Making decisions is a unique and yet one of most painful tasks of life. We all have faced situations in which we are required to face dilemmas and make life changing decisions. Some of these decisions are to be made quickly such as whether to change lanes on the highway when being cut off by another driver. Others have a longer deadline and allow us to think, such as deciding to marry a certain person or not.
Overall, making decisions is not a pleasant task, whether it concerns the self or other people. So how can we make the procedure easier and smother? Moreover, how can we make sure to make correct decisions in life, the ones that will leave us with no regrets?
Scientists have done much research in what part of the brain is responsible for making decisions and how the process unfolds. However, other than identifying certain brain regions, science has not been able to solve the mystery of decision making process for humans. Other disciplines have taken many attempts to come up with certain guidelines for effective decision making processes. For instance, leadership courses always dedicate certain chapters to “how great leaders make decisions” or “how risk takers come up with great decisions of all time”. Different religions have also taken many attempts at this issue. Most of religious guidelines however, discourage making decisions and scepticism and encourage surrendering to certain unbreakable unquestionable rules.
Medicine has come a long way in finding a solution to the dilemma of whether patients should be allowed to decide for themselves or not. However, their guidelines are far from being practical. These principles are also dynamic from society to society. For example, while a woman’s decision to abort her unborn baby is respected in western societies, it is very much the decision of the baby’s father at certain Middle Eastern countries. Same goes with deciding to end one’s life or the whole controversial phenomenon of capital punishment and its validation in certain court systems.
So goes the puzzle of whether we humans are capable of making the right decisions for ourselves and others or not.
In order to answer this question effectively and practically, I observed countless decision making processes in my clients, people around me and also myself. I focused on long term effects of made decisions and also the ones that require snap ones. One observation that intrigues me time after time, is that humans are not patient when it comes to making decisions. The process of sleeping on a dilemma and giving it time is especially a painful one for most of us. Why is that? Why can’t we wait for right answers to come to us rather than chasing them? Having order in life is one of human’s strong tendencies. Not knowing what to do next implies chaos. Or does it? When we are faced with a dilemma, it is the responsibility that we fear more than being in an unknown zone. Taking responsibility for one’s decisions is the ultimate definition of entering adulthood and maturity. That makes the decision making process even more painful. How in the world one could make the right decision and take responsibility for its consequences without being ever stressed by it?
The answer is simple: 1. Start by believing that there is no such thing as a wrong decision. It is all life experiences. You can never go wrong with making a decision. 2. Take pride in being in a decision making position. Imagine a person who is never allowed to make any decisions. Would you rather be that person? 3. Do not rush into making decisions. I know sitting on it is no less painful than sitting on needles! However, doing certain things could ease the pain. Go somewhere or do something that takes your mind off it 4. Do not go too far into the future. You can never know how your decision would turn out. 5. Finally, the most important part of making a decision is not make one! Let the right answer come to you when it is ready to reach you. Do not go and search for it. The more you chase it, the more it will play a hide and seek game with you. Ask for it, and it will be yours when you are ready to see it.
Shahrzad Shahriari
BSc.Psych., MSW., RSW.
www.shahrzadtherapy.com
shahrzad.therapy@gmail.com
647-405-7706
Friday, February 4, 2011
Why Bother?
For anyone who has worked in mental health field, the term “Assessment Tool” should be a familiar one. What it is referred to, is a pre-set questionnaire that an interviewer could use to get to know the client, or in clinicians’ terms, “Assess” the client. Just like a physician who performs a number of examination tasks and questions, a mental health clinician uses an assessment tool to get to know the client better.
Having used these tools in many different setting, I don’t believe that any one of them get us even close to knowing our clients. These tools are nothing but a large number of questions. In them, they give you specific detailed instructions on how to ask the questions and what to ask next after receiving a particular answer from the client. After completing the many pages of questionnaire, the interviewer can sit back and say: “Now I know what is going on with this client”, or can they?
Let’s look at this practice from the client’s point of view. They come into the interview often distressed, anxious and in pain. They are looking to receive comfort and hope. Instead, they sit with a stranger who holds a thick pile of paper in their hand as keeps asking one question after another one. The client gets a good view of the top of the interviewer’s head as they continue writing their answers down. At the end, while both the client and the interviewer are tired out of their minds, the client gets to go home wondering what was the purpose of answering all these questions? It is not until the following session that the client actually gets to tell their story and the reasons for which they seeked help in the first place. That is if they decide to come back after the boring useless assessment session.
