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Woman Standing on Dock
Woman Standing on Docks

Articles written by Cheryl

These are articles I wrote for Social Work Today Magazine.  

The Fun of Marketing A Social Work Practice, Social Work Today Magazine 1/21/02

Most of us go into the field of social work to help people. Few of us realize that marketing ourselves will have anything to do with being a therapist or that building a private therapy practice requires skills which may feel antithetical to the “real work” we are trained to do. In the past years some of my colleagues have attended workshops on how to build private practices. Unfortunately many fail to follow through with the marketing techniques and feel discouraged with developing or expanding their practice. I enjoy marketing my practice and see it as adding variety to my work rather than being a necessary evil. In this article I will look at some of the reasons social workers find marketing distasteful, will reframe the work and describe some of the methods that have been helpful to me. Some of the common beliefs that create obstacles to marketing are as follows:

  • It feels unprofessional to advertise. Who wants to be seen as an ambulance chaser?
  • It is not okay to brag, boast or “toot one’s own horn.”
  • It belies the belief (or is it a wish?) that clients will come to you just because you are good at what you do.
  • We go into the field to help the disadvantage and marketing is only aimed at a population that can afford to pay high fees.
  • There is a basic taboo in our society, especially among women, about talking about money and asking for a reasonable fee for our services.
  • We are afraid to get unscreened clients without referrals if we advertise on an open market.
  • Glossy brochures and advertising belong in the corporate world, not in a professional one.
  • Marketing feels too competitive and it is uncomfortable to be competitive with colleagues.

Many colleagues have spent time attending classes, giving workshops, mailing letters and cold-calling without an increase in their referrals, so they become discouraged and assume that all marketing does not work.

I had done minimal marketing of my practice from the beginning twenty years ago. Four years ago I left a part-time job, changed my focus to couples counseling and worked to develop a much larger practice that required more formal marketing. I found that it could be fun with a small shift of some of the above beliefs. I’ve found several ways to enjoy marketing my practice and myself. I’m passionate about my work. In fact, I love the work I do. I don’t have to tell people how good I am or that I am the best therapist they could find. If they pick up on my energy and enthusiasm as I speak about my work they will have an idea of who I am and how I approach people and problems. Actually, I am selling me by showing them who I am.I believe that I am often helpful to people. I have spent years and years training and working to learn my craft. I may not always know how to handle a situation and am not successful with everyone, but I am always learning and searching. One of my clients who has difficulties with authority figures said he could work with me because I portray myself as a fellow seeker, not as a dogmatic guru. At this point in my career I can acknowledge that I am good at what I do.

Meeting and talking to new people is something I enjoy. In fact my skill is in building on-going relationships and this gives me an opportunity to develop new ones. Whenever I have a conversation with a new person and have an opportunity to mention what I do I ask if they would mind being put on my mailing list and receive a letter two or three times a year. People generally do not respond as if this is an imposition and in fact enjoy getting the letters. If they say they do not want to receive any mailings I do not take it personally.

Completing short-term marketing projects provides a wonderful contrast to the intense relating and long-term process of ongoing therapy. In developing brochures and flyers and updating my marketing letters I learn new computer skills, have an opportunity to express my creativity in a new way and hone my writing and editing skills.

 

What are some of the ways to market ourselves that can be seen as an enhancement to our work rather than a chore?  I see marketing as an outgrowth of my daily life. Being involved in personal activities I enjoy brings me personal pleasure, prevents burnout and also helps develop a wide network outside the therapist world. I am involved in book groups, yoga, volunteer work and three professional organizations. Just belonging doesn’t guarantee a larger network. It is by working with people or forming relationships that people remember me when they need a therapist referral.

