Stepping Out of My Own World

A blog post from SOLES MA in Marital and Family Therapy Ambassador, Madeleine Wiersma.

As a second year student beginning my clinical experience at my practicum site, I have been learning a lot this past month. I’ve been learning how to schedule appointments, how to write proper documentation, how to do risk assessment, and how to sort through referrals to our program. Working in a medical environment at UCSD Family Medicine, I’m also learning a lot of medical terminology, learning about many diagnoses I never formerly heard about, and learning the names of the many doctors and nurses who work at my clinic. The list of things I’m learning could go on and on, and every day brings a new opportunity to learn something new. Out of everything I’ve been learning, one skill stands out to me:

I am learning to step out of my own world and truly listen to the experience of another.

The importance of listening is continually brought up in my classes. As therapists in training, we are always reminded that listening is the foundational skill for therapy. If we can’t listen and understand the concerns of our clients, how can we be expected to help?  I’ve spent much of my life listening to the cares and concerns of my family members and friends. However, through my practicum experience, I’m starting to develop a new perspective on what listening really means.

By learning to listen, I am learning to give up my own perspective, to give up my own feelings and preoccupations in order to be fully present in the world of another. Entering into someone else’s world is difficult because at any given time, we have our own thoughts, opinions and emotional reactions. It is even more difficult because others often hide their own feelings out of shame and fear. Truly hearing someone often involves more than just listening with your ears. We need to use our eyes and our heart as well. We need to use our eyes to look for the lines of tension and worry that appear as someone talks. We need to look for their mannerisms, to watch the way they fold their arms to try and block us out. We need to see the forced smile which tries to conceal all of the hurt, the sadness, the frustration and the pain. We also need to listen with our heart and feel what is really being communicated. If we went through this person’s loss, how would we feel? We must feel their loss, their grief, their anger, and their sadness with them, and accept these imperfect and messy feelings for all that they are.

Children have a strong desire to be heard. They cry, they scream, they nag (“hey mom, hey mom, hey mom…”) in order to express themselves. The truth is, this need never goes away. We need to be able to vent our feelings. When we can’t do this, our feelings will find a way to come out, often in aggressive and self-defeating ways. When we can’t express our feelings outwardly, they are turned inwardly, and the body is torn by uncomfortable physical symptoms: headaches, nausea, hypertension, ulcers, arthritis, fatigue… our physical health is compromised and we pay the price when we do not have an outlet for our emotions. As a result of these physical symptoms, the first place people often go when they experience emotional distress is to the office of their primary care doctor.

At my practicum site (UCSD Family Medicine), every patient who comes in to see their doctor completes a screening for depression. Our goal is to identify and address our patients’ emotional health concerns, so that we can refer them to the proper resources where they can have their voice heard. Everyone needs to be able to express themselves, and this isn’t a need we should feel guilty about. All of us feel. All of us struggle. We are human. It’s okay to voice your concerns, it’s okay to see a therapist, it’s okay to say you are not okay and to ask for help. It’s okay to reach out. And when someone else reaches out to you, step out of your own world and listen. Listen not just with your ears, but also with your heart. 

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