So what does the clinician do after the client leaves? They put the completed thick assessment tool in the client’s file. Does anyone ever read these questionnaires? I guarantee you not. The clinician will have to write a summary of the assessment, containing the history of presenting problem, family history etc., which has very little to do with the many questions been asked in the assessment tool. In other words, the interviewer will not be relying on the assessment tool to write their assessment report. Anyone going over the client’s file will briefly glance at the report and not the questionnaire. No one has time to go over so many questions and try to make sense out of them.
So what is the point of asking all these questions? I would say to do the job for those clinicians who don’t have the innate skills of being in the mental health practice. You either have what it takes to relate to clients or you don’t. Furthermore, these tools cover the clinician from ever being accused of not having done their job. When I conduct an assessment interview, I do not relay on any assessment tools. Nor do I use a thick endless questionnaire to get to know my clients. After having a casual conversation for half the time spent on completing any assessment tool, I get an idea of where to go from there.
The problem is rooted in our education system, where people who do not have the skills to be in the profession are being graduated and thrown into the practice. How do we compensate for their lack of people’s skills? Give them a bunch of questions to ask their clients and give it a fancy name such as “Assessment Tool” is not going to make them good clinicians. To me, these tools are nothing but waste of time which will only scare the clients away.
Shahrzad Shahriari
BSc.Psych., MSW., RSW.
www.shahrzadtherapy.com
647-405-7706
Having used these tools in many different setting, I don’t believe that any one of them get us even close to knowing our clients. These tools are nothing but a large number of questions. In them, they give you specific detailed instructions on how to ask the questions and what to ask next after receiving a particular answer from the client. After completing the many pages of questionnaire, the interviewer can sit back and say: “Now I know what is going on with this client”, or can they?
Let’s look at this practice from the client’s point of view. They come into the interview often distressed, anxious and in pain. They are looking to receive comfort and hope. Instead, they sit with a stranger who holds a thick pile of paper in their hand as keeps asking one question after another one. The client gets a good view of the top of the interviewer’s head as they continue writing their answers down. At the end, while both the client and the interviewer are tired out of their minds, the client gets to go home wondering what was the purpose of answering all these questions? It is not until the following session that the client actually gets to tell their story and the reasons for which they seeked help in the first place. That is if they decide to come back after the boring useless assessment session.
So what does the clinician do after the client leaves? They put the completed thick assessment tool in the client’s file. Does anyone ever read these questionnaires? I guarantee you not. The clinician will have to write a summary of the assessment, containing the history of presenting problem, family history etc., which has very little to do with the many questions been asked in the assessment tool. In other words, the interviewer will not be relying on the assessment tool to write their assessment report. Anyone going over the client’s file will briefly glance at the report and not the questionnaire. No one has time to go over so many questions and try to make sense out of them.
So what is the point of asking all these questions? I would say to do the job for those clinicians who don’t have the innate skills of being in the mental health practice. You either have what it takes to relate to clients or you don’t. Furthermore, these tools cover the clinician from ever being accused of not having done their job. When I conduct an assessment interview, I do not relay on any assessment tools. Nor do I use a thick endless questionnaire to get to know my clients. After having a casual conversation for half the time spent on completing any assessment tool, I get an idea of where to go from there.
The problem is rooted in our education system, where people who do not have the skills to be in the profession are being graduated and thrown into the practice. How do we compensate for their lack of people’s skills? Give them a bunch of questions to ask their clients and give it a fancy name such as “Assessment Tool” is not going to make them good clinicians. To me, these tools are nothing but waste of time which will only scare the clients away.
Shahrzad Shahriari
BSc.Psych., MSW., RSW.
www.shahrzadtherapy.com
647-405-7706
Wednesday, November 10, 2010
The Best of the Two Worlds
Dividing the entire cultural universe into two large categories of Collectivists and Individualists seems like a wild idea. As someone who has grown up, went to school and worked in both societies, I can understand why the distinction could not only be a useful idea, but also an important survival tool for people of dual cultural identities such as myself.
In a collectivist society, the community is placed ahead of the individual. It sounds simple, nice and convenient it sounds, the idea comes with a number of disadvantages. For instance, in a collectivist community, any marriage decision must be made by a number of family members including second relatives. That is where the ideas of arranged marriages and individuals sacrificing their loves for the sake of the whole community come from. While that appears as a disadvantage to the individual, the idea prevents a large number of societal problems that exist in an individualis community such as teenage pregnancy.
