I was a very young therapist with an excellent supervisor and a heavy caseload that gave me regular headaches. My books and my excellent education were failing me. This was the real deal. Real people with real—and I mean real—problems. The seasoned therapists would take their top picks from the incoming clients, leaving the newer therapists the “twice tried to commit suicide” and “severe history of psychosis “ which made zero sense to me on some levels. Quite frankly, I was frightened at times. You’d never know it, as I hid it well, except for the occasional client who would destroy me in our first intake session together. I never cried, but often wanted to. I was here to help, not to need help, and I kept silently repeating that to myself over and over. But in all honestly I did need help and guidance, and my supervisor did that, and did it well. The two supervisors in my training days gave me so much wisdom and helped shape me into the therapist I eventually was proud to be.
I recall one day in particular…I had taken on yet another tough client. His name was Joseph, and our intake went on and on as he recounted a difficult and abusive childhood, and from there things continued to go downhill. He struggled as an adult with bouts of depression and carried the notion that he was unlovable since his mother abandoned him and his sister on the steps of the Catholic Church as a child. He continually messed up his life with drugs and alcohol, chose poor relationships, and never maintained a stable job or living situation. In essence, he continued the legacy of abuse—only he was the abuser now. He abused himself carrying his history forward.
When I asked him what brought him to therapy noting the many previous attempts at therapy—all unsuccessful—he replied, “My kids. Amanda is 7 and Josh 10. I need to be better for them.” As our intake wound down and I turned for my scheduling book scanning over my very full schedule he interrupted, “ Am I fixable?” I was stunned by his question. Carefully weighing my reply I said, “Everyone can fix themselves. You wouldn’t be here if you didn’t believe that too.”
One week later, we met for our first session and several more after that. He came on time, ready to share his history—he worked hard. When I say someone works hard in therapy, it means they confront the issues they are having head on, recognize patterns in their behavior that are damaging, and work constructively to understand the whys of their behavior, and institute change. A primary aspect of this process is vulnerability. Joseph allowed himself to be emotionally open and vulnerable in front of me in sessions, and this was key.
Around session twelve, nearing the limit of the time I was allotted to spend with Joseph, we had a seriously interesting therapy session. He came in distraught over visiting his father for a Fourth of July along with his sister and her kids. He hadn’t seen his mother since she abandoned them, and he rarely brought it up. Only recently had he re-connected with his estranged father. Their relationship was surface at best—strained and tainted by his abusive nature. His father had physically abused his mother, which was one of the reasons she had left and went on to not be able to care for them.
So Joseph tells me about this barbeque that evolves into a Jerry Springer-style family feud, with everyone drunk and yelling. Joseph was at the barbeque cooking burgers when something went wrong with the grill… flaring up the flames and fizzling out. His father attacked him verbally, calling him a dumb ass, and then his sister came to his defense. As you can imagine —things got ugly. That was no surprise with their history, really.
In our session, Joseph cried as he recounted the story and then, he suddenly turned on a dime and got really angry. He started yelling and challenging his absent father and mother as if they were there—and went on until he reached physical and emotional exhaustion. He was loud and full of rage. The young therapist in me was secretly petrified, but I realized that he was taking back his life and his power in front of me, and I was his witness. He allowed me to help him with that…. and I was grateful.
That week in supervision, Joseph was at the top of my cases I needed to discuss. Tim listened closely, and as I finished recounting the series of events that unfolded in our last session he fell momentarily silent. As usual, Tim would ask me how he came in, what he was wearing in the session and how he presented…his mood etc. I recalled he was wearing a baffling tee shirt that was quite distracting to me. It was a “Far Side” cartoon with a cow at the grille serving up “Sh$tburgers” with flies swarming above them. I was further distracted because it related to the family traumatic event he was telling me about grilling.
Tim smiled and shared a valuable therapeutic insight that I had missed as I was immersed in Joseph’s rant. He was accustomed to sh$t burgers. Tim said, “Heather, some people have eaten sh$tburgers for so long, they think that is what they are supposed to eat.” My eyes lit up—I got it. Joseph was done eating the abuse and had declared he would no longer accept it. People who have been abused need to unlearn the abuse and replace it with stronger patterns and boundaries. Joseph had begun to do this.
In our successive sessions, Joseph went on to terminate therapy but not before I got to see him get a decent job, a new girlfriend, and a better life for himself. He sent me flowers at the outpatient clinic following our last meeting and I cringed, hoping the card was appropriate, while my office personnel quietly shot me disapproving glances. Slitting the envelope open, I pulled out the card with the words “Thank you for giving me back to me.” It was a very pivotal moment for both of us. For me, it was recognition that the therapeutic process is about supporting, guiding, witnessing pain, and giving someone the permission to let go and create new ways of acting and thinking. For Joseph it was about saying goodbye to his past and no longer accepting the abusive patterns he experienced as a child. For him—this meant no more Sh$tburgers. Man, I hope Joseph is somewhere this Fourth of July, serving up some pretty nice 100% beef burgers with the works. He truly deserves it.