Meaning-making in the Counseling Process

Posted on by Wendy E. Smith, MA, LMHC

One of the most important functions of counseling is to help people make meaning out of their past and present lives.

Sometimes people come to counseling in a state of existential crisis; something has happened to them (a diagnosis, a relationship breakup) that has made them question their long-held views of themselves and the world. They don’t know what to think anymore. They may be feeling completely at sea. They need someone to help them figure out what they believe now, who they will be now, and how they can move forward from this point on.

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Shame, and Its Antidote

Posted on by Wendy E. Smith, MA, LMHC

From both personal and professional experience, I’m pretty convinced that shame is one of the two most painful human emotions. Shame is the feeling that there is something wrong with us or that we are not good enough or, to put it more strongly and the way clients often do, that we are worthless and unlovable. Shame is usually installed by early personal history (e.g., parental neglect, childhood sexual abuse, growing up with a disability) and, later, becomes a habitual internal process in which part of the adult mind harshly criticizes another part. Viscerally, when shame is triggered, the experience is of a punch in the gut or a knife in the heart. That is why people experiencing shame often visibly cringe.

One problem with shame, aside from how painful it is, is that it stops us from being willing to engage in relationships in an authentic and vulnerable way (who who feels worthless would want to be truly seen?) and therefore people who suffer from shame also suffer from loneliness. Additionally, shame can often lead either to paralysis with regard to life goals (I’m worthless, so why even try?; I’m bound to fail) or unrealistic and exhausting perfectionism (I must ceaselessly prove that I am worthwhile). Paradoxically, despite their intense pain, people who suffer from shame often have very little compassion for themselves, wrongly assuming that their suffering must all be the result of their inherent worthlessness and, therefore, deserved.

Here is a link to an excellent TED talk by Brene Brown that touches on many of these issues:
Brene Brown on vulnerability

I have been consciously working with my own shame for about 20 years and I’m happy to report that I am much less pained by “shame attacks” than I used to be, both because I am less frequently triggered and because I have much more compassion for myself when I do feel shame. Additionally, I’m no longer a perfectionist and my internal critic has softened considerably. This is how I know there is hope for fellow sufferers!

When working with clients on their shame, I (very tenderly) use Emotion Focused Therapy techniques, both to help clients see how their internalized shaming process works so that they can start to dismantle it, and to re-experience with them in a healing way the specific history that installed the shame in the first place. Ultimately, the goal is for clients to start to know and feel that they are lovable and worthwhile in all their imperfection, just the way they are.

Disability: Overcoming versus Integrating

Posted on by Wendy E. Smith, MA, LMHC

This short article was originally published on www.goodtherapy.org.

Media accounts of individuals with disabilities who have achieved something will often refer to such people as having “overcome” their disabilities in order to become successful. Sometimes such people will also be referred to as “brave,” as if they had another alternative to living with their disabilities.

The problem with this formulation is that it suggests that people with disabilities ought to, essentially, disown their impairments; it suggests that we succeed despite our disabilities, and not with them, or because of them. They are not really a part of us—just some sort of encumbrance—and they are certainly nothing we would claim as part of our identity as human beings. The best thing we can do, this way of thinking goes, is, through our achievements, render our disabilities invisible.

So, we end up with this condition (blindness, paraplegia, a learning disorder, or whatever it is) which is like some unwanted appendage that we have to drag around with us and feel ashamed of, get rid of, “overcome”. And our experience is dissonant and uncomfortable, because the truth is that being disabled is inseparable from who we are. We have developed from infancy with our disability, or acquiring a disability has markedly changed our lives. Either way, we wouldn’t be who we are without our disability, and having a disability is woven into the multi-faceted fabric of our everyday life. On the one hand, we are having disability-related experiences all the time, and, on the other hand, society is pushing us to consider our disability as irrelevant.

People with disabilities will often end up in therapy with anxiety disorders and/ or depression resulting from this dissonance. They often can’t feel comfortable in their own skins; they are burdened by shame and a sense of constantly needing to prove themselves; they are hyper-vigilant , self-conscious, self-blaming and/or self-punishing; they are workaholics or, on the other hand, feel blocked in their lives; they feel empty and say they don’t know who they really are.

The work of therapy is often to help people integrate their disabilities into their sense of self and let go of society’s mandates for them. The work is often to help people figure out how to live as themselves in the way that will be most fulfilling for them, given all the parameters of their lives, including their disabilities—society be damned.

So, if we are “successful” as people with disabilities, it is actually because we have succeeded in integrating our disabilities into our sense of self, and not because we have “overcome” them. Then, being disabled is a part of us, just as being Jewish or Turkish or short is a part of us. It is not THE thing about us, and it is not irrelevant.

Granted, we very likely will still have to deal with social discrimination (not to mention downright foolishness) and we still will have to deal with all of the pain-in-the-behind aspects of living with a disability on a daily basis and in an inaccessible world; but, psychologically, we will be freer.