Interview with Dr. Gerald Stein: Blogging About Psychotherapy from Chicago
About Gerald: Trained at Northwestern University, Dr. Stein worked as a teacher (Rutgers and Princeton Universities), researcher, consultant, and as a clinician in the private practice of clinical psychology for nearly 30 years. He was named the “featured therapist” of the Association for Behavioral and Cognitive Therapies. He served as Chief Psychologist at Forest Hospital and performed consultations for the Chicago White Sox, Chicago Black Hawks, Chicago Symphony Orchestra, Right Management Consultants, and Rush North Shore Medical Center. Dr. Stein was an expert appointed by the United States District Court for the Northern District of Illinois in the case of K.L. vs. Edgar, involving the evaluation of the Illinois Department of Mental Health. Dr. Stein performed more than 2500 psychological and neuropsychological evaluations on referral from other mental health professionals. He remains a member of the Association for Cognitive and Behavioral Therapies, the American Psychological Association, and the National Register of Health Service Providers in Psychology, as well as being licensed in the State of Illinois.
[OnlineCounselingPrograms.com] When and why did you originally create your psychotherapy blog?
[Dr. Gerald Stein] I began in February, 2009. There were two reasons. First, I have two adult daughters and I wanted to leave something behind for them, something I perhaps hadn’t mentioned about how I viewed the world. In that sense, the blog began as a very personal enterprise. I was then 62.
The second reason had to do with the inevitable accumulation of a lifetime of experience, considerable formal education, and all the lives I’d had the privilege to learn from and about: the people I touched and who touched me. I believed I had something to say worth reading.
Writing had long been a part of my life, first with journal articles as an academic (at Rutgers and Princeton), then occasional newspaper pieces about sports, over 2500 psychological and neuropsychological evaluations, and a few published pieces on classical music. It was natural for me to pour myself, my interests, and my ideas into a blog.
[OnlineCounselingPrograms.com] What do you hope to achieve by maintaining it?
[Dr. Gerald Stein] I enjoy the process of writing, so my interest was easily maintained at the start, even when fewer than 10 people a week were reading me. What I’m about to say might sound peculiar, but I don’t have much ambition at this stage of my life. I did what I hoped to do and more during my therapy career, consulted with major sports teams, taught, recorded oral histories with Chicago Symphony musicians (which I continue to do for the Orchestra’s archive), engaged in a small amount of work as an expert witness, etc. So, at that point, I was mostly writing for myself and my children.
As the blog became more popular, however, I discovered I was getting thanks from my readers for help with their lives. Many of these good people were struggling, many were in therapy, but perhaps something hadn’t clicked for them. My style of writing, from the start, was intended to be conversational, without pretense, and not requiring too much background in psychology or treatment. I also ask questions of the reader, encouraging him to think along with me. So, I maintain it, in part, because it seems to be helpful, even though I retired at the end of 2011. Of course, it's reinforcing to hear people tell you they are grateful!
Once I retired I began to reveal more about myself. Patients are dying to know how a therapist thinks, what he feels, how he is motivated, and so forth. No therapist will say too much about himself in session because it can make the therapy about him, as well complicate the transference, and suggest an intimacy that feeds the desire of some clients to be friends or lovers with the person who is treating them. But, without patients any more, I was free to give them a rare perspective without risking this complication.
[OnlineCounselingPrograms.com] We highlighted your recent post, “The Arc of a Therapist’s Emotional Life,” because you offer such insightful musings on the therapist’s emotional life as it informs and is shaped by his professional work. One of the points you make is the difference in sympathizing versus empathizing with clients’ emotional states. How would recommend that mental health professionals in training maintain emotional boundaries with their clients?
[Dr. Gerald Stein] With respect to becoming overwhelmed by your patient’s emotions―identifying and empathizing too much―one needs training in the proper perspective about what your job is as a therapist. Two overwrought people in the room can't be of help to one another.
