Monday, November 10, 2008

Just Do It

In his book The Last Lecture, Randy Pausch writes this:

“Coach Graham used to ride me hard. I remember one practice in particular. “You’re doing it all wrong, Pausch. Go back! Do it again!” I tried to do what he wanted. It wasn’t enough. “You owe me. Pausch! You’re doing push-ups after practice.

When I was finally dismissed, one of the assistant coaches came over to me to reassure me. “Coach Graham rode you pretty hard, didn’t he?” he said.

I could barely muster a “yeah.”

“That’s a good thing,” the assistant told me. “When you’re screwing up and nobody says anything that means they’ve given up on you.”

That lesson has stuck with me my whole life. When you see yourself doing something badly and nobody’s bothering to tell you anymore, that’s a bad place to be. You may not want to hear it, but your critics are often the ones telling you they still love you and care about you, and want to make you better.

There’s a lot of talk these days about giving children self-esteem. It’s not something you can give; it’s something they have to build. Coach Graham worked in a no-coddling zone. Self-esteem? He knew there was only one way to teach kids how to develop it: You have to give them something they can’t do, they work hard until they find they can do it, and you just keep repeating the process.

When Coach Graham first got hold of me, I was this wimpy kid with no skills, no physical strength, and no conditioning. But he made me realize that if I work hard enough, there will be things I can do tomorrow that I can’t do today. “

The Bumper Sticker: “Nike Therapy – Just Do It!”

As I read this, I thought of how it feels to watch the process of therapy. Many times, I know that I frustrate patients because I absolutely refuse to “just give them the answer. I also know that some people feel that I am sometimes a bit too tough on some things and too vague on most things. These paragraphs, written by a man trying to leave a legacy as he faced death, summed up the whole purpose behind much of my motivation in my daily work.

I had a great mentor or Supervisor, who once asked me what I was doing when I made a particular intervention in therapy. When I replied, “I was just trying to help,” he quickly came back with “That’s the whole problem! If you try to help all your patients, they’ll never get better.” He went on to explain that my job in therapy was to observe the struggle in which the patient was caught, use the objective viewpoint I had to give them information they might not be able to see from where they were and to be a guide as they found their own answers. If I presumed to help them, I covertly and silently declared them incompetent and incapable.

If I always had the answers, I would teach them to be helpless, dependent and uncreative. If I supported them in the struggle, I allowed them to find something they have no idea they can solve or believe is impossible, conquer it and succeed where they thought they were not capable. Stumbling through this process, they become capable, competent, and strong.

Many days, I’m sure that those painful, difficult moments in therapy or any growth process leave us feeling as though those guiding us are being mean, cruel or just plain hard on you. Like Professor Pausch, I have had to learn to entertain the notion that this is an indication that they have not given up, rather than a message that they are being mean. Some treatment modalities, TV pop therapists and “coaching” techniques teach you all the answers in simple, rote answers that fit on flash cards that are “one-size-fits-all.” I’ve never found that to be particularly effective in the long term and the research I’ve read bears that out. In fact, I’ve found that people in therapy with me often flat out reject simple answers I give them . On top of that, they miraculously come back weeks or months later with nearly the exact same answer, as though it had come to them on a stone tablet while on a journey to some great mountain top!

Like Coach Graham, I do get a bit of satisfaction out of dishing out the extra struggle on occasion. I think that’s the double edged sword of being a therapist – I get to set up the struggle, so it looks like it’s my fault, then walk away and let the patient figure out with whom they are truly struggling. The answer is usually, “Myself.” However, that’s always just too easy because it’s often that “myself” that struggled with my mother or my father or my last significant other, spouse or lover! Sure, I could just say, “I think you’re treating me just like your father” and let them go home mad because I’m talking that Freudian stuff again. However, I’d end up giving that patient something to distract about, rather than the struggle that matters. They would go home mad at me for doing “that Freudian stuff” and not stay mad at the process with their father or boyfriend or roommate or whomever they were really in struggle with.

I really do know how maddening it is when I, like most therapists, don’t give answers, but add to the struggle and seem to make it harder. Like push-ups at the end of a hard, seemingly failed football practice, therapeutic challenges don’t make life any easier and don’t appear to give any answers. They do, however, keep the process going and, hopefully, teach my patients to do something they don’t yet know they can do or to figure out something they don’t yet know they can resolve.

The other important thing about these kind of struggles is that whatever answer that the patient comes up with belongs to them. It is theirs, not mine. If you are my patient and I provide the answer and it doesn’t work, you have to stay in therapy another year! (Not really, but for thought provoking purposes…) Well, at least, you have to fire me and spend weeks with your new therapist getting over how much of a bad therapist I was. However, if you come up with your own answer, it is yours to keep. I can’t take it back and, if it doesn’t work, it can be revised, revamped or recycled. It’s yours. You are free to do with it what you like. If it works, you can use it over and over again without royalty, penalty or tax. It is attached to nobody but you. You earned it, paid for it and own it in every sense of the word. Feel free to take it with you where ever you go.

Here’s the hitch: You have to do it. There’s the Nike part. Just get out there and struggle.

I rather like Coach Grahams Rule of Thumb: …” give them something they can’t do, they work hard until they find they can do it, and you just keep repeating the process.”

Bumper Sticker: Nike Therapy – “Just Do It”

(Thanks Nike Company!)

No comments: