I entered the mental health profession at age 22 with a newly minted BA in English, a job scooping ice cream, no idea about my future, and time on my hands. When I saw a notice seeking volunteers for a local crisis hotline, I thought, “Why not, I’ve got nothing better to do?” 

I loved it immediately: the raw intimacy, the power of connection and presence, feeling like I made a difference. I was in awe of peoples’ dignity and capacities in the face of overwhelmingly grim circumstances.

Scooping ice cream is tasty and fun, but I had found my life’s work. So I decided to go to graduate school to become a therapist. Nearly four decades later, I’ve just retired, and offer these reflections.

As therapists we grapple with the age-old question: “Do people change, or do they remain the same?” Blessedly, we now live at a time when false binaries are called out. “Both/and” replaces the splits of “either/or.” The complexity of paradox is one of the extraordinary riches of being human, and of being a therapist.

A lot has changed in our field. In the extension classes I took to qualify for graduate school, “refrigerator mothers” were still being blamed for autism, with only a hint that perhaps they were getting a bad rap. Schizophrenia was seen in a similar light. Indeed, psychopathology was seen mostly as originating from intrapsychic or interfamilial conflict. Those are important factors, but advances in understanding how biology, neuroscience, trauma, attachment, and systemic social, racial, and economic injustices affect us have shifted the field to a more enlightened position. Intersubjective theory challenged concepts of therapeutic neutrality and the idea that analysts somehow functioned above the messy fray.

My own evolution as a therapist fits the paradox: the more I’ve changed, the more I’ve become myself.  The harsh psychoanalytic jury in my head has given way to greater trust in my instincts and personality. These, of course, are informed by theory and experience, but we fundamentally bring ourselves to the work. It is lovely to know, and appreciate, that self–its pitfalls and gifts. Although I often thought in my role as supervisor, “Do not try this at home” when I was unorthodox with my own clients (such as encouraging them to enlist mental voo-doo dolls as a way of honoring vengeful feelings), I cherished the freedom, authenticity, and confidence that I could tell the difference between acting out and engaging in a way that helped people become more self-accepting.

One of my consultants told me about a revered colleague who shied away from the many opportunities she was offered to teach and present at conferences. She said she didn’t really know that much—all she knew is that she sat and listened to people until she found something about them to fall in love with, and then they got better.

That seemed as wise as anything I had ever heard. The more I was able to do it, the more I was able to recapture those early feelings of intimacy, connection, presence, and awe I’d felt on the crisis lines. Ineffable as our work is, it matters deeply. It changes us, therapist and client alike, as we come to discover and accept who we truly are, and that we are lovable.