A counselor does well to think of himself as if he were a lifeguard at the ocean. A person is drowning and if you aren’t careful about how you swim out to the desperate, flailing soul out there, he will take you under with him: you will both drown. Your stability as a therapist, which depends on maintaining a therapeutic distance, is in service of the client; just as the lifeguard’s careful and practiced approach to the drowning swimmer is.
Boundaries are a challenge, for sure. We’ve gone from a formal, staid way of living (think of the Victorian age) to one in which many people are shameless. Bending and breaking rules is more public today than it was 50 years ago and routinely rationalized. This creates an atmosphere in which the overstepping of “red lines” perhaps is more likely. But the rules for therapists and what is good for the patient haven't changed.
Therapists must be serious about the ethical boundaries of their profession. Arrogance is a danger for counselors, in part because―if we are good at what we do―we get considerable admiration. A therapist who is arrogant or narcissistic might begin to feel that he can ignore the boundaries―view himself as an exception: a train wreck in-the-waiting with a patient whose background includes lots of boundary violations, beginning with those who took advantage of her in childhood.
The greatest danger, by far, is sexual. We treat the not-so-beautiful and the beautiful, the not-so-captivating personalities and the magnetic ones. The temptation is always there. As Oscar Wilde wrote, “I can resist anything, except temptation!” A counselor who is tempted, not to mention experiencing other strong emotions (positive or negative) about his patients, had better obtain some good supervision, if not his own therapist.
[OnlineCounselingPrograms.com] Can you walk us through what motivated you to become a psychotherapist, as well as the educational journey you took to get there?
[Dr. Gerald Stein] My whole life has been an education and I am still learning. Early on I began to develop ideas different from those of my mother. Her family background was catastrophic (poverty, malnutrition, tuberculosis, an alcoholic father, a paranoid mother), and included much sibling rivalry. I started to doubt her capacity to manage our household. Meanwhile, my dad, also a child of the Great Depression, was absent from the home most of the time, working as many as four jobs at a once, one of which was full-time; always shadowed by the economic insecurity of the 1930s, when he was a young man. My brothers and I were challenged in different ways as mom played out her unresolved issues before us and with us, while dad was MIA (missing in action).
I was psychologically-minded by nature, noticed things that didn’t seem quite right to me even as a kid, wondered why people did what they did. As a child of the ’50s and ’60s, discrimination against blacks made a big impact. The combination of my nature, my family experience, and the time I lived in all contributed to an evolving process of questioning the established order of things. I was fascinated on the one hand, but troubled on the other.
My attitude toward our family issues didn’t fit with the accepted wisdom within my home. In one sense I am a stereotypical therapist whose attraction to the field of psychology had to do with figuring out his own existence, but I also had questions about “existence,” in the abstract.
I was lucky enough to win some academic recognition to pay for schooling I knew my folks couldn’t and wouldn’t support. Not because they didn't love me, but rather because they were still shadowed by the Great Depression: a lesson about the long reach of childhood trauma. That led me eventually to a Ph.D. from Northwestern. The high powered academics there moved me toward a research career as a college professor, but I turned from this to clinical work and was in independent practice for nearly 30 years.
Now, my wife and I attend a course of study based in philosophy and fiction at the University of Chicago―a “great books” curriculum taught using the Socratic Method. This has been wonderfully exciting. I’m confident the questions raised by these timeless works wouldn't have stirred me as much without life experience against which the ideas could be tested. In a certain sense, I had to “live” long enough to be able to realize the practical value of the ideas offered by people like Aristotle, Virginia Woolf, Immanuel Kant, Dostoevsky, and Seneca.
The big questions about what is the good, how best to lead a moral life, what gives life meaning, etc. remain as relevant today as when Socrates lived. It is a shame we are so busy “getting and spending,” in Wordsworth’s words, that we don’t stop to think about why material success and status are only temporarily satisfying. Ideally, therapists might benefit if they were required to study philosophy, along with their training in therapy.
