Gregg E. Bernstein - The Heart Is My Beat: Inside the Work and Life of a Psychotherapist

The Heart Is My Beat
Copyright 2018 by Gregg E. Bernstein, PhD

All rights reserved. This book or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher except for the use of brief quotations in a book review.

ISBN (Print Edition): 978-1-54652-162-4
ISBN (eBook Edition): 978-1-54393-245-4

Introduction

The actor Peter OToole told a story about sending a badly soiled coat to the cleaners. Eventually, the coat came back with the following note pinned to it: It distresses us to return work which is not perfect. OToole, a wry and irreverent fellow, went on to say that he would be pleased to have that same sentiment etched on his tombstone.

As a therapist, your work is always imperfect, always subject to question, always a work in progress, but like any other serious artist, you have a vision of what can be accomplished under the circumstances, and you strive mightily to achieve it. Psychotherapy lends itself to metaphor, and over the years I have variously experienced it as detective work, gardening, surfing, midwifing, war, dancing, wilderness guiding, meditation, horse whispering, and, sometimes, even bronc riding. Sports analogies sometimes apply, but they are always those in which patience and failure predominate: baseball, golf, fishing.

Psychotherapy can be one of the worlds most maddening professions, and among its most glorioussometimes all at once. You learn how to do it only painstakingly and by accretion, over years of trial and (if youre lucky) useful error.

Once, as a young and impatient therapist, exasperated beyond measure by a new and stubborn patient, I approached my supervisor and blurted out, Damn it, how do you lead a horse to water?

He thought a moment and said, First, you have to help him believe he deserves water.

* * *

I wrote this book to serve as a human look at the imperfect world of therapy, and the world of a therapist. Most books written by psychologists and therapists for the general public are either informational, providing expertise about a specific topic (addiction, depression, anxiety), or focused on particular techniques, tools, and systems to effect personal change. But in this book, I am not offering answers, exhaustive expertise, or techniques.

And yet I feel you may find a sort of self-help within these pages if you read with an open heart, because I offer you what in Alcoholics Anonymous they call experience, strength, and hopenotes from a veteran fellow-traveler on the path to self-awareness, growth, and change. Some of the stories are about the process of therapy itself, or about specific patients I have worked withpeople and experiences I treasure. Some are about the events and people that shaped my lifepreparing me for, and pointing the way toward, my career as a therapist. In a few chapters, youll find that I allude to the death of my six-year-old son in an auto accident a number of years agoa profound event that eventually became a positive turning point in my own development, both as a person and a therapist.

For some, this book may help provide the courage to continue individual journeys they have already begun, as well as the virtual companionship of those who have walked that lonesome valley before them. For others, new to psychotherapy and perhaps even the idea of personal growth, it may at least sketch out what psychotherapy can accomplish, answer their questions about what therapy might look like, and give some form to vague concepts such as being yourself and getting better.

I hope you will be kind enough to indulge some of my references to films and popular music, as they have served me as grand allies in making my way through life. Also, youll notice that I usually refer to the people I work with as patients, rather than clients. The term client was introduced by the great and justly revered psychologist Carl Rogers to help the profession move away from the medical model and to put things on a more egalitarian footing; however much I agree with Rogers on these important points, I still prefer the earlier term because it feels more warm and caring to me, and because, whimsical though it may be of me, it has that felicitous homophonic resonance with patiencea most relevant virtue!

While I have altered many details, and in some cases combined the stories of more than one person, in order to shield the identities of my psychotherapy clients, protect their confidentiality, and make the stories enjoyable to the reader, I have worked to maintain the emotional honesty of these stories and keep them true to the spirit of the actual events. There are portions that are humorous, sad, triumphant, puzzling, and humbling, because thats the way real life is, but throughout, I sincerely hope I have been able to convey that I have always felt fortunate and honored to be allowed to do in life what I came here for, as the great poet John ODonohue wrote.

My life has been devoted to helping others find out what they came here for as well, because as my supervisor said so many years ago in response to my outburst, we all deserve water.

For Brett Morgan Bernstein:

Since you lost your life,

The least I could do was find my voice.

The Marquis de Carolina

They say Caesar was born in a caul. Well, I was born in a Chevy, but that dont seem to count for nothin. He get, Hail, Caesar! All I ever get is, Hail, no!

Thus began my association with Curtiss M. Jones, the self-styled Marquis de Carolina, drug dealer, man about town, love machine, and pimp extraordinaire. He once described himself to me as da pimp de la pimp, and while his wordiage (another of his terms) may have run slightly afoul of the style guide, he got full marks for originality, and his meaning, as always, was crystal clear.

Curtiss ( Dont forget that last S!) was a sometime outpatient in the North Carolina V.A. Hospital where I worked one summer during my training days. He was a Vietnam vet who had suffered a service-connected disability during his tour of duty. I still dont really know whether his manic-depression (now gussied up as bipolar disorder) was really brought on by what he went through in 'Namhe used to say it was, or it wasnt, depending on his mood and how he felt about me at the momentbut the fact is, when he went away to serve his country, he had a 3.75 grade point average at his inner-city school (he once showed me the report cards, which hed preserved carefully in a sealed plastic bag, like holy relics), and was aiming for collegeand when he came back, he was a changed man.

This may sound like a crackpot theory, so feel free to toss it out if it doesnt make sense to you, but oftentimes, when people suffer from conditions (bipolar, oppositional-defiant, Tourettes, even ADHD) that temporarily hijack their regular mind or behavior to a raw and coarser place, their day-to-day personalities eventually start drifting in the direction of their altered states.

Maybe I can explain it this way: Lets say youre an actor, a person who is normally quiet and unassuming, even reserved, and you win a role in a play as a rowdy, roistering truck driver. You play this role over and over again, until finally, you find yourself beginning to incorporate aspects of the truck driver into your civilian behavior. Your girlfriend says, Did you just call me Toots? Your friends say, Whats with the Brooklyn accent? Youre calling AT&T to discuss your bill, and you hear yourself shouting, Believe me, sister, you really dont wanna mess with me! Its not that youre becoming someone else, its more that playing that role has pulled out of you parts of yourself that might otherwise have remained dormant.