In an individualist society on the other hand, the needs of an individual always come ahead of the community and even the family. As selfish and self-centred the idea sounds, it has many advantages over considering the community’s benefits over self’s. for instance, it advocates for focusing on one’s true needs which in turn could put the individual on their path towards self actualization. In an individualist society, one learns to take responsibility for their own decisions and actions instead of blaming others for their mistakes. For the same reasons, the individual is more likely to face life problems alone with less community support than their counterparts in collectivist societies.
The interesting idea arises when migrations happen between the two cultures. Movement is more likely to happen from collectivism into individualism either in idealistic transformation or physical movement than the other way around. Either form of movement will result in very well defined concepts:
Acquiring individualist thoughts in a collectivist society will result in “Radical Feminism”, while practicing collectivism in individualist societies will result in “Patriarchy”. One should not cherry pick as they go along in either societies as that will result in “Stereotyping”. For example, arranging marriages in an individualist society will imply the idea of oppression against women in collectivist practices. The important idea is to “act as Romans when in Rome”. Practicing against societal and cultural norms will not only result in isolation but is likely to put the individual in conflict with the law.
Let’s not forget about the existence of sub-cultures in either societies. Each community could come up with their own ways of practices in a larges society. Each family, community, group and even city could have collectivist or individualist ways of functioning in a larges society which itself could be individualist or collectivist. Familiarizing oneself with both ways of relating to the larger community will insure the benefits of the best of the two worlds.
Shahrzad Shahriari
BSc.Psych, MSW., RSW.
647-405-7706
shahrzad.therapy@gmail.com
www.shahrzadtherapy.com
In a collectivist society, the community is placed ahead of the individual. It sounds simple, nice and convenient it sounds, the idea comes with a number of disadvantages. For instance, in a collectivist community, any marriage decision must be made by a number of family members including second relatives. That is where the ideas of arranged marriages and individuals sacrificing their loves for the sake of the whole community come from. While that appears as a disadvantage to the individual, the idea prevents a large number of societal problems that exist in an individualis community such as teenage pregnancy.
In an individualist society on the other hand, the needs of an individual always come ahead of the community and even the family. As selfish and self-centred the idea sounds, it has many advantages over considering the community’s benefits over self’s. for instance, it advocates for focusing on one’s true needs which in turn could put the individual on their path towards self actualization. In an individualist society, one learns to take responsibility for their own decisions and actions instead of blaming others for their mistakes. For the same reasons, the individual is more likely to face life problems alone with less community support than their counterparts in collectivist societies.
The interesting idea arises when migrations happen between the two cultures. Movement is more likely to happen from collectivism into individualism either in idealistic transformation or physical movement than the other way around. Either form of movement will result in very well defined concepts:
Acquiring individualist thoughts in a collectivist society will result in “Radical Feminism”, while practicing collectivism in individualist societies will result in “Patriarchy”. One should not cherry pick as they go along in either societies as that will result in “Stereotyping”. For example, arranging marriages in an individualist society will imply the idea of oppression against women in collectivist practices. The important idea is to “act as Romans when in Rome”. Practicing against societal and cultural norms will not only result in isolation but is likely to put the individual in conflict with the law.
Let’s not forget about the existence of sub-cultures in either societies. Each community could come up with their own ways of practices in a larges society. Each family, community, group and even city could have collectivist or individualist ways of functioning in a larges society which itself could be individualist or collectivist. Familiarizing oneself with both ways of relating to the larger community will insure the benefits of the best of the two worlds.
Shahrzad Shahriari
BSc.Psych, MSW., RSW.
647-405-7706
shahrzad.therapy@gmail.com
www.shahrzadtherapy.com
Wednesday, July 7, 2010
What is Counter Transference?
In my profession, I work very closely with people. I listen to their pains. Clients come to me to feel better, to seek relief, to leave happier. Psychotherapy is a very delicate work. It makes the therapist get very close to people’s feelings, sometimes too close as they could touch their clients’ feelings with their fingertips. Being in such position, it is very important for therapists to be aware of their own feelings. Monitoring their responses to what they experience in a therapy session is one of the most important aspects of being a therapist. Counter Transference therefore, is when a therapist has a personal reaction to what they hear from a client. Detecting this reaction, identifying it and defining it, is part of the therapist’s work.
Now, what to do with this reaction is a matter of debate among scholars. Whether it needs to be shared with the client and be discussed or be kept to the therapist depends on how the phenomenon is being defined. Some schools of thoughts believe that Counter Transference is a therapist’s issue and they need to resolve it or analyze it with their own supervisor/therapists. According to this school, it should never be shared with the client. Others believe that Counter Transference belongs to therapy. While already rooted in the therapist’s past experiences, it has been elicited by the client. According to this school, the client has every right to know how their therapist is reacting to what they say. And as with any other controversial issue, others take a middle stand position. They believe that it all depends on the context. According to this school, the therapist has to know the client well enough to decide whether sharing a Counter Transference feeling might be helpful or harmful to the client. It is all about the client. That’s what the therapist is getting paid to do: To think of the client first.
