What Connects Us: Vulnerability

In the early days after my accident, whenever someone said they wanted to have lunch or dinner with me, I felt I needed to prepare them by reading down a list of everything I would need and everything that could happen. I would talk about how I would need help getting my coat off and on, that my food would need to be cut, my catheter bag might need to be emptied, that I might feel unwell (a.k.a., have an anxiety attack) and need to leave early. The implied question, at the end of my soliloquy, was, “After hearing how vulnerable and dependent I am, do you still want to go out with me? Do you still want to be my friend? Can you put up with my ‘stuff ’?” It may have seemed silly to run through the logistics like that. But behind it all was the question: “Given what I need, given all the things I can’t do for myself, are you sure you want to be with me?”

Of course I needed their reassurance. After all, I found my dependency and vulnerability so shameful it was almost reprehensible. I couldn’t tolerate my own neediness, so how could they? I felt like such a burden when I had to ask for help getting in and out of a restaurant or having my food cut or my jacket taken off and put on. It was so embarrassing to me, I wanted to scream. In those early years, I felt so full of shame, I felt like people were staring at me, and all I ever wanted to do was go home and hide.

I felt such intense hatred for my own vulnerability that I had aggressive, even violent urges. As we know from the news, shame and humiliation can produce angry and violent reactions. Of course there was no one to be angry with, so I just took my anger out on my broken dependent body. There were times when I was alone and I would pound my legs in anger. Of course I didn’t feel any better, just sad. So very sad, impotent, and alone.

Then there was my therapy practice. Before my accident I read a great deal and even gave talks about the value of the vulnerable therapist. But it’s so easy to talk about the virtues of being vulnerable when you are still under the illusion that you are not vulnerable. What happens when it’s absolutely impossible for a therapist to hide his vulnerability?

This was uncharted territory. I was scared when I first returned to the office and began seeing patients. I recall the first therapy session after my accident, pushing my wheelchair down the hallway on my way to see that first couple. It felt like a life-or-death moment. I was insecure anyway, but what if I were rejected by my patients on top of it all? How would my patients receive me? I was supposed to be caring for them—but here I was, so broken. How could they trust me or feel safe with me?

From the age of twelve, all I wanted to do was be a psychotherapist. I had begun to be pretty good at it. And because that had been the focus of my attention, it was really all I knew how to do for a living. Even after a number of sessions with patients, the feelings of exposed vulnerability and shame did not go away.

One of my early patients coming into my office glanced at my wheelchair and asked, “What kind of chair is that?” I got defensive, fearing that she was judging me. “Why do you want to know?” I asked.

Very casually she replied that her sister was in a wheelchair and mine looked much more sophisticated.

I think you could have heard my sigh throughout the building! So my vulnerability was no big deal to her. My patient had come for therapy, and that’s what she wanted. Little did she know that what just happened was incredibly therapeutic for me. Finally I could relax and we could just be humans in the room.

It was as if she were saying, “I know you are vulnerable and dependent, that’s no big deal. I need your help, let’s get started.” With that came the realization that my relationship with my patients had begun to change. It was the beginning of a process that has represented some of the most valuable learning of my entire life.

Slowly I grew into becoming more comfortable as a vulnerable therapist. Today I experience myself as both vulnerable and comfortable; my patients feel the same about themselves. We begin as kindred spirits—two vulnerable human beings sharing openhearted space, something I consider sacred space. During a session, I frequently have to ask my patients to help me with my beverage, to open a window, or to excuse me when my blood pressure goes up and my catheter has to be checked. I can’t even remember how many times I’ve dropped something on the floor or spilled my beverage on myself. Several times, my leg bag has leaked all over the floor while I was in session. It even happened twice with the same patient! (I thought about terminating her prematurely, thinking she might have bad catheter karma!)

What has happened is that many of my patients feel deeply caring toward me. When things happen to me, their response is about me and not them. They feel deeply when I suffer, and they want to help. They are protective of my health, so they cancel sessions when they have a cold—or what could become a cold—because they don’t want me to catch the bug. When we start a session and they say to me, “How are you?” they mean it. It’s not just the fact of my vulnerability that makes them feel safe, it’s my comfort with my own vulnerability—my gratitude for the life I have—making them feel safe and hopeful. Just as important, my vulnerability has enabled them to feel a kind of compassion that is one of the building blocks for well-being.