By Ellie Spencer
“One hand I extend into myself, the other toward others.” — Dejan Stojanovic
I look down at my hands and study their lines. The crevices are deepening, and the knuckles are swelling. But they are still soft and small.
These hands have been the midwife for a barn cat. They have planted and nurtured the best red bell peppers I have ever tasted. They have clasped and steadied the heaving shoulders of women who have suffered an immeasurable loss. They have rested gently on the hands of those diagnosed with a terminal illness.
I wonder what they will look like in ten years. Will my wedding rings loosen as the flesh thins, bumping up against knotty knuckles? My fingers are starting to twist like the branches of a mature oak. One day, I hope to see the resemblance of my grandmother’s hands in my own. I neatly fold them together, quickly release them, and run my palms down my denim-clad thighs to wick away the moisture. And take a deep breath. The door opens, the bell rings. My next patient is here.
One of the most profoundly sacred places in my life is a royal blue armchair that sits in the corner of my office. It sits on the edge of a gray rug, adorned with white leaves. This chair is positioned directly in front of a blue loveseat, which is my patients’ own sacred space. I fold up my legs and sit on my feet. Sometimes I clasp my hands in my lap. Most of the time, my body language naturally mirrors the person across the rug. In this sacred space, I earn trust. I sit across from people as they share some of their darkest moments and paralyzing fears, their grief and anxieties—narratives of suffering that are uniquely individual to them. I have never practiced the same therapy twice because they don’t make carbon copy humans yet.
“Are you telling me there isn’t just a switch you can flip?” My patient’s eyes are glassy, but her lips curl slightly as she softly chuckles and blots away her tears.
This sacred chair holds a lot of power, yet I often feel powerless. Some patients believe that when the board issued my license to practice, it ordained me with a mandatory superhero cape. They often think that I should have “all the answers.” But I don’t. Or they believe my job is to “fix” them. But it isn’t. My job is to be a mirror in which they clearly see themselves, free from the fog of judgement. I look at my hands in the same manner as I look at my patients.
“I just wish you had a magic wand. I just want all of this to go away.” She sobs, her hands masking her face, pressing her lips to her palms.
Using my words like a scalpel, with precision and intention, I cut away painful scar tissue and provide the needle and thread to close the wound so it can heal correctly.
“I want it to all go away, too, but first we must look at it, shine a light on it, and give it the time to be seen. I see your fear of being unloved and unworthy because of these mistakes. I’m still here, and you were born worthy of love and connection. What shall we shine a light on today?” My elbows rest on the arms of my chair and my spine straightens to meet the back. I prepare to hold the weight of what’s to come, my hands opening in my lap.
“It is so hard to talk about this.”
“It sure is. It sounds like it is even harder keeping it in the shadows.”
She agrees, and then brings it into the light.
Still, a healed wound does not erase painful memories. If our stories appeared on our skin, we would look like the pages of an atlas, with lines twisting and turning and intersecting, covering every inch of space. To ground myself in my own humanity and to connect with my patients, I ritually meditate on my hands and their evolution. The skin is growing thinner, the blood vessels clear beneath the surface of the ever-deepening creases. Ten years ago, there were not nearly as many lines on these palms.
To embrace therapy is to embrace change.
“Well, you’ll never believe it. Here I am coming to talk to you about surviving this cancer, and I’m pregnant. I don’t know what to do.” She stares into my eyes, looking for an answer.
I have none. And then it is silent for a moment as she retreats to search within herself.
Silence in therapy can sometimes be so, so loud, but it does not need to be smothered. It needs to breathe, like wine, before sipping on the reflections and the feelings that fill the glass. Silence is not to be avoided, but embraced, for in the stillness the answers arise out of a whisper.
The only sound in the room is the faint ticking of a clock. My patient is focused on her wringing hands for a moment before her eyes dart around the room, first out the window, then to the tissue box. Holding my body steady, I watch her feet, hands, and eyes, and wait patiently for her to find the courage to say what she is trying to hold back. I wait for her eyes to meet mine, give her an encouraging nod. Her voice slowly emerges.
“I have been deeply betrayed. My mom outed me to my family, and they are going to make my life miserable. They already hate me. I should never have said anything.” Her eyes drop from mine and fall to her untied shoe.
The day comes to an end. I look over at my chair from the desk where I do my charting, and I try to make sense of all of today’s stories, each a reminder of how we all crave connection and long to feel understood. I need to process how I reached in to talk about their shame, vulnerabilities, and imperfections, how the therapy fertilized their hearts and minds for new growth. Then, I look back to my hands to reset my system and remember who I am in the room.
Before I was a psychologist sitting in the blue chair, I was a daughter, a sister, a softball player, a Siamese cat mom, a Mario Kart Champion. A writer. A scrappy, sarcastic little fighter. An animal lover. An explorer.
Though I do not talk about the invisible atlas inked upon my skin with patients, I must invoke my humanness. When a patient is grieving, I call upon a memory of sitting in the first row of church at my grandmother’s funeral. Elvis’s voice came ringing through the speakers, singing the gospel song “How Great Thou Art.” My hands covered my face and did not soak up the tears. As the patient raises her face from her hands and sees my own watery eyes, she knows her pain is valid and real. She keeps right on crying because she feels like she has been given permission.
When someone learns of her terminal cancer, I summon my own fear of suffering and dying and picture myself telling my family, how I would look as I lay dying.
“I’m afraid of suffering at the end, too.” I say. “It is terrifying. What are you afraid of?”
Most often, though, I hear about a patient’s shame and imperfections, which is harder than picturing myself dying. It calls for me to embrace my own embarrassments and blemishes. I beckon the shameful memories of using tequila to cope with feeling imperfect, inadequate, unlovable. I acknowledge my drive for people-pleasing to avoid rejection from my peers.
Like my patients, I have yet to escape the inevitable suffering as a side effect of existence. And like many of my patients, I learn and grow and persist, by acknowledging and embracing failures, mistakes, and vulnerability as parts of living. I call upon the directions etched into the lines of my palms that point to the bits of scar tissue where only empathy grows.
Ellie Spencer lives in an old farmhouse with her partner and an array of animal companions. She is a psychologist and an emerging creative nonfiction writer, with equal devotion to both crafts, and has a penchant for sprinkle doughnuts She holds a Ph.D. in psychology and is fascinated by the human condition, which she explores in her writing. Conversation, coffee, and internet cats fuel her writing habits and she indulges whenever she can.
Photo by Mackenzie Martin