Internship: Taking Off the Training Wheels and Finding My Balance

Psychotherapy is a sanctuary; it is a battleground; it is a place I have been psychotic, neurotic, elated, confused, and despairing beyond belief.

—Kay Redfield Jamison

Right up until the day I walked into my internship class (Case Consultation) for the first time last quarter, I had an image in my head about how the class would unfold, what the discussions would sound like, and what I would learn. Of course, as is so often the case, reality and imagination did not coincide so much as create a sort of Venn diagram with a sliver of intersection.

Internship has loomed large and mysterious as I have made my way through the Clinical Mental Health Counseling program at Antioch University. I have had my own fantasies about what happened behind those doors in those small groups full of counseling interns who had managed to get that far. I imagined heady, intellectual discussions about thorny therapeutic issues, discussions that I could not quite imagine myself having. When I started classes way back in April 2014, I envisioned something much different than what I am doing now. I pictured myself as a competent counselor in a cozy private office in the hip part of town meeting with the Worried Well Insured.

This vision has not come to pass. Not even close.

After three years at Antioch, I am still adjusting to being a counselor with training wheels. I feel as awkward as a toddler on a bicycle. Even though I have been in counseling, as a client, for the better part of my adult life, and am comfortable in therapy per se, I struggle being on the other side of the couch. I want to be a master counselor. I want to be as helpful and insightful for my clients as my therapists have been for me. I do not have much patience for the process. Frankly, I am tired of feeling awkward and incompetent. It is exhausting and demoralizing.

But I had a helpful epiphany the other day after a particularly arduous experience with a client. In my previous career working with computers, I was the expert. I could fix things. I could leave a call knowing that I had made everything work again. Computers, unlike counseling clients, do exactly as they are told. I quit working in Information Technology when my career was at its pinnacle, I felt competent. Accomplished. I had buckets full of confidence and ability. I knew what I was doing and could do it well, excellently in fact, and better than most. Counseling does not work like technology, however.

Fortunately, no one else in my Case Consult class is a master counselor either (except perhaps our instructor), and I find myself in good company. The mystique has given way to clarity. No one is going to wave a magic wand and imbue me with master counselor qualities, nor am I as much of a natural at this gig as I had imagined. So, unlike in my previous career (which did come easily and naturally to me), I am going to have to apply myself if I am to become the counselor I intend to be.

And first, I have to learn to be comfortable with the clients I have. Right now, these clients are not the Worried Well. Not even close. It’s not easy for me to walk into a client’s house. I have had to let go (for now) and learn how to swim in this alphabet soup that is reality for the people I am counseling: SSI, SSDI, ETOH, THC, LWTC, LHM, SJH, ED, ER, PRN, CPS, DV, CHINS, EBT, TANF, DSHS, SI, HI. Case managers, lawyers, social workers, multiple exes, drug abuse, child abuse, sexual abuse, alcohol abuse, opiates, benzos, meth. I have no idea how to fix any of these things for a client. But, I can listen. I can create a frame and be a witness. I can hold their pain. I can show up. And I can learn.

As these quarters wear on, I will learn. I will persevere. Internship and case consult will get easier. I can do this job. I can hold space for clients. I can learn the skills specific to my internship sites, just as I did with practicum. I can even offer intelligent feedback and the occasional and useful insight to my classmates. After all, I am an old hand at this now. I have been at this (meeting clients) for nearly a year now. I have co-facilitated two group therapy groups in the past two summers. I have spent nearly half a year working with an incredibly challenging population at one internship site and have a handful of clients recently out of homelessness who I see in their homes at another site.

During one of my internship interviews, the director asked me what I thought about working there. “It seems terrifying,” I answered, probably too honestly. At that point, I thought I had blown my chances to get the job. But, he hired me in spite of my naiveté, and thus far, terrifying is not at all what I have experienced. Sadness, frustration, despair, yes. But not terror. Terror is reserved for the clients themselves at this short term inpatient facility when they have to discharge into the 20-degree evening with no firm plans for housing. Terror is a transgender man faced with staying at the all-male mission. Terror is voices telling clients to bite off fingers or jump off an overpass into traffic. Terror is with me here, but not in the way I had imagined.

My whole notion of what it means to be a counselor has shifted since the beginning of my internship. No longer do I think that it looks easy to sit across the room from a person who is baring their soul and looking for help with managing the stressors in their life. I now know how difficult it is to simply hold the space for someone whose world is falling apart. I now know that just sitting in my chair and being a witness has to be enough. I cannot rescue anyone or save anyone. I do not have to come up with the right answer or the perfect solution, and learning to be okay with not having all the answers has been my biggest learning these past two quarters.

Every now and then I start to panic and think that I need to sign up for more trainings or workshops, that I need to Specialize in Something Useful: trauma, attachment, CBT, DBT, chemical dependence, sensorimotor, Gestalt. But then I take myself to see my own therapist who admonishes me to slow down, to get comfortable in just being with clients, to listen, to be empathic, to focus on the basics. Indeed, as I talked with my supervisors in the last two weeks, they both reminded me that they have had years in the field, that what looks like ease is in fact experience. There is no shortcut.

12 thoughts on “Internship: Taking Off the Training Wheels and Finding My Balance

    • Thanks–I used to think I could put myself in their shoes, but not until I actually sat there doing the work did I have any idea what it meant. Revelatory. Thanks for reading!

    • Attending. Yes. In one of my classes last year we had quite the debate about whether we should call ourselves therapists or counselors (http://wp.me/p2G7F8-hz). Technically, I am a counselor, but in my heart and practice, I am a therapist. (but don’t tell anyone)

  1. Great blog, Pam. I’m sure your intelligence and empathy will be a big help to your clients. You might want to fix the typo in your title.

  2. Yr humility in the face of all this testifies to how correctly you have chosen yr profession. Anyone who wades into another ‘s suffering without humility is deluded, and thus, dangerous. L

    Sent from my iPad

    >

    • Thanks–I feel like I need bigger waders some days! But there’s nothing like this work to make me grateful for what I have: friends, family, a roof over my head . . . my list grows each day. Thanks for reading, Amiga.

  3. Pam, I’m glad I stumbled across your blog! I was in your shoes very recently and I am reminded of all those thoughts and experiences. I have found that the more I sit with client’s the more confidence I feel even if I still can’t “fix people’s problems.”

  4. Thank you for your honesty and inspiration Pam, it’s a pleasure to meet colleagues who are human and admitt, that even with all the experience and training, the stories of people who trust in them, make them feel humble, fragile and yes, even confused. There are still too many ”know it all, will fix anything in 30 minutes” causing further dismay and not living by what they preach. You’ve hit the nail, we need listening and companionship more than ever nowadays. Have a delightful day, Marketa

  5. Pingback: One More Quarter to Go: Reflections on being Almost Finished with School | Pamela Helberg

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