Image credit: Vitaly Gariev @silverkblack

One of the most important things I’ve learned about feelings from being in therapy and doing therapy is that feelings are a response to something outside of ourselves, in the environment, or inside of ourselves, in our minds. Feelings are data. You can interpret data. Hold that thought. I’ll get back to it shortly.

During the third year of my psych residency at Einstein, I worked with outpatients in the Montefiore Hospital clinic for the year, learning the basics of psychotherapy and medication management. My patients were a mix of working people suffering from chronic psychiatric illnesses such as depression, anxiety, and post-traumatic stress disorder; and disabled people with severe psychiatric illnesses such as schizophrenia and bipolar disorder. I totally appreciated being able to competently prescribe life-changing medications. That said, my primary area of professional interest was individual psychotherapy.

To be an effective psychotherapist, you have to be aware of your own limitations and biases, so you can tell the difference between your stuff and the patient’s. That is surprisingly difficult! To that end, I was already in a training analysis— therapy with the dual agenda of uncovering those limitations and biases while learning how to be a therapist.

Peter Buckley, the director of outpatient training was aware of my interest in insight-oriented psychotherapy. He assigned a very senior, very well-respected psychoanalyst to supervise my therapy work for the year.

I traveled once a week to his clinical office, sat on the edge of the patient chair, and presented any patient I needed help with. That presentation included my understanding of any symptoms that might benefit from medication, as well as my formulation of the patient’s psychodynamics that could benefit from psychotherapy.

It is a limitation of supervision that mentors don’t observe us working in real time with patients. All they have to work with is what we tell them. (The same limitation applies in therapy.) It was tempting to present what I did well and avoid presenting what I did poorly. Why? In order to please and get a good evaluation, of course. I knew residents who did that. But I was on fire to learn as much as possible. That meant revealing to my supervisor what I didn’t know and mistakes that I’d made. Which I did.

A few weeks into the supervision, I was frustrated. He wasn’t listening to me. I was spending most of the precious supervision hour getting him to understand what I needed help with. Then time would run out, and I’d leave empty handed, no further along on how to move the treatment forward than when I’d arrived.

You need to know that I have always been good at explaining myself in multiple ways to be understood. Having four parents from four different countries who all speak English as a second language does that for you. That I was failing to make myself understood gave me pause and made me doubt myself.

But being polite and hesitant to complain, I kept plugging and hoping for the best. A couple of months went by before I acknowledged to myself that this supervision was a waste of my time. I went to Peter Buckley and asked to be assigned someone else. He actually gasped with shock. “But he’s one of our best!” he said. “Why would you want someone else?”

“Because he’s not helpful,” I replied, impatiently. “He doesn’t listen.” I went on to give him examples.

Another thing you need to know about me is that I was an excellent resident, at the top of my class, especially with respect to psychotherapy. I think it blew Peter’s mind that I was so dissatisfied with his very senior, very well-respected supervising analyst.

“He’s very good,” he said. “Sometimes it takes a while to get used to each other.”

“I’ve already given him two months. I’m not learning anything. My patients deserve better.”

He begged me to give it another month. I agreed reluctantly.

Well! My next supervision went swimmingly! I couldn’t believe it. What had changed? He was listening! He was asking questions to make sure he understood me. He asked me what ideas I had about how to proceed with patient X. I enjoyed an interesting and useful back-and-forth with him. I left the session worried that wouldn’t last. But it did. Being heard and understood is a wonderful thing. I learned a lot, from him and from my patients. I had an excellent year.

When a treatment ends, it’s standard procedure to discuss with the patient how it went— the gains as well as what still needed work. Ditto a supervision. At the end of my third year, my supervisor and I reviewed the year’s course of supervision, including the unsatisfactory first months.

I know I asked him what changed but can’t remember how he answered. Probably something along the lines that it was his job to figure out what wasn’t working and change his strategy to make sure I was learning.

(Kevin, my husband, also a third-year resident in the same program, cynically thought Peter had called and given him a good talking to, as in: She’s one of our best. She says you’re not listening. Do better.)

In closing, let me circle back to my opening assertion that feelings are a response to an outside or internal stimulus. Feelings are data, and data can be interpreted. So, let’s analyze what I was feeling in this supervision and how my interpretation of those feelings drove what I decided to do.

The first couple months, I assumed my frustration meant I was doing something wrong. I was the problem. (That’s my default.) I wasn’t being clear. I expected too much. I bent myself into a pretzel looking for what I could address in myself that would lead to my supervisor giving me what I needed.

But it takes two to have a relationship, including a mentoring relationship. It finally occurred to me it wasn’t okay that I was so dissatisfied. The problem wasn’t me; it was outside me. The problem was my supervisor. It was the residency’s responsibility to make sure I acquired certain skills. Therefore, if he wasn’t working out, there were others.

Feelings are non-verbal messages from our higher, smarter selves. Instead of sinking into them and floundering, I thought about what they could be telling me—without words. Feelings are the effect in the cause/effect relationship. My supervisor wasn’t helpful—the cause. I was dissatisfied—the effect.

Once I figured that out, I knew what to do. I needed to request another supervisor. That had an immediate positive effect. Did Peter call him? Probably. That call had to have startled my supervisor out of his complacency. He had to rethink how he understood me, and how to mentor me. Problem solved.

Aside from learning to take my feelings seriously, what else did I learn from working with this supervisor? The core of good mentoring is actively listening to the mentee. The core of good therapy is actively listening to the patient. What is active listening? Not assuming you understand. Instead, you make sure. How? One way is to ask if you’ve got it right. If you have, great. If you haven’t, admit you don’t get it! Ask them to tell you again, in a different way.

In closing, I’ve found that active listening coupled with interpreting what I’m feeling works well to understand what’s happening and what action to take, with just about anybody. I do this with patients. I do this with my husband and son. I do this with my friends. It’s my go-to approach and I can’t recommend it strongly enough.

How I Used My Feelings to Deal with an Unhelpful Mentor

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