Clinicians on the Couch: 10 Questions with Christine Selby

Every month, in our interview series, we give readers a rare glimpse into the lives of therapists. Rare because how often do you get to ask a therapist about how they personally cope with stress or whether they’d actually follow the same professional path again? Rare because how often do you get to sit with a therapist and explore the most challenging and rewarding parts of their job?

Therapists share their answers to these questions, along with many others. They reveal everything from the biggest myth about therapy to what they wish their clients knew.

This month we’re pleased to feature Christine Selby, Ph.D, a licensed psychologist with a part-time private practice , and an associate professor of psychology at Husson University in Bangor, Maine.

Selby is a certified eating disorder specialist with the International Association of Eating Disorders Professionals and certified consultant with the Association for Applied Sport Psychology. She has published primarily in the area of eating disorders in athletes for largely non-academic audiences.

Selby also has presented locally and nationally on eating disorders and related topics at professional conferences and to allied professionals who work directly with those dealing with eating disorders and related concerns. She is the author of the book Chilling Out: The Psychology of Relaxation .

1. What’s surprised you the most about being a therapist?

I think the biggest surprise is how much I truly enjoy the work. I don’t mean to suggest that it is always easy or that hearing about people’s pain is “enjoyable”; however, I enjoy the challenge of helping people figure out what is going on and why. I also enjoy the process of helping clients live the life they want to live and helping them resist the messages that the life they want is not good enough.

2. What’s the latest and greatest book you’ve read related to mental health, psychology or psychotherapy?

I don’t know if it is the latest book I’ve read but one of my favorites is Irvin Yalom’s Love’s Executioner & Other Tales of Psychotherapy . I read it sometime during my graduate training to become a psychologist and remember feeling intrigued by the complexity of people’s struggles. But perhaps most importantly, I was relieved to read that someone considered to be a master psychotherapist wrote openly about his internal reactions to his work.

Psychotherapy is a complicated process that at its core involves two human beings working together to resolve a lifelong or newly emerged concern. Yalom masterfully portrays this imperfect process through the stories. I also really like his newer book The Gift of Therapy , which is also a really good one for students of psychotherapy to read.

3. What’s the biggest myth about therapy?

That there is some version of a magic wand that the psychotherapist has. Psychotherapy is really difficult work. And even situations or problems that seem “simple” often do not have simple or easy solutions. There truly is nothing magical about the process. There is no particular phrase or thing a psychotherapist can say that will make things better.

I don’t think most people view psychotherapy this way. But when this expectation exists—that the client/patient just has to show up and the psychotherapist will fix them —the initial work then becomes about educating them about the process; allowing them to say what they think and feel about what psychotherapy really is; and helping them decide if they want to proceed or not.

4. What seems to be the biggest obstacle for clients in therapy?

Change. I work with adults, none of whom are mandated by any authority to be in my office (though some may schedule an appointment because a family member really wanted them to). So when they come to see me they are doing so because they have already identified that there is a problem and something needs to be done about it.

Once I fully understand what their concerns are (as fully as possible), we then move in the direction of determining what may be keeping these concerns from going away and what it might take to do things differently. It is usually the “doing things differently” part that becomes the obstacle. It is not the case that the person is not motivated to change, or to make things better for themselves. But it is one thing to want things to be different, and it is another to make dramatic changes in their lives to make it so.

5. What’s the most challenging part about being a therapist?

Feeling helpless. Usually when I’m feeling helpless with a client it is a reflection of how helpless the client has been feeling. There are some situations where there is truly nothing anyone can to do make it better. I can listen, empathize, and not “run away” from what they are experiencing. But there may be nothing that I or anyone else can say or do to make the experience stop or go away.

Alternatively, in these situations there may be something that can be done. But it involves the client feeling even more pain before things start to feel better. That is difficult to recommend to a client. I believe in the transformative power of effective psychotherapy but do not begrudge a client who elects not to volunteer for a highly painful process—especially when the promise of feeling better feels so ethereal.

6. What do you love about being a therapist?

Helping. It is quite cliché, but I love when I’ve been able to witness a client’s journey from pain, hopelessness and/or helplessness (especially when they have stated out right that this is their last ditch effort to try to make things better) to feeling like life is worth living—and they know exactly how they want to live it. It is an honor to be a part of that process and to provide some measure of assistance along the way.

7. What’s the best advice you can offer to readers on leading a meaningful life?

Listen as best as you can to your own voice. We each have one. I’m not necessarily talking about an inner child or anything like that, but the voice, experience, feeling, etc., that lets you know what is a good fit for you and what is not. Left to our own devices we are usually quite good at knowing this.

Unfortunately, our voice may have been muted for so long we don’t think we really know what we want or need. Alternatively, our voice is there but is drowned out by others around us telling us what we ought to do, how we should think or feel about something, etc.

When you hear your voice, listen to it as best as you can. You don’t have to act on it immediately, but listen to what it has to say. Eventually you will learn to trust that it truly has your best interests at heart and is worth honoring. And, by the way…the voice..”it”…that’s you. That is who you truly are.

8. If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently and why?

I absolutely would. I would not change my educational path at all (student loans at all). I love what I do. It is fulfilling to me professionally and personally. It challenges me intellectually when I am trying to help someone figure out why they keep ending up in the same place time and time again. The work fuels me personally as I often learn about myself through my clients. They teach me ways of looking at things I hadn’t considered before.

And sometimes they have surpassed me in one way or another. Sometimes when my clients are ready to move on, I know that they have some life skills that are now more well developed than mine. That is humbling for sure!

9. If there’s one thing you wished your clients knew about treatment or mental illness, what would it be?

You deserve to take care of yourself. You don’t need my or anyone else’s permission to do so—you just deserve to take care of yourself because you exist. We are continuously told and expected to look out for other people and to consider them before ourselves. On the surface that is a nice idea and in some cases it is wholly appropriate. In many cases, however, it is not.
Granted my frame of reference is working with people who by definition are not happy about something in their lives; however, I continually work with people who in one way or another realize their needs and wants are not being met, in part because they are not attending to them and/or asking for help from others.

We are consistently told that thinking about ourselves first or at all automatically makes us selfish and self-centered. Nope. Not automatically, and depending on how you go about it not at all. The analogy I often think of is the instructions on a commercial passenger plane about oxygen masks. If you are traveling with someone who needs help getting their oxygen mask on, the instruction is to put yours on first before you help them.

You cannot help them if you are impaired or incapacitated. This is no different psychologically. Moreover, taking care of yourself gives you a better chance of being genuinely happy and content—and you deserve that too!

10. What personally do you do to cope with stress in your life?

That has been an ongoing challenge for me, particularly since I grew up with the idea that “being productive” was important. This, of course, meant that any form of relaxation was a waste of time. So, I had to learn how to relax by figuring out IF I relaxed what would I do (or not do!). Then I had to do the work of eliminating the mantra that I needed to be productive at all times.

So the short answer to the question is that I relax (watch TV, read Facebook on my phone, hang out with one of my cats who will allow me to). The slightly more complicated answer is that I had to figure a few things out for myself to make all this happen. One of those things was recognizing that I am an introvert, which means that I require time to myself so I can recharge. Being around others even if we are just sitting in the same room not interacting was not sufficient. I needed zero distractions from human beings.

This is not always easy to come by when you live with others. But over the years I taught myself how to ask for what I needed and educated others in my life what it really meant to need time alone. It didn’t mean I was mad or didn’t want to be around them per se. I didn’t want to be around anyone and need to NOT be around anyone so I could more fully relax and recharge…and not be unbearably cranky.

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