Crossing to Safety

A Master Clinician Shares Her Most Therapeutic Moment

Courtney Armstrong • 6/19/2018 • 1 Comment

Michael swaggered into my office, his flannel shirt flapping and his faded jeans threatening to rip at the knee. Before sitting down, he glanced at my footwear and looked up with a smirk. “I see you’re wearing new boots today,” he said. “Is that what you do with the money from our sessions? Or are you wearing those boots because you think you’re going to kick my butt with your psycho mumbo-jumbo?”

I was used to getting this kind of challenge from Michael, who liked to spar and use sarcasm as a defense. Graduate school hadn’t prepared me for this, but growing up with two obnoxious brothers had. Over the three months I’d been seeing him, I’d learned that the only way to soften his sneering was to playfully razz him right back. So channeling my best Albert Ellis, I teased, “Yeah, I know you want to test me to see if I know what I’m doing and whether or not therapy has been worth your while. So I’ve got a challenge for you.”

He folded his arms across his broad chest. “Okay, lady, bring it on,” he jeered. “Give me your best shot!”

For all the arrogance emanating from his six-foot, two-inch frame, Michael was a fragile 32-year-old guy, who struggled with depression, alcoholism, and a fear of crowded places, along with his terror of crossing bridges.

A bridge phobia poses an especially big problem in our town of Chattanooga, Tennessee. It’s actually nicknamed Bridge City because it’s hard to go anywhere without driving over a lake or the Tennessee River, which meanders right through the center of town. Michael’s bridge phobia was locking him into a prison of despair and isolation.

He never admitted to a suicidal plan, but all the elements were there: major depression, loneliness, uncontrolled drinking, and a firearm in his house. For all the cheeky games he played, I knew that therapy was a last resort for him. We’d been preparing him to face his fear of bridges for several weeks now, and I knew we needed a breakthrough soon or he’d give up on therapy. Even worse, I feared he’d give up on himself.

At this point, I sat up straight, looked him in the eye, and said, “I think you’re ready to cross a bridge. Since it’s a beautiful day, we could go to the park and start with the wooden footbridge that crosses Chickamauga Creek.” Michael began to chew on his lip. “You don’t have to cross the whole thing today,” I continued. “But we could start and see how you’re feeling around it. I’ll even meet you there in my kickass boots, if you’d like.”

In a flash, Michael resumed the role of disdainful cool guy. Rolling his eyes, he said, “No, Miss Courtney, I don’t need you to hold my hand. I can do it all by my wittle self.”

Part of me wanted to slap the snarky smile off his face, but I was delighted that he was even considering this challenge. Realizing that he was motivated by the chance to prove me wrong, I winked at him and prodded, “I know you can do it, but I bet you won’t.”

“I bet I will!” he shot back. “In fact, I’ll do it right after I leave here.” Leaning forward, he added, “And I’ll take a picture on my phone to prove it to you, Miss Smarty Pants.”

Quick as a flash, I retorted, “I don’t believe it. I bet $50 you won’t do it!”

Oh, no. Had I just said that? I wondered. The challenge had popped out of my mouth before common sense could run interference. What kind of therapist makes a wager with a client, with actual money involved? But I’d thrown down the gauntlet, and it was too late to pick it up.

Michael raised his eyebrows in disbelief. “Are you serious?” He was laughing now. “If I do it, you’ll give me $50?”

Hiding behind what little pride I had left, I said, “Yes, sir, I will. But I don’t have to worry about it because you’re so stubborn. I know you won’t do it.”

Michael shook his fist at me and leapt from the sofa. “You’re on, lady! And I don’t need you to come along and babysit me. I’ll go do it right now and show you. I want my $50!” He pivoted toward the door and strode out.

Alone in my office, I took a shaky breath. My stomach churned with excitement and dread. I was thrilled that Michael was finally facing his fear, but a series of disastrous consequences flashed before my eyes. What if he gets over there and has a panic attack? Should I follow him and lurk behind a tree, to be on standby if he needs support? What if he does do it and I have to give him $50? Will he expect me to give him $50 every time he achieves a goal? Which one of my countertransference issues had triggered this incredibly dumb idea? Do I need to go back into therapy?

Just then, my phone vibrated. Michael had texted me a picture. He was standing tall on the other side of the bridge with his tongue sticking out. The caption read “Never make a bet with a crazy person.”

Phew! He’d done it. I breathed a sigh of relief and figured it was worth $50 if this experiment boosted my client’s confidence and helped us get on a new, productive track. Michael returned to the office 10 minutes later, grinning from ear to ear. Since we had a little time left in the session, I invited him in, reached into my purse, and handed him the cash. As he reached out to take it, his hands trembled and his face grew red. His lips quivered. Then he bowed his head and began to cry.

I placed my hand on his shoulder. “That was a big step, Michael,” I said. “You did great. You did it, man.”

He wiped his eyes and took a shaky breath. “Thank you,” he said in the softest tone I’d ever heard from him. “I can’t believe you got me all caught up in that. But I really did it. I can do this.”

Smiling, I said, “Yes, Michael, you absolutely can. We just had to find something more compelling than your fear to get you to take a risk.”

