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"I Am How I Am"

I've come to know a common set of phrases from clients, which often show up in their relationships, too. You probably hear these as well: "I am who I am." "This is just me: take it or leave it." "I'm not changing."

There's a useful twist that I've developed in response to this moment in treatment. It goes something like this: "You know, Joe, I can fully understand how annoying it is that Carol keeps asking you to be more emotionally open with her, especially since you feel that you already do so much to show your love. You often tell her that you're just a typical 'guy' who doesn't show a lot of emotion. 'I am who I am,' you say. And, while it may be true that you'll never be as expressive as she'd like, I do think that you aren't being exactly who you are.

"You say you have a lot of love for her, but you only express a portion of what you feel. You aren't fairly representing all of you—in some ways, the best parts of you. Do you think the 'how you are' is a true match for your feelings? She only gets to see the 'how' but not the entire 'who.' That's too bad, because the 'who' of you has a lot of really good stuff inside."

Of course the same holds true for you, the clinician. It's moments like these in which you want to be sure that how you communicate delivers the intended message of who is sending it. If you want to let the forever-disappointed and avoidant client know that her inner Eeyore—"Nothing makes a difference." "I can't do that." "I don't know how I feel."—is really becoming a problem for you, besides pointing out the pattern and linking it to her life themes, you might share that those statements have become off-putting to you. They demotivate you, even though you're fully aware of where they come from, and if she wants you to continue to be an advocate for her frightened side, she'll need to promise to be more conscious of the use of language like this.

Zingers, Jibs, and Jabs

Therapists in training programs frequently approach me asking, "What do you say to clients who say that their childhood issues are resolved and they see no point in looking back?" I usually respond to such clients with a question: "How uncomfortable is it for you to look back at your early experiences?" This is a tad provocative, but it inserts a concept I like to call the "implicit assumption."

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