 Although I see myself as a generalist with expertise in certain areas I advertise myself as a specialist. It is much easier for referral sources to remember a therapist if something about the work stands out to them, and it especially helps to work in a niche area such as couples, acting out adolescents, chronic illness or trauma. Targeting appropriate gatekeepers is helpful. It is effective to find and develop a relationship with four or five people who have potential clients for your specialty. For example, connections to specific employee assistance contacts, non-therapist professionals and therapists who tend to get more referrals than they can service may be more helpful than sending letters to people you have never met. 

It helps you to get the gist of your work across to people if you have developed an “elevator pitch,” a marketing term for a short, concise description (which can be told in the time of an elevator ride) which gets people interested in what you do. I have found that something simple that people can identify with is most effective. For example, I often tell people I work with couples. I tell them that we all tend to get locked in non-productive repetitive struggles with our partners over the silliest things, and when they nod or laugh, I tell them that I teach a technique (Imago intentional dialogue) that helps them out of the defensiveness and struggle.

As previously mentioned I send out a letter two or three times a year. I have developed a personal mailing list of 450 people over the past four years. I discuss workshops and groups I am leading in a personal, down-to-earth style and include a brochure, flyer or article I have written.  The response to the letters constantly amazes me. I generally get several calls after a mailing, sometimes from people I haven’t heard from in a long time, thanking me for the update, referring a couple for a workshop or therapy or calling to get more information on a resource I discussed in the letter. Marketers teach that it takes many times of seeing a person’s name before there is name recognition; sending letters has been a helpful way for me to accomplish this.

I love using my social work skills of resourcing and am known for making (non-client) referrals of all sorts: therapists, coaches, doctors, painters, volunteer positions, non-profit organizations, entertainment.  Whenever I can be of help to anyone I try to make useful connections for him or her. I also engage in personal outreach by sending news clippings, congratulations, articles and announcements of classes when I see something that matches a person’s interests. I do this because I enjoy it. But it also pays to be generous since people remember my practice and me when they call on me for resources. I believe there are enough clients to go around for all of us. Whenever I have an opportunity to refer to other therapists it increases a sense of cooperation rather than cutthroat competition.

Another way of staying in the public and professional eye is to teach workshops and give speeches. As the director of wellness programs at an employee assistance program for several years I developed and presented over forty corporate lunchtime seminars. Although the referrals went to the EAP rather than to my practice, this can be an effective way of marketing a practice. Since public speaking is high on the list of common fears, brief training or coaching can be helpful in developing the confidence and skill of presenting. Peer supervision groups, coaching and therapy are ways to feel more comfortable dealing with issues of fee. Attending conferences and annual conventions and making connections is another way of developing and maintaining a network.

What better way to put many of the basic social work skills to use, skills such as determining the need of the community and creating and maintaining relationships than in marketing ourselves and the important work we do in our community.

 

Caring For the World, Caring For Me: 

Being a Social Worker after September 1  Social Work Today Magazine 12/24/01 

Nothing prepared me for the attack of September 11 and its continuing aftermath of terror. Few  of us who have grown up in the United States have lived through this combination of massive loss and trauma. I have been challenged during the last eight weeks as I listened to countless stories of people who were downtown during the attack, who lost family, friends, homes and workplaces, who lost a safe, familiar world. I  worked while reeling personally from the events which shook our world. I had to care for myself as I shifted from shock and disbelief, to profound sadness and grief, to anger and fear. It became even harder as the threats of bioterrorism accosted us daily.

 

I have asked many colleagues who are a part of my social work/ psychotherapy network : How have you taken care of yourself since the attack on our city and country?  As you listened to gruesome stories and client’s painful feelings, how did you protect yourself? And how have you dealt with the ongoing concerns which threaten our personal safety such as riding the subway or opening the mail? I will share what I experienced and  learned as well as some of my colleagues’ responses.

