No, it isn't.

The therapist's chair provides a unique perspective on culture. Our primary task is trying to understand the thoughts, feelings and behaviors of our clients. Over time we start to see patterns, both on an individual and societal level. We see trends, styles, popular sentiment, even lexicon change gradually, one unrelated individual at a time.

Here's a phrase I've heard a lot recently, from all types of people: it is what it is (iiwii for short). The phrase seems harmless enough, but I actually think it can be a bad sign, psychologically. It's a defense mechanism.

We hear it all the time, particularly from athletes on losing teams. As spoken by the coach of the UCLA football team who lost to a horrible Notre Dame squad. USC loses to the Oregon Ducks, same statement. USA Today even named it the 2004 Sports Cliche of the Year. There are t-shirts, blogs, tattoos, even a support group utilizing this phrase. Here's a discussion describing how iiwii has replaced "it's all good" in common parlance. The urban dictionary tries to define it, but none of the definitions quite capture what I see in my office.

The problem is, iiwii is a deceptive statement. The words and tone imply acceptance of the current state of affairs, but the underlying sentiment is frustration and helplessness. Don't get me wrong, I'm quite familiar with irony, cynicism and satire. But that's not what this is. This is a defense mechanism. Not only that, it's the Ebola virus of defense mechanisms: denial.

Let's say I have a client, a man who has been in a miserable marriage for 20 years. Every perceptive muscle I have tells me he feels angry, sad and very stuck. But I ask him how he feels and he drops the iiwii bomb: "I don't know," he says "my marriage is what it is, and that's that." Here is my translation: This situation makes me very upset, but I'm powerless to change it, so I'm trying to push away my feelings and begrudgingly accept my helplessness. I don't want to talk about it anymore. We both know he has strong feelings about it, but iiwii won't let us get there. That's what a defense mechanism is: any mechanism that protects (defends) us from unwanted thoughts, feelings, or drives.

I'm not trying to be grammar police, or take away freedom of speech. I actually don't mind the phrase when used appropriately. I'm just calling out iiwii for what it often is: denial. Normal, healthy emotional processing includes 1) injury 2) feeling the emotion 3) expressing the emotion, then finally 4) acceptance. What I'm seeing is people wanting to leapfrog steps 2 and 3 in order to avoid the pain and get to the acceptance. They hope that shortcut won't hurt as bad.

But you know what? Bypassing the emotion doesn't work. It has to be expressed sometime. Talk to someone who took antidepressants following the death of a loved one. Prozac doesn't eliminate the grief, it just postpones it. Emotions like grief and anger are natural, necessary phases we must experience in order to move on. In order to achieve real acceptance. And what happens when we don't deal with the underlying emotions? Most of mankind's health and relational problems. I'm afraid that's the harsh reality.

Power to the People

Psychotherapy is supposed to be a collaboration - therapist and client working as equal partners to achieve the client's goals. This is the ideal. But all too often, it's not the reality.

Why? Consider this: therapists have from two to eight years of graduate training learning their role in the therapist chair. They have thousands of hours of experience honing their craft. There are roughly 500 recognized theoretical orientations (approaches to problems and their origins) for them to choose, practice, and perfect. The client entering therapy for the first time has none of this training and experience.

This imbalance results in countless hours of frustration for numerous clients - and therapists, too. It's like pairing Tiger Woods with someone who's never picked up a club and expecting them to win the tournament. The gap in skill, training, and experience is often too great. For many, the first few months of therapy is spent raising the client's therapeutic aptitude to a workable level. Even then, the client is adopting the orientation of the therapist - which may or may not be the best approach for the client's personality or issue.

It's time for a change. Clients need to be empowered to know what they want, ask for it, and participate in the process. We're stuck in a medical model mindset where the patient is passive recipient of the doctor's intervention. This doesn't work in therapy. In fact, there is a movement in medicine to make patients their own case managers - equipped with more information about themselves and their condition (thanks to the internet), patients want to take control of their treatment away from the MD's and insurance companies. Shouldn't this be even more the case in psychotherapy? Collaboration requires client empowerment, not passivity.

I'm hoping this idea of client empowerment shakes some people up. Especially therapists.

Check back as the plan for this revolution unfolds.

Being In Therapy

"How does this work? What should I talk about?" Every therapist has heard these questions, and most clients have asked them. This blog will take a stab at giving some answers.

The simple answer is: talk about yourself. Therapy is a laboratory where you and your therapist meet regularly to explore this one topic. Why you think, feel and behave the way you do, how you came to be the person you are, and what can be changed if you so desire.

Anyone who has spent some time being in therapy knows how this simple task can become quite complicated. There are an endless number of approaches to exploring one's self. Should you rehash your week? Talk about your childhood? Your dreams? Do you mention the discomfort you feel when the therapist gives you a certain look? Your doubts about the effectiveness of therapy? Or should you wait for the therapist to ask you questions? Each are valid approaches, but it can be confusing to know which one most effectively helps you reach your goal: to understand yourself better, resolve your problems, and not waste your time and money.

As a psychologist with a decade or so of experience, I've dealt with this dilemma plenty. I often need to spend the first several sessions helping clients learn what to do and say to get the most out of their treatment - at a significant expense to the client. It occurred to me that there exists a huge rift between client and therapist where the process of therapy is concerned: therapists spend many years learning theories and techniques of psychotherapy, while the client may know nothing. No wonder many clients leave therapy frustrated, unable to reach their goals because the process remained a mystery to them.

My goal for this blog is to level the therapeutic playing field. I'd like to equip clients - beginning as well as current - with the tools necessary to get the most out of their time, money, and emotional expenditure. I plan to talk about:

1. How to find and begin therapy
2. The rules and roles within therapy
3. How the exploring/healing process works
4. How to relate to the therapist
5. Topics many choose to cover in therapy
6. How to overcome roadblocks in therapy
7. Knowing when and how to end therapy

Thanks for joining me, and I welcome your feedback.

*NOTE: While I am a psychologist who will be discussing the process of therapy, I will not be conducting any on-line therapy. I welcome your questions about how therapy works, but know that I won't be giving specific advice about your particular personal issues - hopefully, some of what I discuss will help you get that kind of assistance from your therapist!