February 1st, 2016

Learning new ways to connect

With the gift of time that retirement brings and the opportunity to continue doing some clinical work, I am noticing a change in the way I talk with people in and out of the office.

It may have something to do with a change in perspective that comes from shedding some of the trappings of professional life and having more time to be truly present in my encounters with others.

In a hospital where I consult, I see a man who is far from home and family. He was depressed to begin with and the holidays hit him hard. Now he tells me that he is still going to his therapy groups and work assignments but he finds it more and more of a struggle to get out of bed in the morning.

Not only does he forgive me for canceling our session during last week’s snowfall but also says he would not have cared if I had cancelled again today. He has come through the worst of his depression and he knows that withdrawing from his daily routine is a sign that he is headed for relapse. He says he feels lazy. Well then, I reply, you are talking to the right person. Now that I am mostly retired, I have learned a lot about lazy. He laughs.

Our playful exchange in the midst of his inexpressible sadness happens, not in English, but in his native language of which I know almost nothing. Over years of working together in therapy, we have become comfortable with each other and with our reliable interpreter. At least I believe he is reliable. Not knowing the language, I never know what he is saying. On this day, all I know for certain is that I made a lighthearted comment to a depressed man and he laughed.

The exchange started me wondering about how therapists and patients communicate with one another. It also raised a question about how any two people manage to have the kind of conversation that marks a moment or a lifetime of connectedness.

Using a common language either spontaneously or with the help of an interpreter is crucial but probably not sufficient to ensure mutual understanding. In an on-going conversation that deepens over time, both partners have to lay the groundwork for the emergence of rapport and trust and neither can do this without taking some risks.

When I first started working with this man, I didn’t know what to expect and everything I did felt like a risk. He spoke not a word of English and because there were no peers or staff who spoke his language, he spent much of his day in silence.

I was encouraged to supplement whatever I said to him with pictures and diagrams and we spent months reviewing a deck of cards illustrating a wide array of coping strategies. Which ones did he use? Which did he have no interest in developing? Which might he like to learn and use to manage his distressing emotions?

I drew pictures of brains as well as speech and thought balloons to illustrate principles of cognitive behavior therapy. We played cards to give him an opportunity to demonstrate his skill and lighten the atmosphere when he had shared more than he could bear thinking about.

With every new therapeutic gambit, I wondered if he thought I was as foolish as I felt. I kept trying new things and he kept showing up for his appointments. Over time, he took the enormous risk to share the depths of his sadness as I risked comparatively little by responding with ever more sophisticated yet often ineffectual therapeutic techniques.

Only recently and probably with a sense of freedom that comes from the perspective of retirement, I have taken the risk to share selected elements of my life that we have in common.

We are still patient and therapist but we are also two guys who can appreciate being lazy and two fathers who worry about their children. He still tells me about the immensity of his sadness complicated by the reality of his impossible situation and I continue to search for more effective therapeutic interventions. All of this goes on as before but he smiles more and we smile more together.

The perspective of retirement not only makes it easier for me to be more genuine in my encounters with people who happen to be patients, but it also gives me the time to be more present in my interactions with family, friends and people I meet as I go about my daily routine.

In the past week, while waiting for a prescription to be filled, I chatted with a clerk at the drug store and learned that she is an avid reader of English literature, history and science. As one of the first customers of the day in an enormous empty store, I discussed with the cashier the prospects of snow shovel sales for the coming winter.

All this calls up a memory of riding the bus with my father from suburban New Jersey to New York City. I was a newly minted psychologist heading for the APA convention to learn how to be a good therapist. My father was a retired county roads sign painter on his way into the city to buy lottery tickets for his friends. He was a quiet, warm, and gentle man who amazed me with his capacity to connect with everyone from the bus driver to the woman who sold him his ticket for the return trip. People joke in mock horror about turning into their parents as they get older. I am as old now as my father was then and there is nothing I would like better.

Alan Bodnar, Ph.D. is a psychologist formerly at the Worcester Recovery Center and Hospital.

By Alan Bodnar Ph.D.

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