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Saturday, January 1, 2011

Psychotherapy and Beginner's Mind

"In the beginner's mind, there are many possibilities, in the expert's mind there are few."
Shunryu Suzuki

What is "Beginner's Mind"?
Beginner's Mind, also called Shoshin in Japanese in Zen Buddhism, is maintaining an attitude of openness and curiosity, even when you're considered to be at an advanced level of whatever you're doing, whether it's spiritual, emotional, interpersonal, or just living your daily life.

Psychotherapy and Beginner's Mind

I'm not a Buddhist, but I like the concept of Beginner's Mind because it reminds us not to prejudge ideas, people or places. In this way, we remain open to the experience. If you think you already know, then your mind is closed off to new possibilities, even when you're an "expert" in the field. We can think of many ideas and inventions that wouldn't have been created if their creators had gone along with accepted wisdom at the time of what people thought they "knew" about what was possible and what wasn't.

I believe that Beginner's Mind is a state that we can continually remind ourselves about and bring ourselves back to in our daily living. It's not a place where you "arrive" and then can forget about it. It's normal to revert back to old habits and ways of thinking beause they're so ingrained in us.

Self Compassion and Beginner's Mind:
Rather than berate ourselves for falling back into the same old habits, as we are apt to do, it's far better to acknowledge our humanity and bring ourselves back to the practice of Beginner's Mind, as we do when we meditate and we find our minds wandering.

 During meditation, when we find our minds wandering, we bring our attention back to our breath or whatever we were focusing on before we got distracted. With practice, it's possible to get better at maintaining our attention.

Psychotherapy and Beginner's Mind

 In the same way, practicing Beginner's Mind can improve our abllity to cultivate this state of mind over time.

We're not looking for perfection, only an increased awareness.

With Beginner's Mind, We Don't Throw Away Our Experiences and Skills:
We're also not looking to throw away what we already know when we talk about Beginner's Mind. So, for instance, if we're crossing the street or driving a car, we don't want to approach these activities as a complete beginner. If we were in plane, we wouldn't want the pilot to forget about experience and abandon all of his or her skills. The same would be true if we're having surgery. We would want the surgeon to be experienced and know what he or she is doing. We want to use the skills that we have and pay attention.

It's more about creating a balance between using what we know and also being open and curious to new things.

Beginner's Mind and Children:
It's wonderful to observe children, especially infants from about six months to a year old, as they explore their world. Everything is new and exciting to them. A simple spoon can be an object of complete wonder and fascination as something to look at, put in the mouth, bang on a table or hurl in the air.

Beginner's Mind and Children
I remember being a very curious child who wondered about a lot of things and asked a lot of questions. Somewhere around the first or second grade, I learned in school that it was better, in the teacher's eyes, to have "the right answer" rather than to question or wonder about things. It seemed that whenever the teacher had a question, a sea of hands would go up and if someone gave "the wrong answer," the teacher went on to the next student until she heard the "right answer" and then she rewarded the student with a smile and praise. There was no rewarding smile or praise for "the wrong answer" or encouragement for working your way through the process so that you could learn and grow, possibly by starting out being wrong and learning from there. The emphasis was on knowing and being "right."

Hopefully, this has changed in schools and teachers are more interested in developing curious minds and not people with "the right answer," which tends to stunt curiosity and creativity.

Being a Beginner as an Graduate Intern:
When I was an intern in graduate school, as I've mentioned in earlier blog posts, my internship was working primarily with men who were homeless in a homeless drop-in center. The atmosphere at this drop-in center could best be described as organized chaos with hundreds of clients with many complex challenges.

After a three week training by the internship clinical supervisor, we began our work with these clients. At the time, I was transitioning from the human resources field and I was working full time at a commercial bank, where I worked with investment bankers, going to my classses on Saturdays, and doing my internship in the evenings from 5:30 PM-8:30 PM every evening during the week. It was a very busy schedule.

I remember thinking then, more than I had ever experienced before, that I didn't like being a beginner. Nothing in my work history, education or personal therapy had prepared me for the experience of working with clients who needed so much with regard to housing, their physical health, their emotional health, and the need to connect interpersonally.

I felt completely unskilled and found myself often thinking that these clients really needed someone who was far more experienced and skilled than I was as a complete beginner. I felt like they were being cheated.