Call to action after 9/11

On the Thursday after the attack, a day in which there were numerous bomb threats and building evacuations in the city, I ran debriefing groups in a mid-town advertising agency. Traditional Critical Incident Stress Debriefing (CISD) leads victims of trauma from their thoughts, actions and feelings at the time of trauma through an exploration of their coping methods. Most employees were overwhelmed and in shock from the attack, were frightened to be in their building and frightened to leave it to return home. I tried to ignore my own headache as I elicited their experiences and educated them about the expected symptoms and responses to catastrophic trauma. I felt detached, as if I was watching myself from the outside. Feeling numb was a useful defense o the overwhelming, surprising and unbelievable destruction. It kept me focused  and unafraid as I led the group.

The next week I led a group of downtown workers who together watched the attack and collapse of the World Trade Center from the entrance to their building. Everyone had a different story. One recalled escaping in the previous bombing of the World Trade Center in 1993, another was panicked about her son’s immediate deployment in the air force, one was unsure how to help her boyfriend, plagued with recurrent violent imagery, who had run down forty flights through collapsing rubble. Work, for me, has always been a wonderful antidote to helplessness and despair. Providing a safe atmosphere for them to express their feelings and concerns  and helping them digest the trauma made me feel useful.

A few days later I ran a debriefing with a dozen people who escaped the towers by running down fifty-two flights of stairs or climbing out of the subway. This was the first time they were all together in their temporary quarters and heard each other’s stories.  I did my best to facilitate this, my first group of primary victims,  but  felt physically sick and numb as we ended. I realized that it was hard for me to keep necessary boundaries, to take the distance I normally take with clients. This experience was different since we all shared in the event to different degrees. When I returned home I needed to regress into the comfort of my bed.

Protection from the media

Like most people, I was mesmerized by the television news during the first few days after the attack. I needed to make it feel more real and also to follow updated events. After the first day I stopped watching the repetitive scenes of the towers collapsing and a few days later stopped watching the tearful interviews with family members of the missing and dead. I have never been particularly skilled at emotionally detaching from other people’s pain. Watching the news in addition to hearing the anxiety of clients daily drained my energy and reservoir of optimism. I, like many other colleague, felt utterly exhausted. I advised clients to avoid or limit TV news since many people were being continually retraumatized by the media. As an Israeli colleague said, even without watching the news or reading the paper, bad news will travel to you quickly.

Connecting to family and friends

Getting calls and e-mails from family and friends around the world (even a friend I hadn’t been in touch with for thirty years) made me realize how much closer and smaller our world is now from the one of my childhood. Their concern and caring (not their hysteria) gave me strength. Relatives and friends were also called me for help with their own fears, guilt and anxieties. Although I was tired, being able feel helpful to those I cared about did a lot to counteract the hopelessness and despair I felt. Receiving comfort from my spouse was a soothing way to care for myself many evenings. At the end of the first week I shared a restaurant dinner with family,  including a nephew who ran from the collapse. We eagerly changed the focus of our conversation and relaxed and laughed, something we hadn’t done all week. It has Clearly, connection with loved ones has been of utmost value.

Professional connections

Next to family and friends, my professional connections have been essential for my mental health. I reached out for support to three professional groups. I was in a meeting with an employee assistance counselor group when the World Trade Center and Pentagon were hit and we heard the news together on the radio. Bonded by that experience and our subsequent group and individual debriefings, we decided to meet biweekly rather than monthly to provide support for each other.

I also attended New York City chapter meetings of the National Association of Social Work. One meeting drew over 600 social workers. In five smaller weekly groups focused on trauma, catastrophe and loss we also shared our professional experiences. All of us were on the front line in different ways, working with the firefighters, displaced workers, families of the dead and those who were already disenfranchised before September 11. In listening to my colleagues I felt a swelling of pride for my profession. I went into this field to make a difference in the world, and I ws proud as I saw it put into action. Again, this was a balm for the pain and helplessness I felt.

My monthly supervision group of couple psychotherapists was especially helpful in supporting me when I became retraumatized after running the difficult groups. The victims’ descriptions of bodies and body parts and details of running while terrified left me with visual images which haunted me. After talking to my colleagues and understanding how the terrorist attack triggered my own losses and traumas I felt better. My personal world collapsed with  my father’s death when I was ten years old and I realized that the buried feelings of aloneness and terror were revived. Although I was pressed for time and exhausted, making the effort to be a part of my professional community was one of the most stabilizing supports for me.

