down the hall who’s just urging his patients to do 16 more leg lifts.”
Tears began to roll down her cheeks as she said, “You’re right. I do have that understanding, and I value life more than I ever have since this happened. We can’t let tragedy, accidents, or violence take our joy for life away.”
I also did trauma-reprocessing work with Vanessa in the session, but she said it was my impassioned belief in her ability to make a difference in people’s lives that caused the emotional shift for her. At our next session, she said her symptoms had decreased and she didn’t really feel the need to talk about the shootings. Instead, she became more focused on preparing for her exit exam at school and, metaphorically, learning how to walk again in her own life.
The Power of Play
I’ve learned that being a therapist is a bit like being an improvisational actor: we need to have a sense of what the situation calls for and adapt our lines on the spot. So while clients like Saundra and Vanessa respond to more heart-centered interventions, other clients respond better to play and humor, which engage the emotional brain, too. For me, getting comfortable using play, irreverence, and humor to spur clients into change was more challenging than delivering heart-centered interventions with more emotional expression. However, inspired by Connelly, I began the process gradually by asking a few clients whether they wanted to try something new in our sessions. If they agreed, I invited them to “get into character” with me. It seemed risky at first, but my clients enjoyed being jocular and engaging in lighthearted role-play to work through difficult emotions. This newly spirited way of doing therapy inspired positive changes, not only for my clients, but also for me. Instead of leaving my office feeling drained and discouraged, as I often had before, I’d leave feeling energized and uplifted.
Michael is a good example of a client who responded positively to my being more playful in our sessions. We’d been working together for a while on his struggles with alcoholism and a debilitating phobia of driving over bridges. Unfortunately, this phobia had shrunk his world, since our town is nicknamed Bridge City and you can hardly go anywhere without driving over a lake or the Tennessee River.
In our sessions, Michael often wore a mask of arrogance and loved to distract me with sarcastic comments anytime we got close to exploring his inner terror and pain. One day, he started by saying, “Ah, I see you’re wearing new boots today. Is that what you do with the money from our sessions? Or are you wearing those because you think you’re going to kick my butt today with some psychomumbo jumbo?”
To motivate Michael, I realized we had to play and have some fun so he didn’t feel threatened. I knew that playing would help my own emotional brain avoid feeling threatened by his unnerving comments. So I laughed and replied, “Yeah. I’ve got a challenge for you. I know you want to test me to see if I know what I’m doing and if this therapy thing has been worth your money. I think you’re ready to cross a few small bridges on foot between now and our next session. You can start out with the little footbridge that crosses the creek in the park a couple of blocks from my office. I’ll even meet you there in my kick-ass boots, if you like.”