by Nicholas Hack, Psy.D.

A CROWDED ROOM

Sometimes I look around the consultation room – me in my chair and my patient on the couch – and I’m surprised by just how crowded it is.

I’m used to listening to-and-for the gang that my patients bring. Some of the voices from their past – usually the people in whose eyes they saw a version of themselves – are loud and easily identified. “I think we’re hearing your dad right now,” I might say to somebody. Or, to another, “It sounds like your mom taught you that painful lesson well, and even though you disagree with it and she’s gone now, you keep it alive within yourself.” These people and ghosts come to mind quickly. 

Other voices are much quieter and more easily missed. At times I’m surprised to learn that somebody has been present with us for years but hasn’t ever been acknowledged. Perhaps a grade school peer made an hurtful comment that crystalized something already inside, shaping the language a client has used about their body ever since. Or maybe an early boss said something caustic and set in motion ideas about the self and work that have constrained the patient for decades.

Our social worlds, our cultures, our countries, these clearly have voices and presence as well. 

Recently, though, I’ve also been more clearly hearing the crowd I bring with me into sessions. There are times when I have a thought to share but am not quite sure how to put it into words. In these moments I might hear from the friends and colleagues I’ve learned so much from, imagining (projecting?) how they’d express themselves. I may imagine what my long-time mentor would say, not only her words, but her tone, her energy, her posture. I usually imagine what my own therapist might say as well, his voice so familiar after our many years together that I can hear in my mind the mid-sentence pauses that he takes when he’s thinking. Somewhere in there I’ll find something that feels like my voice, or close enough to my voice, and that’s what I’ll share with my client. I may be the one that speaks, but this internal consultation group sits with me, offering themselves even when they’re not physically there.

At the start of the year Luba Palter, Editor-in-Chief here at Impulse, encouraged us to think about what gets said and what doesn’t; what gets spoken, and what stays silent. I’m left thinking about that strange middle ground that is both spoken and silent, how both our patients and we ourselves may speak with one voice, but it’s a single that contains multitudes. 

On Zoom or in the room, a session begins. My patient looks at me and I look at them. There are just us two, and yet there are so many people here.