Identifying and accepting my feelings

I have developed strength and learned from multiple traumas in my life. Surviving these previous difficulties helped me anticipate and identify my feelings of disbelief, sadness, horror, guilt and fear as I came out of numbness. Not surprising to me, it took a longer time for me to access my anger. After a few weeks I wished for everything to settle down and did not want to be constantly reminded of the attack, the war, or anthrax.  I felt angry at each new worry which challenged my feelings of personal safety. And when I heard myself saying that I “should” go to see ground zero even though I thought I might  feel too overwhelmed, I recognized that my familiar childhood survivor guilt had again appeared. Understanding and accepting my feelings with compassion rather than with perfectionist expectations made it easier for me to take care of myself.

Taking care of my health

Healthy eating, getting enough sleep and exercise...all of these ways of caring for myself suffered in the first few days.I realized that we were in for a long haul and knew that our work as social workers had only begun. Therefore, I tried to eat in a healthier manner, maintained my vitamin regimen and took short naps as often as I could. It was difficult to attend my regular exercise classes because of the changed schedule, so I took advantage of the unusually beautiful fall weather by walking around the reservoir in Central Park. Several colleagues made a point of leaving the city on weekends and getting away from all the negative associations, sights, smells and especially the contagious anxiety. For me, being in nature, even in the city parks, had a soothing influence. Lying on grass and hugging trees was good therapy.

Respites: alone time,napping,cooking,laughing

The common response when I asked colleagues how they were managing was exhaustion, both physical and emotional. I worked many extra hours in addition to my regular psychotherapy practice. I was surprised that my normal way of distracting myself and entering into other worlds through reading was not useful to me.I recovered  by spending time alone listening to music or staring out the window. Giving and getting hugs was nurturing and many of my friends and colleagues were as eager for  the physical connection as I. One weekend after a particularly difficult group I stayed home all day and made big pots of chicken soup and tomato bean soup. It was so nurturing: the act of chopping vegetables, the familiar smells, the warmth of the soup and the emotional link to my mother. I joined numerous other well wishers by bringing soup to the firefighters and feeling pleased with performing a small concrete act.

A colleague told me that he canceled several sessions in the first three weeks when he was heavily involved in supervising volunteers, running groups for managers in their temporary locations and doing debriefing groups. He paced himself by taking off the mornings to exercise, rest and do mundane errands so he could be available emotionally for the trauma work.

Dark humor was also relieving. At one meeting an EAP counselor told me he longed for the good old days of critical incidents: “Give me a good old bank robbery or heart attack on the job.” It doesn’t sound  funny in print, but it did a lot to relieve our tension. Another counselor laughed with her colleague when they were asked to be experts for a biological warfare panel. They laughed at material they thought would make a great Saturday Night Live skit, laughed until the anthrax really started appearing.

Spiritual community

For many people meditating, praying or going to religious services helped revive the spirit. The day after the attack I attended a healing service at  my synagogue. As a community we sang, prayed, shared feelings, cried and provided support to some of the congregants who had family members missing. Singing and hearing music always makes me feel closer to a Higher Power and the songs of peace were especially moving. Because the attack came right before the Jewish High Holidays, I was able get comfort from some of the oldest prayers which felt uncannily timely. Being in community and performing familiar rituals helped me feel connected rather than alone.

Conclusion

Horror is not new to the world but for me and most of my colleagues, this has been an unprecedented event and time in our lives. I worked while experiencing a collective trauma which made it harder to take distance from my client’s feelings.Yet it has bonded us all, therapists and clients, as human beings struggling to do our best in difficult times. I have learned the lesson I keep needing to learn: it is necessary for me to take care of myself as I care for the world.

