Mental Health

Finding Power in Powerlessness

“I feel powerless.” I hear statements like this often. Any experience of trauma or loss—loss of job, intimacy, relationship, health—can evoke feelings of powerlessness. Similarly, the sense of being trapped in an unsatisfying career or unsatisfying relationship, being the parent to a “rebellious” child, an unwanted medical diagnosis can stir up powerlessness. Powerlessness is often a symptom of depression; powerlessness also induces anxiety.

Indeed, the experience of helplessness and powerlessness is one that most of us avoid at all costs. It is a deeply disorienting and disturbing experience. Depressive symptoms arise: tunnel vision, narrowing of interests and activities, lowered self-esteem, lowered energy. The experience of powerlessness also evokes strong feelings of shame, and shame can engender identification with the powerlessness and reinforces negative beliefs about self-efficacy: “I AM powerless; I AM incompetent; I AM inadequate.” The experience of powerlessness can become paralyzing and traumatic.

Powerlessness is often a response to factors that appear to be—and sometimes are—outside our control. And too often, the experience of powerlessness produces a regression where power is completely given over to external forces.

Emotional reasoning is one of the hallmarks of that regression. We typically tell ourselves stories about powerlessness, and the stories often reflect our misperceptions and dysfunctional beliefs about ourselves and where our power lies. And often the stories we tell about our present circumstances resonate with older stories of powerlessness that originate in early family experiences. Often, that early childhood story is repeated throughout adulthood, with variations that reflect the current situation.

Herein lays one of the keys to moving out of powerlessness: focusing on the facts of the here-and-now situation. This means detaching from the feelings and looking at the facts of the situation—including an acknowledgment of the real, fact-based limitations of self-efficacy. It means changing one’s relationship to the situation. It often means widening one’s focus to see the larger picture and one’s place in it—which may also mean asking for help in order to see the situation a bit more objectively. It means letting go of, and even changing, the story. It sometimes means taking risks and making decisions that take us out of our comfort zone. It means living with uncertainty. Paradoxically, there is power in ambiguity: the power to make new, different decisions.

Moving out of powerlessness takes time because meaningful change toward empowerment is a complex, multi-layered process. Therapy is about empowering people make decisions that alleviate anxiety and depression, and create freedom; therapy is about helping people create and own power. Engaging in a fact-based examination of the circumstances, engaging in some short-term problem-solving, exploring patterns of thinking and feelings, exploring the beliefs that fuel the feelings and thoughts of powerlessness, exploring the meaning of power and powerlessness, and experimenting with new thoughts and activities can help. Of course, looking at the roots of shame and powerlessness is also critical to long-lasting, meaningful change.

The work continues…

Psychotherapy Matters

Psychotherapy matters. I recently had a conversation with a friend who said that he believed that a person would never need to consult with a psychotherapist if he or she had a “really good friend—someone who will honestly tell you about yourself and help you see yourself objectively.”  He had never been in therapy and had typically managed to sort through various dilemmas on his own or with the help of a few intimates.  He admitted that he’d recently considered a consulting with a therapist to help him manage feelings of anxiety that plagued him throughout a period of unemployment; but now that he is working again, he dismissed the idea of entering therapy.

The conversation got me thinking about my own work as a therapist.  I’ve been working in mental health and addictions for more a long time, and I continue to be astonished by the misperceptions and mistaken beliefs many people have about what psychotherapy is, why people go to therapy, and how it helps people. 

Psychotherapy and friendship are very different experiences.  And while I agree that a good friend is vital for most people and can provide useful insights and feedback, psychotherapy offers a great deal more.  Psychotherapy provides a freedom and space to explore yourself, to understand how you work, to help you find ways of living that are best for you.  The psychotherapist is someone who creates a safe space where it becomes possible to be vulnerable, take risks, try new ways of thinking and acting, help you through a change process (if this is what you want), and find optimal mental health.  It most definitely is not a friendship (although, hopefully, the psychotherapist will be friendly.) 

The title of this blog can be understood in two ways:  first, it refers to the wide variety of  issues—matters—that regularly arise during the course of psychotherapy: intimacy, relationships, addiction, depression, anxiety, the experience of powerlessness, among others.  Second, the title reflects my belief that psychotherapy does indeed matter—that it has a purpose, that is positively changes those who experience it, that it helps, that it works.

My goal here is to share insights on a variety of issues that arise in the consultation room.  The blog is not intended to be a substitute for therapy, but rather a place to share information, stimulate thinking, dialogue with others, and perhaps even correct some of the misperceptions about psychotherapy and the therapeutic process.   The nature of blogging also prohibits lengthy and deep discourse on clinical topics.  Thus, these are thoughts and reflections stimulated by the work in the consultation room.  They are not meant to be definitive statements on psychotherapeutic practice. 

The blog is, however, one clinician’s perspective, on clinical problems and processes.  It is a means of sharing “practice wisdom.”