I wish that I had known about Beginner's Mind at that time. Of course, the clinical supervisor was there for part of the time and we had weekly supervision. But most of the time, when I was in the moment with these clients, I didn't know what I was doing, especially at the beginning of the internship.

I think most of the interns felt this way during that internship, and we often talked to each other and our supervisor about it. Our supervisor had a completely different view. He thought that the clients really benefitted from having beginners assist them because most of us didn't have very many preconceived ideas about the work or about the clients. He thought that we could approach the clients with open minds, and he encouraged us to maintain a sense of openness and curiosity. Again and again, he emphasized being curious and open, the same concept as Beginner's Mind, although he never called it that.

Learning about the concrete services that the clients needed came a lot easier than beginning to understand the emotional fallout of being homeless, and most of the clients had long trauma histories.

Spending my days working on Park Avenue with investment bankers and my evenings with the poverty-stricken clients made both worlds seem unreal after a while because each world seemed so extreme. It also struck me as unreal that I could walk just a few blocks from Park Avenue to this homeless drop-in center and I was in a completely different world, but this is so true of many areas in New York City and other large cities.

Over time, I realized that my supervisor was right. I began to see many experienced social service workers who were jaded and somewhat inured at the center. Many of them were burnt out and just trying to survive themselves on low wages.

But most of the interns felt they had to be on their toes all of the time. We knew that we were beginners. We also knew that, often, we didn't even know what we didn't know. But most of us were ready to roll up our sleeves and do what needed to be done, trying to remain curious and keeping an open mind.

Not only did we learn a lot from our supervisor, but we learned even more from our clients. I was amazed at how generous most of the clients were, considering their circumstances, to share whatever information they had from being in and out of different social service systems over the years or learning about the law while incarcerated.

Most of the clients were truly grateful that we spent time and effort with them. And, even though there was violence at times at the center among the clients, while I was there, I never witnessed any violence towards any of the interns. The clients seemed to have adopted us as their "students," even though most of us were older than them, they were protective, and most had a genuine affection for us. It was an experience that I'll never forget.

Being a Beginner as a Psychotherapist:
After I completed graduate school, I went on for postgraduate training at a psychoanalytic instiitute. It was one of the most intense, rigorous, and fascinating educational experiences of my life. It was considered an "immersion" experience because we attended classes, supervision, our own 3x per week personal psychoanalysis while seeing clients for psychotherapy at the same time.

Once again, I was a beginner, especially the first year, with all of the feelings of anxiety, humility, and confusion that went with that experience. During the first year, most of us felt like we were in a fish bowl, being observed by our instructors, supervisors, as well as our clients.

Many of the clients who came to the institute were feeling depressed, anxious, panic stricken, challenged by difficult relationships, and traumatized by their childhoods, among other problems.

During the first few months, I was more frightened than I would've admitted to my supervisors or teachers, about what might come up in a psychotherapy session--maybe something that I wouldn't know how to handle. Of course, as new therapists, we were not alone and there was an entire institute of seasoned professionals to call on--eventually. But in the moment when each of us were sitting with clients in an office, we were alone and on our own.

I still didn't know about Beginner's Mind or meditation at that time. I felt that I was expected to know, even though I often didn't know. And each week, each of us were on the "hot seat" at least once or twice in our individual supervisions or group supervisions to present a client's case, verbatim (what the client said, what we said to the client).

I don't want to make it sound like we were being grilled as new therapists because we weren't. Most of supervisors and instructors were kind and compassionate people who had gone through the same training that we were going through. I think, as new therapists, who wanted to help our clients and who wanted to seem competent to our instructors and supervisors, we put most of the pressure on ourselves. This also served to keep us on our toes to be diligent about finding out about situations that we didn't know about or to understand unfamiliar concepts.

I remember thinking to myself, once again, that these clients deserved to be seeing someone else--a therapist with a lot more experience and knowledge than I had. Even though there was no secret that this was a postgraduate training center, I wondered how many clients really knew that they were seeing psychotherapists in training. I suspect that many of them thought that if you were seated in the psychotherapy room and you were seeing them, you must know what you're doing, which only added to the pressure the trainees felt.

By the second year, we were over the period of "baptism by fire" of the first year. Many of us were continuing with the same clients and we were feeling a little more confident, still new, but not so worried about the proverbial fish bowl.

