Clinicians on the Couch: 10 Questions with Psychotherapist Susan Lager

In our monthly series, clinicians share slices from both their professional and personal lives. They reveal everything from what they love about being a therapist to how they cope with stress to their insights for leading a meaningful life.

This month we’re pleased to interview Susan Lager, LICSW, a psychotherapist and relationship coach. She specializes in marriage counseling at The Couples Center PLLC, in Portsmouth, New Hampshire. She’s also the only practitioner in the state to provide Discernment Counseling for couples on the brink of divorce.

In early 2010, Lager founded Couplespeak™, the coaching division of her practice, which provides live and online programs and products for people in all kinds of partnerships.

Happily married for 29 years, Lager understands firsthand about what it takes to have a joyful, lasting marriage with reasonable concessions.

She’s also the author of two short, humorous self-help workbooks about communication and connection: I’m Talking! Are You Listening? Fix Communication Problems With Your Partner In No Time Flat! and Become Relationship Smart Without A Lifetime Of Therapy .

Since 2011, Lager has been the host of a BlogTalk Radio show, The Couplespeak™ Relationship Forum , which explores personal growth and relationship success.

Plus, she and her colleague — a collaborative lawyer and conflict coach — provide couples’ retreats on the coasts of New Hampshire and Maine.

Learn more about Susan Lager, and read her blog about love, self-care, family and marriage at SusanLager.com .

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

The most surprising things about being a therapist for me have been:

A. The sheer amount of “sitting still” indoors required to be a therapist. Before I began this work, it never occurred to me how stationary and still I’d need to be — a foreign concept for someone who “relaxes” through movement!

B. The constant learning inherent in doing good work. You come out of graduate school and post-graduate training thinking you know a lot, then realize that you know very little relative to what will be required of you. The humbling factor has been a big discovery — thankfully, I love “school” and learning new things, so this has also been a good surprise.

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

The Five Love Languages by Gary Chapman. He’s not only a lovely writer, but he demystifies the whole process of loving in ways which truly resonate for partners. I read it at the recommendation of several couples I’d been working with, and now I always recommend it myself.

I see it as helping partners line up their loving intentions with behaviors and attitudes, which will speak fluently to their partners. That way, committed relationships don’t become an arena of well-intentioned rumination.

3. What’s the biggest myth about therapy?

The first biggest myth about therapy is that the therapist will know what they’re doing, be helpful, or have all the answers. Unfortunately, some clinicians are kindhearted blockheads who happen to have degrees and fancy offices.

Also, “the answers” are internal and subjective to each client, who, with help, need to discover their own authentic path. A competent therapist doesn’t have the right “answers,” but instead asks the right questions.

Another myth is that “communication problems” are the root of the problem — very often not so. It’s an oversimplified, benign, popular soundbite explanation which resonates with people, but often belies the deeper issues.

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

The biggest obstacles for clients in therapy as I see it are: They may not be sufficiently motivated to do the work and may be ambivalent about what they “want to fix,” so getting prematurely busy with them on action plans and tools may miss the mark.

They may not know this consciously, so they may be working at cross-purposes.

They come into treatment too late. In couples work, sometimes the relationship no longer has a pulse, yet they have a magical wish for reconciliation and renewal. Or they know the “body” has “flatlined,” yet they come in needing to feel that they’ve done all they could to rescue the relationship.

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

A. The indoor sitting and stillness required.

B. Dealing with certain financial issues. There was no formal training for this piece in my graduate or later work, so I’ve had to rely on consultation with peers who are often themselves befuddled about how to set appropriate boundaries regarding fees, cancellations, etc. I learn more as I go about where to draw lines with clients, where to be flexible, and how it all relates to clinical issues they may be presenting. When clients act out financially, I remind myself that this may not be personal to me, but may be more emblematic of their internal struggles, which we might need to confront.