I know counselors must be careful about imposing their values on their clients, but a therapist must know not only that the “American Dream” doesn't fit for all lives, but have awareness of other possible value systems according to which a life can be organized. I realize therapists are pressed just to keep up with the literature in their field, make a living, raise a family, etc., so adding this requirement would be difficult. But, still...
[OnlineCounselingPrograms.com] How have you seen your blog and profession evolve over the years?
[Dr. Gerald Stein] The profession has gone from a time when insurance companies paid for almost anything, to one in which restrictions on your work imposed by those same companies became the norm. Moreover, there is more competition among therapists, at least within urban areas, making the creation of a successful independent practice a challenge. Meanwhile, the rural USA is underserved.
More of those who seek counseling are under financial and job pressure than was typical 35 years ago. Not surprisingly, one sees the nature of practices change. Existential questions, allowing a therapist to deal with a person who is trying to “find himself,” can be squeezed out by the practical ones deriving from a stagnant economy.
I know more than a few therapists who treat mostly very well-to-do people, folks who don’t rely on third-party-payers. I also know those who counsel a wider array of clients, some who are experiencing difficulty making a decent living themselves. Instead, they often work for a public agency or someone else who fills their practice. Still, almost all counselors didn't go into therapy to make a fortune. They were motivated by the desire to help and even, on occasion, by a sense of “calling.”
Regarding my blog, readership has grown considerably, though I’m not on conventional social media and make no effort to promote myself. I only follow a handful of other bloggers. I don't talk down to readers and am not hesitant to offer them the perspectives of some philosophers and towering fiction writers, as I mentioned earlier.
Although I don’t have any pretense about my writing lasting much beyond my lifetime (except for my friends, relatives, and a few readers), I'd like to think that―very, very occasionally―my essays might accomplish a goal Franz Kafka set out for books: “A book should be like an ax, to break the frozen sea within us.”
[OnlineCounselingPrograms.com] During your nearly three decades as a practicing psychotherapist, what would you say were your most challenging and rewarding experiences, and why?
[Dr. Gerald Stein] The reward came in being of assistance to many good people, of having the privilege of being told their secrets, to watch them change and to be changed by the interaction with them. I was enriched. I became more comfortable with my own emotions in the course of time, and my clients played a considerable part in my personal metamorphosis. Their difficulties, in effect, challenged my technique, my humanity, my compassion. I always had to grow and learn more.
I went from being a behavior therapist, to one with an orientation mixing a psychodynamic view with CBT (cognitive behavior therapy). By the end of my career I found value in ACT (Acceptance and Commitment Therapy). As research progressed and demonstrated the efficacy of some treatments over others, I welcomed the need to learn what I didn’t know and incorporate the growing body of knowledge into my practice.
As the years passed, I discovered an increasing desire to know more, not because I had to, but because I wanted to. Meanwhile, I worry about therapists who don't adapt their methods as the decades pass, don’t know of the research progress, or haven't been trained in how to evaluate a journal article and the experimental design described therein.
[OnlineCounselingPrograms.com] What advice would you offer to aspiring psychotherapists?
[Dr. Gerald Stein] If they have a calling they should pursue it. That said, it is a tough time to be in the changing field of health care, at least in the USA.
I hope they receive a broad education in the humanities. Our educational system, at all levels, is in danger of raising a generation of technicians. Technique is essential, but those of us alive today face the same issues our ancestors faced 2000 years ago, the same motivations you find in Homer’s Iliad, an even older tale.
Take Achilles in The Iliad. He is in the middle of a years-long war, the siege of Troy. The man in charge of the Greeks, Agamemnon, humiliates him, doesn’t give him the recognition he believes he deserves as the greatest warrior among the Greeks. Achilles is angry and simply stops fighting for his side. He sulks. No persuasion works to get him back in the battle and the Greek’s come close to losing the war. Achilles’ best friend takes Achilles armor, masquerades as Achilles in order to save the day, but is killed. Does Achilles feel responsibility? Guilt? He now returns to the battle, even though he has been told by his goddess-mother that if he does so he his life will be shortened, as compared to the peaceful but unremarkable long life he will enjoy if he quits Troy and war-making.