Part of what came next in training was that we had to become more proficient at diagnosis. While the psychodynamic processs was the emphasis of training and, fortunately, diagnosis was not the major focus of psychoanalytic training, it was still significant.

While I think it's important to be able to diagnosis to a certain extent, especially if clients have major depression, bipolar disorder, ADHD, or other problems that have a strong biological component and where medication might be needed, focusing exclusively on diagnosis is very limiting to the work.

When you're first learning about diagnoses, it's an occupational hazzard that not only do you feel you often see the diagnoses in your clients, but you begin to see it in your friends, family, loved ones (much to their chagrin), and in yourself.

I can laugh now when I think that it was not unusual in that early stage of training for new therapists who became friends to say to each other, "Do you think I suffer with narcissistic personality disorder?" or "I think I have some borderline personality disorder traits."

I've heard that medical interns go through similar experiences. I think this happens when you're so immersed in learning about the diagnoses that you think you see them everywhere.

The problem with too much of a focus on diagnosis is that you can reduce the client to a particular set of behaviors and dynamics. It becomes too easy to rely on the American Psychiatric DSM (Diagnostic and Statistical Manual) and forget that you have a client in front of you who is multi-dimensional and multi-faceted in many ways. People are too complex to reduce them to a few lines in a manual. And when we reduce people to a diagnosis, it's easy to lose compassion for them.

The other problem is that when a therapist reduces a client to a diagnosis, it's often the opposite of keeping an open mind because the therapist can think that she or he knows, using only the diagnosis, what's going on with the client. It's the opposite of Beginner's Mind. It's far better to remain open and curious about what's going on, holding onto any particular diagnosis in a tentative way, if it's relevant, keeping in mind that this might not be correct, it could change, each person is unique and that not all people with a particular diagnosis are the same.

Beginner's Mind as a Psychotherapist:
I don't want to sound like I'm presenting myself as someone who has reached the pinnacle in the skill of using Beginner's Mind. Far from it. I still need to remind myself to be open and curious, but I think I remember more often now beforehand rather than remembering after the fact. Now that I have more experience, I'm also more willing to be wrong, as compared to when I was new to the field years ago.

Part of the job of any experienced psychotherapist is to approach each client and each new session with Beginner's Mind, even if they don't call it that. Skilled therapists who are willing to use their skills and their intuition are usually better therapists than therapists who think they always know what's going on with clients.

Psychotherapy and Beginner's Mind

Therapists are only human and it's easy to make the mistake by assuming that you absolutely know. It's a far better approach for therapists to consider ideas that they might have as possibilities, not to get wedded to them, so that, if they're wrong, these possibilities can be thrown out and the therapist can learn from the client what's really going on.

If they're right and their skills and intuition have lead them in the right direction for the benefit of the client, that's great. But assuming, as a therapist, that you're always right is a big mistake (as it would be for anyone). It's better to start with Beginner's Mind. And if a therapist forgets, as I sometimes do and must remind myself, it's better to acknowledge it and bring yourself back to an open mnd. This is a humbling, but necessary process.

Being a Smart Consumer of Mental Health Services:
It's a delicate balance and an ongoing challenge. Clients, of course, want therapists that are licensed, experienced and skilled. Licensure, skills and experience count, just as they do for a doctor, a pilot, or a teacher. Before there was licensure, anyone could call him or herself a psychotherapist in NY, but now that there's licensure, it's no longer legal to call yourself a psychotherapist if you don't have a license.

Getting Help in Therapy
As a smart consumer of mental health services, you want to know that your therapist is qualified to treat you. I've seen many clients hurt when they went to unlicensed, inexperienced and unskilled people for psychological problems. Unfortunately, there are some people who advertise themselves as coaches or New Age counselors, offering "quick fixes," who are working outside the scope of their skills and knowledge, and this is often hurtful to clients.

Getting Help in Therapy

If you want to find out more about Beginner's Mind and how you can develop more of an openness and curiosity about life, I suggest you read a book called Zen Mind, Beginner's Mind by Shunryu Suzuki. As I mentioned previously, I'm not a Buddhist, and I've found the concept of Beginner's Mind to be valuable. Even if you're not a Buddhist and you have no interest in Buddhism, you could benefit from reading this book to learn more about Beginner's Mind.

I am a licensed NYC psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist.

To find out more about me, visit my web site:  Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (212) 726-1006.



photo credit: Eddi van W. via photopin cc