 

 

To Disclose or Not Disclose:  Social Work Today,  March 18, 2002

Early in my social work and analytic training I was taught that it was best to reveal little of myself to clients, to act as a blank screen so they could project their fantasies and transferences onto me that would then be analyzed. While it provided me with an initial guide and structure, as I developed my own style the formality and distance did not feel comfortable or useful to me. With maturity and more than twenty-five years of experience I have become clearer about my own identity, defenses and boundaries and skills evaluating clients.  Even without revealing specific personal data, the client already knows a lot about my personality, style and values from interacting with me. Yet much cannot be seen in the context of the consultation room with therapist as teacher. I have found that much healing comes from the therapeutic relationship and I am more informal and open sharing information about myself with clients. Revealing oneself to clients always has to be done thoughtfully and carefully, with attention to the client’s level of disturbance and reactions. After reviewing some of the reasons to be cautious with disclosure, I will look at some of the benefits of sharing personal parts of myself.

Disclosure should occur only if there will be some therapeutic value for clients. The client is paying for his or her time and expects and deserves to have the focus and attention in the session. When the therapist talks about her parallel experiences or shares daily events, she may be taking the focus and time away from the client. Therapists can feel very isolated in their offices, seeing one client after another, and It is easy to relate on a more personal level with a client who is particularly warm or intuitive or who you have known for a long time. However, it is important that the therapist not share information in order to be personally heard or work through some of her/his own issues. Social and professional connection, supervision, therapy and a balanced, nourishing life helps to prevent reliance on using the client for personal connection.

Too much information about the therapist’s personal history, family situation or health, can be worrisome. Clients, especially if they are highly attuned to other people’s  feelings and needs, are sensitive to loss and abandonment, or have a history as a caretaker, may focus away from their own feelings. They may try to care for or protect the therapist at their own expense, obviously repeating a defensive position.

It is useful and important to elicit and analyze a client’s reaction to personal information. Even if I know a client’s history, personality and defenses well, I can never anticipate what this new information about myself might trigger in them. One of my clients continually felt hurt at my lack of sharing basic information about myself with her despite analyzing why it felt too one-sided. When I revealed to her that I was divorced and happily remarried, she was judgmental of me and denigrated my ability to help her as she moved into a marriage. We examined her reaction and personal standards of perfection, her wish to avoid mistakes and her need to idealize. She saw that denigration of me was the flip side of idealizing and was able to work through many of these issues as we dealt with them in the here and now  between us in the room.

There are many reasons that therapists may reveal information about themselves. Sharing some of their personal side can put clients at ease and erase some of the power imbalance that is inherent in the client coming for help. Clients often feel relieved to know that their therapist understands them and identifies with their feelings from their own experience. For example, one of my clients, a brilliant scientist, was ashamed at the panic he felt whenever he seriously contemplated separating from his girlfriend. We examined his history of separation anxiety and analyzed his fear of abandonment  but he avoided taking any action and remained frozen in terror. When I shared with him that I have also experienced considerable separation anxiety and that I have been able to predict when it will appear and how to compensate for it, he felt less ashamed of being “incompetent.” The fact that I could acknowledge the difficulty and view it with curiosity as a problem to be solved (something he was very good at) helped him out of the self pathologizing. It was not necessary to share all my personal details; knowing that I have struggled and found a way to cope helped him normalize his emotional states and behaviors. When it relates to a client’s experience, I share that I have felt guilt or terror or despair and have found a way out. I feel that it helps when clients realize that we share human traits and are all a part of the human comedy.                                                                          

Often it is helpful to guide a person through the suggestion provided by a story. Telling personal stories helps present the therapist as a role model, especially for those who have had such poor modeling as they grew up. I share funny or poignant stories of my own experiences with my daughter with clients who are struggling with parenting issues. One client who has difficulty with authority figures shared that it was easier to listen to me because I present myself as a “fellow seeker” rather than “a voice from on high.” If the client becomes too interested in focusing on the details of my experience as a way of avoiding his own, I draw the parallel and gently bring him back to his situation. Although I use allusions to personal success after struggle judiciously, personal stories can provide the client with a sense of hopefulness.