After this success, we continued to do experiments outside the office that got more and more interesting. No more wagers. But one time, he drove downtown with me to cross the narrow Market Street Bridge that towers 70 feet above the Tennessee River. At the stoplight before the bridge, I noticed that his hands were shaking as he gripped the steering wheel. “Are you okay?” I asked.

When he looked at me I realized that he was laughing, not panicking. With a noisy snort, he asked, “Have you seen who’s driving the car next to us?” I turned my head to see a grown man dressed as Smokey the Bear driving a yellow Volkswagen. We roared with laughter. In the throes of his giggle fit, Michael proceeded to drive across the bridge with ease. Elated by that triumph, he managed to drive across the bridge several times in the succeeding weeks. There was no Smokey to the rescue now, but Michael had tasted fearlessness, and something inside him had shifted.

In another experiment, we met at a Starbucks to help him overcome his fear of crowds. Before we entered, he looked pale. He paced up and down the sidewalk a few times, flicking his wrists in an effort to dispel his nervousness. When I offered to walk with him, he looked down at my shoes and smirked, “Nah. I see you’re wearing your kickass boots again. We better go on in.”

As we approached the counter, I did a double-take. The woman in line in front of us was wearing jeans that were two sizes too small and, without a trace of self-consciousness, exposing half of her rear end. I was so thrown off by the spectacle that I tripped over a chair and knocked over a whole container of straws on the counter. Once again, Michael doubled over with laughter. Later, he teased, “I suppose if you and that lady can go out in public without being embarrassed, I can too.” And after that, he did, visiting a grocery store, a shopping mall, and then Walmart—a store whose mega size even makes me anxious.

As Michael gained the courage to face his own fears, he mustered the nerve to enter a 12-step recovery program. He worked diligently in our sessions to heal the pain of growing up with a distant, alcoholic father, a major source of his anxiety and depression. He even invited his dad to a session to begin the process of repairing their relationship—another bridge he’d long feared to cross. Getting on speaking terms with his dad was vital to his healing. Recently, he wrote me to say that he was maintaining his sobriety, continuing to work things out with his father, and even playing in a rock-and-roll band on the weekends. Toward the end, he wrote, “You’ve got a strange way of doing therapy, but you saved my life.”

I treasured that appreciation, of course. I was thrilled and relieved to find out how well Michael was doing. As it turned out, the help was mutual. While I’d prodded my client to face his fears, he’d nudged me to face my own. Before meeting with Michael, I was timid about confronting tough clients, doing sessions outside the office, and taking therapeutic risks for fear I’d offend my client or make a mistake. How often do we hold back, believing that therapy can only happen in the confines of our office as we maintain a reserved, composed presence, squelching the feelings and impulses that well up inside us?

Mind you, making bets with clients hasn’t become one of my standard interventions! But Michael helped me realize that clients can benefit from seeing our raggedy humanness. They watch our willingness to take risks—or even make fools of ourselves—in the hope of moving forward, of supporting growth. We need to take care not to hurt our clients, of course. Yet often our own leaps of faith can empower them to muster the courage to try something different and keep going in the face of the unknown.

I had no idea that making that bet would open a gate for me, for Michael, and even for his father, but I’m glad I took the leap. I’m grateful that I crossed that bridge.

***

This blog is excerpted from "Crossing to Safety" by Courtney Armstrong. The full version is available in the May/June 2016 issue, Unexpected Gifts: Six Master Therapists Recall Their Most Unforgettable Sessions.

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Photo © Jacob Love

Topic: Anxiety/Depression

Tags: Anxiety | anxiety and depression | anxiety attacks | boundaries | courage | Courtney Armstrong | Courtney Armstrong LPC | ethical | ethical issues | Ethics | fear | panic attack | panic attack symptoms | panic attack treatment | panic disorder | phobia | Professional Development | rapport | therapeutic alliance | tough customers

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1 Comment

Saturday, July 7, 2018 5:39:14 PM | posted by Cathy A Castagna
Hey Courtney, An absolutely delightful read! Thanks for posting it! It's always wonderful to hear successful outcome stories! From my perspective there is another feature of this story that captures the very essence of the therapeutic process. Your humanity! Your connection with Michael, the relationship, the playfulness, the creativity, the eye contact, the sincerity of your efforts to help him! You trusted him! Accompanying him to agreed upon places, at each point and every time he was ready for the bigger step! You let him be him and you matched that. Sarcasm, wit, teasing, and repeated engagement with "who he was" without effort to change his style, his presentation, or his "attitude". IMHO, the story totally "captured" the very essence of effective therapy. Letting him be him, welcoming and accepting him right where he was, constantly staying "at his side" in a sincere and generous effort to help him...IMHO....this is the way, this is truth, and this was the light on his path...beautiful! As it's said...you took his hand and walked him home! Was it safety? Yes....and heavily seasoned with love. The power in the Journey of therapy is always the process...the relationship and the connection! Please post a photo of those "kickass boots"....we may never be able to plan out the journey of therapy, but it's fun to hold on to the "moral" of the story! Warm Regards! Cathy A Castagna