It’s almost always the case that one of the tasks of therapy is to foster or restore a sense of hope. We often seek therapy because we have exhausted other avenues for healing, or the ways we have soothed ourselves in the past don’t work the way they used to. Hope may be eclipsed by despair, loneliness, or loss. It may be that we can’t see our way out of our current circumstances or current feelings. The future may feel bleak. We reach out for help. We want relief. We need hope.
I’ve had people share, sometimes even in a first session, that they feel hopeless. I think this is probably at the heart of most of the work we do in therapy. After all, if despite all odds, we can believe things can get better, we can more easily tackle many of the obstacles that come our way. Maybe that is the very definition of hope.
Where Is The Hope?
Recently I’ve been talking with a number of people who have a terminal illness, whose loved one is dying, whose child has an on-going mental illness, or who have a debilitating disease that may not kill them, but will make life more and more difficult. As I was talking with the father of a young adult son with a serious mental illness complicated by substance abuse, he asked me toward the end of a session: “Where is the hope?”
I was glad it was the end of the session, because I realized I had no answer. It wasn’t that I believed his circumstances were hopeless. It was more about the pressure I felt in the moment to be able to answer his question. And not just answer it, but provide an answer that would feel substantial, helpful, and most of all, hopeful. His question stayed with me for the rest of the day and even into the week. I thought about the times in my own life where I have struggled with hope, and tried to think about what I did and what had helped. I also thought about other people who I’ve seen in therapy and how they found hope.
How Richard Found Hope
Richard was a man who had been married to a woman for 25 years. They had three children who were all in college. Richard began to see me because he was coming out as a gay man. He had told his wife and though she was empathetic to his experience, she was also confused, angry, and felt a sense of betrayal. Richard worked with me for almost 8 years as he told his children he was gay, divorced his wife, and entered a long term relationship with a man.
It wasn’t until he returned for a “check-up” five years after we ended our weekly therapy, that I learned how he found hope: “I don’t know if you remember this, Jeff, he volunteered, “but during one of our sessions, you said I had an incredible ability to find and use resources and supports, and that I had done this my whole life, even before I came out.” I didn’t remember saying those words, but Richard did. And without my knowing how I had helped, from my words he found a source of hope.
How Sharon Found Hope
Sharon was herself a therapist who was seeing me for therapy. She was incredibly insightful, intelligent, and wise. She also had a history of depression that waxed and waned her entire life. She often shared that she didn’t believe she could be a good therapist if she couldn’t effectively manage her own depression. She felt embarrassed sharing with me, another therapist, insecurities about her work.
We spent time exploring negative self-statements, challenging them, and replacing them with alternatives. We worked on acceptance without judgment. And we also explored strategies like exercise, yoga, and meditation. Sharon found ways to manage some symptoms of depression, but she didn’t feel particularly hopeful.
I remember distinctly during one session when she was questioning her capacity to help others when she still struggled. Spontaneously I shared about times in my life when I have felt depressed and even hopeless. Sharon looked at me with astonishment and, for a moment, I didn’t understand what had happened. It wasn’t all the interventions and evidence based practices that helped her most. It was knowing that she wasn’t the only therapist in the world who had personal struggles. And even though she knew this intellectually, hearing me say it affirmed she was not alone, and that we could be competent therapists and also have our own struggles. Sharon felt hopeful.
How Kevin Found Hope
I was having a conversation with Kevin, one of my older clients who had lost a partner to cancer. The cancer was diagnosed quite late, and despite aggressive chemotherapy, his partner died within eight weeks of being diagnosed. The sudden loss, combined with feeling too old to find someone else with whom he could connect intimately, left him struggling with a sense of dread as he thought about the rest of his life.
I understood and validated his feelings. It is hard to start again later in life. And it takes a lot of energy to explore new relationships after spending many years with the same person. He knew he wanted and needed to date again, but he didn’t have the energy to begin and didn’t believe anyone else could love him as much as his deceased partner.
During a session he looked up and saw a painting on one of my walls. “Is that new?” he asked. Interestingly, the painting had been there the entire time we had been seeing each other. It is a watercolor I had painted of one of my dogs, now long gone. I gently responded: “No, actually that painting has been there since we’ve known each other.” “That’s so strange that I never noticed it,” he responded. “Is that your dog? Did you paint it?” I told him the story of the dog in the picture and also talked a little about the dogs who have come into my life since losing him. At the end of our session, I remember wondering why I had shared so much about my dog!
Several weeks later, Kevin came to his session visibly brighter. He took his phone out of his pocket. “Let me show you something,” he said with excitement. And he scrolled through the pictures and arrived at the photo of a small, brown dog, “A terrier mix,” he shared. He went on to tell me that several days after the session when he asked me about my painting, he had gone to a local animal shelter and had adopted this three-year-old dog he had named “Harold.” “You wouldn’t believe the number of people I’ve met in the dog park,” he beamed. Kevin found hope.
Hope Appears in Unexpected Ways
I’d like to say that I have some calculated strategy for infusing hope into my clients who so desperately need to feel hopeful. I’ve thought about what theory or intervention I could extract from these three experiences that I could use in the future when I am with someone who struggles with feeling hopeless and is looking for a way out. Or perhaps a way back. And I realize there is nothing I have learned academically or theoretically that I can extract from these experiences.
I am reminded of psychiatrist Irvin Yalom’s experiments with the effectiveness of his work with his patients. He asked each patient to write down what had been the most important or influential aspect of each session and he also wrote down what he thought was most important or the most effective moment of each session. When he and his patients compared notes, he was astounded by what they shared.
He had notes to himself about how he had made an important connection for a client about how present behavior connected with something historical, or how he had illuminated the cause of a patient’s current dilemma. And surprisingly, his patients shared that what they found most helpful: when he made a compliment about a sweater, when he reached over and touched another’s knee, and when he spontaneously shared a funny story about one of his children. He came to the conclusion that despite all he had learned, what was most effective in his eyes was not always what was most effective for his patients. And almost always, what his patients found effective were moments in a session that felt most human, when he was vulnerable, and when he reached out spontaneously.
I certainly can’t claim to be Irvin Yalom. And I know I’m telling his story without getting all the details exactly right. But I think I am capturing the message that brings me back to how my own clients, and most likely how many of us, find hope. It’s not because I can answer my client’s questions about finding hope with clarity and exactness. And it’s not about how astute and insightful I am as a therapist. Actually, I think the way I have found hope in my life is much the same.
We find hope in some of the small, sometimes spontaneous, often unexpected connections and inspirations present in our relationships with others. When our vulnerability becomes visible, when we share our experience of another’s strength, and when our own stories of victory over despair enter our relationships, when we come to believe we are connected to others, we may find hope.
I still don’t know that I have an answer for my client who asked “where is the hope?” But I’m not sure I need to answer him. More than an answer, I will continue to share his journey and trust that in so doing, our shared humanity will open a space for hope to emerge. And I’ll remember that if I like his sweater, I’ll be sure to tell him.
Hope is the thing with feathers that perches in the soul and sings the tune without the words and never stops at all.
—Emily Dickinson
*High Hopes—Please click this link for the music that includes the title of this post.
By Jeff Levy, LCSW, CTRS