When I teach specific techniques such as breathing and relaxation exercises for calming anxiety, Imago couples’ dialogue for lowering reactivity and increasing hearing a disparate point of view or monitoring cognitive distortions for developing more realistic personal expectations, I share that I also practice these techniques. I share that the learning curve can be frustrating but that it is worth it to put in the time and energy because the techniques work. Clients are often more motivated when they know that I practice what I preach and that my views are not just from “book learning.”

As therapist my role can be a listener, coach, cheerleader and teacher. What really brings about change is a genuine relationship, not a role or a pose. By carefully revealing some of my own feelings and experiences for the purpose of helping the client and by always checking with the client about their own triggers, personal responses and associations, I am able to add to a relationship which is truly therapeutic.

 

Baby Cuddling Teaches Therapist to "Hold" Self and Adult Clients Social Work Magazine Janurary 7, 2002

       I went into social work to help people. I wanted to save people, help them reach their potential, stop them from hurting themselves, restore rifts in their families and help them save their marriages. Much of this desire reflected the role I played in my family while I was growing up. But

becoming a psychotherapist put me exactly into the space I feared the most -- chaos and pain. I briefly considered leaving the field and going into catering. Baking seemed much more nurturing. Yet I felt I was drawn to this field for a reason. What I had to learn was how to bear witness to another’s pain without being drawn down into the depths, to do less fixing and staying more in the murky feelings. Through my own personal work and developing skills, especially Imago Relationship Therapy, I have learned how to create an environment that holds others and myself in the most difficult of circumstances

       As I’ve matured I’ve given up some of the grandiosity that brought me into the field. Although early in my career I realized the impossibility of fulfilling my rescue fantasies, it was upsetting and draining for me to

remain in the pain with people or watch them as they went into a downward spiral. I have an innate ability to deeply experience what others feel. In those moments I don’t imagine what they feel, I merge and experience some of their feeling. At times I feel hopeless and immobilized. Through my years of professional work and personal growth I have learned how to better protect myself psychically, to imagine other’s feelings briefly without letting myself sink into them. In that way I can rise up with an outside perspective and use my knowledge, experience, intuition and caring to help them. Often I can be a quiet presence, accompanying them on their personal journeys.

       A few years ago I began a weekly volunteer job as a “Cuddler,” the best job title I have ever had. I work at the Mount Sinai Medical Center pediatric ward with babies who are in isolation, many of whom are waiting for or recovering from liver and/or small bowel transplants. There are some babies who find a special place in my heart. Briyanna is one of them. She has a special fighting spirit that draws everyone to her. When I met her she was an extremely tiny six month old. Because of an enlarged liver she had a huge distended stomach. Her body was badly bruised from the IVs and she had a tube down her nose for nutrition. Yet she was so alive and was more related than many of the babies who have spent most of their lives in a hospital. Her deep brown eyes were alert and she made direct eye contact with me. She regarded me curiously and reached out for my earrings each time she saw me. Clearly she wanted to be held, nestling her head into my neck. My job was just to hold her and comfort her while she was in isolation. I followed Briyanna while she waited for a liver, recovered from one failed transplant and then received a second. At thirteen months she remains several months delayed in her development. Although she barely vocalizes she makes her desires clear with reaching arms and dramatic facial expressions. She has a beautiful wide smile, impish eyes and a gleeful laugh when tickled or bounced. And she fights with all her might when something is done to her that she doesn’t want. Periodically when I hold her she hoarsely whimpers, arches her back in pain and rolls her eyes before relaxing and making eye contact with me again.

     The last time I saw her she was not feeling well. She wanted me to hold her for the entire three hours. I sang to her as I rocked her in the rocking chair and played little piggy which caused her to squeal with delight. I talked to her in soothing tones and moved her so she could see people and activities through the door. Most of the time she looked at me and snuggled.