C. Certain clients habitually taking my time for granted — not giving me the courtesy of sufficient notice regarding canceling sessions, or others wanting lots of free phone or in person consultation before we “start.” Although I understand that clients need to get a sense of a comfortable “fit,” I dislike the notion of auditioning to be someone’s therapist and the objectification inherent in that.

D. Maintaining a posture which simultaneously allows me to be empathic, while not over-identifying with clients. It’s a critical tension between enough closeness, allowing for bonding and a working alliance, versus enough distance, allowing clients to feel emotionally safe. It’s often a fine line.

6. What do you love about being a therapist?

Everything except Question 5a and 5b! I feel blessed every day to be in a position to be so intimate in this way with people who are often so courageous, to be trusted, and to facilitate a process of transformation for so many people.

It’s important, meaningful, loving work which requires that I be open, always learning and growing.

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

What a great question! I’d probably say: “Be true to yourself, stand up for yourself, honor your head and heart, be open, be humble, be curious, be honest, and be loving, respectful and compassionate in all your relationships. Set an intention to treat your life and everyone in it as a precious gift, each and every day.”

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’d still be a psychotherapist, but I’d train for subspecialties which would allow me to travel and be more active physically with clients, like special needs skiing instruction, or animal-assisted therapy.

Or I might have taken a path toward more consultation/workshops with groups related to their teamwork (preferably in warm, beautiful places I’d get to see).

So, I guess I would have trained to work more holistically with clients in their own environments, so I’d have a broader context, and wouldn’t be glued to my therapy chair so much. (Luckily, I have a beautiful view!)

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

I wish that more clients understood that everyone has “issues,” and that the challenge for each of us is to know our own demons and to find appropriate tools to work with ourselves so that the demons don’t define us.

I also wish clients would understand that there are many paths to wholeness, that there are many daily ways besides being in the therapy chair that they can nourish and heal themselves psychologically, and that self-esteem and joy are really daily action words.

I wish that clients would more fully appreciate the impact of their own role in shaping their lives, and more often would ask themselves, “Where am I in this problem, and where am I in the solution?”

All we can really change is ourselves.

Finally, I wish clients would recognize the value of daily gratitude practice toward a joyful life. What we pay attention to shapes everything.

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

Here are the ways I cope with stress:

• I work out daily either outside or in my own home gym. (Yes, I have a gym so that, living in New England with a 7-month winter, I don’t go bananas indoors when it’s 10 degrees outdoors).
• I practice meditative strategies, like deep breathing and visualization, to calm down when I get hyped up.
• I stay in connection with the people I care about, not only because it brings me joy, but because it centers me, can offset a foul mood, and gets me out of preoccupation with my own problems. Love is the best medicine for stress.
• I write blogs, articles, books, etc, because the creative process shifts my experience from stress to something stimulating, exciting or soothing.
• I practice good self-talk when I’m stressed, so I’m treating myself like a loving family member or friend would.
• I make lists to get the endless “garbage” tasks out of my head. I also make daily action plans to deal with stressful situations, so I amplify my own sense of “agency” and personal power, and reduce feelings of helplessness or frustration.
• I read whatever and whenever I can, usually late at night.
• I occasionally play my guitar (when I allow myself to do more sitting) and I sing.
• I engage in Retail Therapy to treat myself to beautiful or functional things. T.J. Maxx is part of my self-care routine. Like many women, (some men too), I often go into a lovely trance when I’m there. The trick is to limit the time, and not ever do it on a gorgeous day, because then I’d feel bad, and that undermines the point of it.
• I go kayaking, skiing and boating with my husband and our son and daughter-in-law when they’re here. We love the time together, and make a pact to not bring any “work” with us. This is another vehicle for being fully “in the moment,” an antidote to stress.
• I listen to comedy radio on the way home from work to “decompress” after the tensions of the day. It changes the frequency in my brain so much that I arrive home most nights laughing!
• I limit my exposure to the news on TV — too much horror and crime as the focus.

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