Isn’t this the stuff of our everyday lives? Hurt, anger, humiliation, guilt, loss, retribution, and deciding what kind of life we want and at what cost?
I'd encourage aspiring psychotherapists to benefit from the great books and ideas. Yes, we live longer and have more amenities than those thinkers, but the most basic questions are the same: finding love, facing loss, balancing our desires against the needs of others, nurturing the young, and dealing with our mortal condition. I hope counseling students read books like Anna Karenina and Earnest Becker’s The Denial of Death, a Pulitzer Prize winner. Shakespeare too, of course.
I recall reading about a Ford Foundation study of perhaps 30 years ago claiming the average 16th-century-person had less information to process in his short lifetime than can be found in a single daily edition of the New York Times. Surely the information explosion and speed with which technology changes complicate our lives, and the therapist must maintain his balance while helping others deal with those changes. No small challenge.
[OnlineCounselingPrograms.com] Music plays a major role in your blog. What has been the value and influence of music in your practice of psychotherapy?
[Dr. Gerald Stein] Classical orchestral and instrumental music, which I fell for at about age 17, helped open me to the range of emotion in the human experience. Mahler, in particular, was therapeutic. He was a man who thought a symphony should contain the whole universe! By changing me, those musicians who might have long since died, changed the person I was in session.
Psychotherapy is about words. Music, other than songs, is about those things that cannot be expressed in words. While I encouraged my clients to read good books, listen to music, etc., I'd say the value of the great musical works of the Western Tradition was more in what it made me as a human being than what part of its message I could impart directly to others. Only the music has the capacity to communicate those messages directly.
[OnlineCounselingPrograms.com] Is there anything else you’d like to add?
[Dr. Gerald Stein] I’ve had a lucky life―so far! A wonderful wife and noble children, and now a new grandson; friends, new and old; including my brothers, Ed and Jack, with whom I've become closer late in life. Sure, there were devastating and challenging events, emotional tsunamis, but never of the kind I could not survive or overcome, however much they discouraged, saddened, or terrified me in the moment.
At the same time, I never faced the trauma experienced by some of my patients, and doubt I could have overcome their tragedies as many of them did. They are the most courageous people I ever met. I remain humbled by their resilience and therapeutic integrity: the will to overcome everything; in spite of everything, to achieve a better life.
Too many of us wait for permission, find reasons not to do things, hesitate to the point of losing opportunities. The day is short. We must make use of the limited time we have. I wasn’t a brave 20-year-old, but I eventually took on some challenges and opportunities because I didn’t want to live in fear.
We share so much with other fellow human beings, most of all our vulnerability. Yes, there are differences among those from different backgrounds, but much more likeness. I treated Hindus, Muslims, Catholics, Protestants, members of the Greek Orthodox Church, Jews, atheists, agnostics, blacks, Hispanics, Asians, whites, Buddhists, and more. I treated the rich, the down-and-out, defrocked ministers, a few famous people, and many others who are, like me, pretty anonymous.
They came with problems that were variations on the same themes I've already mentioned here. In our political, religious, and racial silos, our shared humanity is easy to miss. When therapy works for people, at least for a few, they are enlightened and opened to the beauty and tragedy of life, a life best shared with others than fought over for a few more dollars.
I was recently in the Canadian Rockies and reminded, in the face of the staggering beauty and scale of the timeless mountains, how little is our place―my place―in the big picture of life on earth. The reminder was comforting.
Thank you, Gerald! Learn more about Dr. Gerald Stein: Blogging About Psychotherapy from Chicago on our Top Therapy Blogs list.
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