       The nurses and doctors and numerous support staff are working hard to provide for her medically. Even so, they are not in control of how her body responds. What I bring into her life of pain and suffering is clearly limited and I often feel so helpless. Yet I know that I am doing something important by cuddling her. It gives her a feeling of safety, of having someone with her while going through a painful experience. I am a witness to her experience. She relaxes and is able to melt into my body after a wave of pain passes. Sometimes she falls asleep with my hand on her head, hearing my soothing sounds. She seems comforted and on some level knows she is not alone. Briyanna clearly feels better in my presence.

       A holding presence is not just important with these babies. It is also essential in psychotherapy with couples. Fear and pain are underlying much of the anger that is omnipresent when couples in trouble enter my office. What they desperately desire is to feel connected and understood. Instead they often feel so alone, misunderstood and in pain. I, as therapist, contain the pain and feeling without ignoring, denying or minimizing it. It is helpful for them to see that I am not overwhelmed or afraid of the feelings.

       When I returned to my office from the hospital this week I had a marital therapy session with Steve and Emily. They came in after a relatively peaceful period followed by a familiar, dramatic fight and subsequent cold withdrawal. This left them both traumatized and shaken. Emily had reverted to a childlike place, afraid of Steve’s rage. Steve was terrorized by her behavior that he interpreted as suicidal and had returned psychically to the chaos of his early life. They came into my office with rigid bodies and tight faces, breathing shallowly, unable to talk to each other or make eye contact. They were afraid to experience or express the fear, hurt and betrayal they brought into the room. I felt concerned and anxious about Steve’s state. His facial expression, his hurt, dazed eyes and his uncharacteristic inability to express himself showed that he was in an immobilized state. After Emily attacked me I felt angry and cautious. Several times during the session I had to take deep breaths and center myself so I would be able to draw from my empathy. I needed to be direct and genuine in my validating of each partner. After asking for their intentions for this session I reassured them that I would help them get their messages across to each other. Since neither of them was available enough to mirror each other, I had them take turns describing their experience of the fight. I mirrored and validated them in front of their partner and also used sentence stems to have them more fully describe their feelings, responses and what was being triggered from the past. I expressed my concern for both of them, normalized their feelings and helped them feel heard and understood. I let them know that I would do my best to help guide them to a place they could not reach alone. Emily found it difficult to contain her responses and to allow me to focus on Steve. She expressed feeling angry and unsupported by me. I softly mirrored and validated her feelings. Slowly each of them was able to clarify what they needed from their partner to bridge the rift and prevent further similar explosions. In the end they were able to look into each other’s eyes and say which of their behaviors had hurt the other. They stated that they were sorry for the hurts they had caused. The Imago Dialogue provided them with a structure which allowed safety and the opportunity to be heard, mirrored and validated. In addition, they also needed help learning positive ways of expressing affection in nonverbal ways. They may never have learned these behaviors when they were growing up or may have lost them as they became more wounded in the relationship. As with the babies, they began to feel safer when they learned to gaze into each other’s eyes with softness, hold hands, use comforting gestures such as nods and smiles and speak in soothing tones. I showed them how to be in the moment, direct and clear and with compassion.  Because we have a strong, ongoing relationship they could draw on my hope, confidence and energy. Most importantly, I helped them create a safe, comforting space and held them in it.

       Whether it is cuddling in the hospital with babies or working with clients in my office, I have learned an essential way of tolerating people’s pain. I continue to empathize and provide a safe, calm presence in which they can experience their feelings. I model this safe, soothing experience over and over again, whether through actual cuddling of a baby or by creating a soothing environment for adults where any feeling state is accepted. In this way I help people develop confidence that they can tolerate and learn from painful experiences and internalize paths to self soothing. And as I hold them, I keep learning how to soothe, hold and accept myself.

Written in 2001, Reprinted in Social Work Today