Going back to my school days, I trained with a physician psychotherapist. According to his medical model, under no conditions you would ever share a Counter Transference reaction with your client. As part of my training, I also worked with a social worker psychotherapist who would share small bits of his own feelings with the clients from time to time. Having observed both of my supervisors for many hours, I could never come into a solid conclusion on what is the right approach to take when dealing with Counter Transference.
Having started working with clients as a professional, what I learned through my personal experiences is that there are no doubts that Counter Transference is a very powerful phenomenon. It could stir up a lot of feelings in the therapist. Overall, it is a positive outcome of the therapy for the therapist as it could teach them a lot about themselves. As it goes for the client, it could show them that their therapist is also a human being who comes with all different normal feelings just like them. Now, to what extend that should be shared with the client, I believe depends on the clients’ level of intelligence and understanding of the therapy. Working with a lot of young abused women, I find them in need of hearing from an older wise, yet sensitive and sympathetic female. I find telling these women something like: “I wish I had a little sister like you” would make them more receptive to my suggestions on how to end an abusive relationship. It has worked for me every single time. In a different context, telling an intelligent successful client who has a troubled relationship with his younger sister something like: “I envy your sister for having a brother like you” elicits a reaction like “ Maybe one day my sister sees me like that too”. To me, sharing my Counter Transference reaction with the client has shown him that despite not being appreciated, he is a good brother.
Counter Transference is powerful and useful and could help therapy process more useful for the client. It is a natural normal human reaction which is one of the most beautiful by-products of the client/therapist relationship.
Shahrzad Shahriari
BSc.Psych, MSW., RSW.
647-405-7706
shahrzad.therapy@gmail.com
www.shahrzadtherapy.com
Now, what to do with this reaction is a matter of debate among scholars. Whether it needs to be shared with the client and be discussed or be kept to the therapist depends on how the phenomenon is being defined. Some schools of thoughts believe that Counter Transference is a therapist’s issue and they need to resolve it or analyze it with their own supervisor/therapists. According to this school, it should never be shared with the client. Others believe that Counter Transference belongs to therapy. While already rooted in the therapist’s past experiences, it has been elicited by the client. According to this school, the client has every right to know how their therapist is reacting to what they say. And as with any other controversial issue, others take a middle stand position. They believe that it all depends on the context. According to this school, the therapist has to know the client well enough to decide whether sharing a Counter Transference feeling might be helpful or harmful to the client. It is all about the client. That’s what the therapist is getting paid to do: To think of the client first.
Going back to my school days, I trained with a physician psychotherapist. According to his medical model, under no conditions you would ever share a Counter Transference reaction with your client. As part of my training, I also worked with a social worker psychotherapist who would share small bits of his own feelings with the clients from time to time. Having observed both of my supervisors for many hours, I could never come into a solid conclusion on what is the right approach to take when dealing with Counter Transference.
Having started working with clients as a professional, what I learned through my personal experiences is that there are no doubts that Counter Transference is a very powerful phenomenon. It could stir up a lot of feelings in the therapist. Overall, it is a positive outcome of the therapy for the therapist as it could teach them a lot about themselves. As it goes for the client, it could show them that their therapist is also a human being who comes with all different normal feelings just like them. Now, to what extend that should be shared with the client, I believe depends on the clients’ level of intelligence and understanding of the therapy. Working with a lot of young abused women, I find them in need of hearing from an older wise, yet sensitive and sympathetic female. I find telling these women something like: “I wish I had a little sister like you” would make them more receptive to my suggestions on how to end an abusive relationship. It has worked for me every single time. In a different context, telling an intelligent successful client who has a troubled relationship with his younger sister something like: “I envy your sister for having a brother like you” elicits a reaction like “ Maybe one day my sister sees me like that too”. To me, sharing my Counter Transference reaction with the client has shown him that despite not being appreciated, he is a good brother.
Counter Transference is powerful and useful and could help therapy process more useful for the client. It is a natural normal human reaction which is one of the most beautiful by-products of the client/therapist relationship.
Shahrzad Shahriari
BSc.Psych, MSW., RSW.
647-405-7706
shahrzad.therapy@gmail.com
www.shahrzadtherapy.com
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