Navigating Hopelessness in Therapy

Often, therapists are drawn to become specialists in the very area where they once suffered and felt most vulnerable. In Mike’s case, he describes his own feelings of failure, betrayal, bitterness and hopelessness in his early career, and how he found his way to become a star in the TEAM therapy firmament.

Today, he describes a breakthrough approach in the treatment of hopelessness as well, based on the A = Assessment of Resistance portion of TEAM.

Mike began by saying that treating hopelessness is always a challenge. . . in fact, I can vividly remember when I felt hopeless!

And of course, part of the challenge is the fear that hopeless patients may try to take their own lives. This is the “dark side” of clinical practice, and it is not often talked about because of the terror it strikes in the hearts of mental health professionals.

Mike started out with a bit of his traumatic personal history. He explained that he once owned and ran a bicycle shop in Canada when he was in his mid- to late-twenties.

“There was a fellow businessman in my town who was a bit older than me and somebody I really looked up to. He was successful, had a beautiful family, was well respected in the community and had some wonderful friends. One day I got a phone call from my wife and she said to me:  ‘Did you hear what happened to John? She went on to tell me that it was shocking and terrible because he was somebody who enjoyed hunting. One day he went out to the family cabin and took his shotgun and took his own life.

Mike said that at his funeral, “I can remember it like it was yesterday hearing his daughter's voice when she spoke and those words that she said.  “Daddy, why were you so sad?”

“A number of years later we had moved on, sold the business and our home and moved to another town to work in an organization supporting people. I had done my degree in theology with focus on youth and counseling and was working with young families. Unfortunately there were some real difficulties in the situation and it did not turn out very well after a little over a year. He felt betrayed, and ended up with no job. He was now in his mid to late-30s, and got a job in a hardware store. “I was really struggling with the sense of confusion, frustration, depression and hopelessness. Even though I had a supportive family, and had been successful in many areas of my life.

He recounts, “One day I looked in the mirror and as I was having those thoughts of hopelessness I was reminded of John, my business colleague who had taken his own life 10 years earlier and I thought about my 2 young daughters.  I could hear John’s daughter's voice: “Daddy why were you so sad”  in my head and I thought I have to get some help”

“My wife is a nurse and has a very wise family physician, Dr Mariette deBruin, who is incredibly skilled at empathy. Fortunately, she had been at a mental health conference earlier that year and heard this brilliant psychiatrist share a powerful approach to treating depression without medication. That psychiatrist was Dr David Burns.

She suggested I get a hold of the book, Feeling Good, and that was the start of my recovery in 2006. I went back to grad school  to do my Masters in Counseling Psychology and then attended my first workshop with Dr. Burns  in 2009.”

Looking back, I realized that hopelessness was actually my best friend. I was in a tremendous amount of pain. Here were some of the positives I discovered in my feelings of hopelessness:

1. In my previous work, I’d been hurt badly, stabbed in the back. My hopelessness was my way of punishing the people who’d hurt me. I was saying, “Look at me. I’m a broken shell.” I felt like this gave me some value. . . as well as a sense of revenge.”
2. I had placed a lot of value in my success in my life, three beautiful kids, and a great athletic career (biking), and my hopelessness protected me from the disappointment of dashed dreams in my new career. I felt I was being realistic.
3. Hopelessness validated how severe my problems were. Hope trivialized it.

When I'm working with practicum students or interns that are early in their counseling or therapy career, one of the greatest fears that they have is that one of their clients or patients will take their own life. Sadly, when you go into this line of work the reality is that at some point, someone we work with in some capacity will experience that level of hopelessness and so I have to inform them that “suicide is not if, but when.” This is why it's so critical for us to know how to  work with it.

He explained that “Hopelessness validated how I felt. People were all trying to cheer me up. That’s the WORST thing you can do.

“My TEAM training was pointing me in the opposite direction. Validating it and acknowledging it took the pressure off of it and began the process of bringing about tremendous relief.”

We discussed the power and value of Positive Reframing, even with the hopeless patient, as well as the value of empathy. He said the Positive Reframing shows that “you totally get what this is like for me.” The positive reframe serves as our most profound empathy tool. By enabling us to perceive the world through the eyes of our clients or patients, it eliminates their sense of isolation.

The hopelessness shows something beautiful and awesome about you.

He recalls his early training in TEAM, and the immense value of the Externalization of Voices and Feared Fantasy work he did with David to challenge his negative thoughts, including:

1. I really AM a failure.
2. David must be thinking that I’m an embarrassment to him.
3. David is also thinking, “I can’t believe I let you on this podcast.”

We illustrated the Externalization of Voices and Feared Fantasy live on the podcast, including the blow-away Acceptance Paradox. Because of that training, “I am no longer afraid of failure!”

Thanks so much for joining us today!

Mike, David and Rhonda