I was asked to define the word,
competence. I put this off for several weeks for a variety of reasons, the most important of which is plain old avoidance. Thinking about the meaning of this concept would mean that I'd have to look below the surface at my own competence levels in the things I do that are important to me. I'd have the task of looking at the inaccurate perceptions I hold about competency which would mean I'd come to a more accurate understanding of myself. That sounds like a good thing, right? Then why am I avoiding it? Perhaps there is something I get out of my daily complaints of being incompetent that eats away at any motivation to discover the truth. I'd have to encourage acceptance, I'd have to change a very old, ingrained way of thinking that has served me these past 47+ years. The process is daunting. Why, then, would I ask any patient to do this if I am not willing to do this?
I began a new job this past January. With it came heightened anxiety, feelings of ineffectiveness and worry. I've had many thoughts that perpetuate the worry and no amount of reassurance from my husband or friends have changed my perception or feeling. In fact, a text book will tell you that reassurance only increases anxiety. I refuse to put up the plaque given to me by my former boss that thanks me for eight years of excellent clinical service. I didn't provide excellent service, but I'll spare you those details.
I have excellent health insurance with excellent medical care but limited access to mental health treatment. In fact, I do not like the mental health program that it offers but I cannot afford to pay out of pocket full fee to meet with someone who does the work that I do. I took the recommendation of a friend and inquired about working with an intern at a local, non profit agency that trains therapists for private practice. I would have liked to have done my training there but they didn't offer any pay, so I declined.
I am sitting before my own therapist in the chair designated for the client. I am paying her to do the work I have been trained and licensed to do. I know she is working on a stipend and I am unhappy about this. She has not yet completed her 3000 hours of clinical work, but she is ready to meet with me just the same. I tell her about my anxiety symptoms and how they are impacting my work and overall life. She listens to me and begins to engage. I have just given her my diagnosis with a fairly complete justification. Over the next few weeks she attempts to uncover a pattern of anxiety with similar triggers and underlying causes that span from childhood. I am impressed at how she pulls the information together from past weeks, delving deeper into memories and linking them to current feelings. I can no longer track information like this. I know the medication I take impairs cognitive functioning. I am wondering just how impaired I am and if I am fit to work. The question of competency arises but like every other important person in my life she pushes back. I ask her not to. I tell her I need her to believe that I am incompetent. She asks me to tell her how. I begin to explain the numerous times I failed at developing a therapeutic relationship or ruined the one I had. I explain the challenges of this new job compared to my lack of expertise in the areas I am asked to focus. I ask her if I could continue giving her examples and she agrees. I know what she will do next. She will show me the inaccuracy of my thoughts, but I will tell her she is wrong. She cannot sway me.
She says she is keeping track of the number of times I have presented a reason that justifies my perceived incompetence against her tally which is based in reality. Each week we play ping pong: I throw out yet another reason I am incompetent and she hits it back with a reasonable response of how I am actually a rather good therapist, with the most important qualities a therapist can have. I then test out this new perception during the week while sitting with patients who bring out the best and the worst of my abilities and contemplate the very question each of them presents to me, "Can you fix this?"
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Kitchen Table Kibitzing is a community series for those who wish to share part of the evening around a virtual kitchen table with kossacks who are caring and supportive of one another. So bring your stories, jokes, photos, funny pics, music, and interesting videos, as well as links—including quotations—to diaries, news stories, and books that you think this community would appreciate. Readers may notice that most who post diaries and comments in this series already know one another to some degree, but newcomers should not feel excluded. We welcome guests at our kitchen table, and hope to make some new friends as well.
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