Psychotherapy Bulletin

Psychotherapy Bulletin

It was the night before one of my doctoral interviews and the current students of my program had organized a welcome event for us interviewees. Some of the advanced students talked about anxiously awaiting to hear whether they matched for internship the next morning. Doctoral interviews are always scheduled on the same Friday as internship match day. As I took in their excitement, nervousness, and energy, I vividly remember thinking that I was so, so far away from applying myself. I admired that they had been through the doctoral journey I was only trying to begin and had arrived at this final step—internship. I looked at them in awe and looked forward to internship as this final and beautiful destination.

I am writing this as a current intern. Sometimes I am struck by the idea that other students who are just beginning their programs see me as I saw the advanced students that night. Throughout my doctoral program, internship was hailed as this incredible experience, full of uncertainty but also of possibility. Each year, I waited for the email announcing where students would be going. I texted students asking about their transitions to new cities and roles. Students raved about getting to see snow or have their own offices. On social media, I saw pictures of students with their new internship cohorts. Taco Tuesdays. Happy hours. Meet and greets with partners and significant others. Relocated cats and dogs. I admit that I glamorized the internship year. This simultaneous last year of training and first year of professional work. This dual year of student and staff. This year marked the beginning of the end and the end of the beginning. While I heard about the difficulties in moving, separating from loved ones, financial strains, and increased responsibility, there is one thing no one talked about—the other interns.

Looking back I think that I assumed that I would instantly become friends with these two other travelers in this doctoral journey. Where they came from I would not know, but I assumed that we would understand the long road we had taken to be where we were and that we would embrace one another amid the many changes. The pictures on social media only highlighted the budding friendships, sightseeing to landmarks, new cuisines tried, and smiling faces of students joined at this this specific moment in time. I expected instant friendships.

In this field, our work is full of difficult dialogues. We talk to clients about losing loved ones, questioning their sexual orientation, and pain they would never dare share with others. We build rapport and create a strong bond; once built, we often use this foundation to give our clients truthful feedback about themselves that can help them make the changes they want. As teachers, we have difficult discussions with our students about academic dishonesty and being in danger of failing. As social justice advocates, we discuss issues of privilege and oppression, microaggressions, and implicit biases. We talk about having been judged and misunderstood. Hopefully, we acknowledge when we have been the perpetrator. As researchers, we have difficult conversations with our teams surrounding differences in opinions about study designs and manuscript edits. As students, we have difficult dialogues with our advisors about our dissertation progress, or lack thereof. Our work is characterized by the use of honesty, genuine care, and discernment to communicate in ways that are challenging but foundational for advancement.

There are other dialogues, equally difficult, that go undiscussed in our own lives. The internship year is ripe with opportunities for discussions that we are somehow less prepared for and less eager to begin. And yet, these personal discussions are incredibly important. These are conversations with our fellow students—our peers.  

My internship year did not start off as glamorous as I had envisioned. For one, I did not get matched with my first choice. It took time to grieve what I had envisioned and accept the different reality in front of me. I am also spending the year apart from my spouse, which has brought more than its fair share of expected and unexpected consequences. And, I did not make instant friendships with my cohort. Personality differences, as well as differences in training, background, and what chapter of our lives we were in, presented challenges for connection. Unlike the school friendships which I had invested in and committed to cultivating for years, this new cohort felt tentative and sometimes forced. Add to these factors the changes involved in moving, adjusting to new systems, becoming a colleague, meeting a new supervisor, and settling into a new city, and you have grist for difficult dialogues to be had or avoided.

The dynamics of my specific cohort formed early and grew in intensity. Toward the second month of internship, I felt less excited for days filled with training. I found myself tired, defensive, or uncomfortable in interactions with fellow interns. I spent far more time than I would like to admit trying to make sense of it all. Why were we not having weekend bowling tournaments and game nights on the weekdays? Why was this not easy?  

It was a Friday in October. My internship started in August. We were in training. One moment we were engaged in a discussion about the readings; the next moment, I was being confronted by a fellow intern about making a comment that they found dismissive. It hit me like a ton of bricks. Here we were, talking about our dynamic after months of feigned ignorance or intentional avoidance. My heart was racing and I found myself needing to remember to regulate my breath and stay present. I was activated. We were at the end of our seminar and needed to wrap up. When I got back into my office, I burst into tears. Months of talking with clients about their deepest issues—and yet I had not been prepared to breach this very real, very personal conversation. What in my program had prepared me for workplace difficult dialogues full of personality differences and hurt feelings and clashes and unfulfilled expectations and adjusting to change?

To be fair, our training director had laid the groundwork for this type of discussion. The first training seminar of the year was devoted to discussing “transitions,” and we had been given an article to read to prepare us for this discussion: “Transition From Graduate School to Internship: A Potential Crisis” (Solway, 1985). While we did talk about the transitions we had undergone to get to internship, we did not talk about the transition to one another. Maybe we needed time or safety.

At the next seminar, it would have been easy to gloss over what had happened and to chalk it up to a situational misunderstanding that had been resolved. But we all knew it was not resolved and so we did something we ask our clients to do all the time: We were brave. We asked our training director if we could focus on the dynamics between us instead of the planned seminar. With that support, we engaged in the “realest” conversation I have ever had in a professional setting. We talked about expectations, disappointments, jealousies, assumptions, first impressions, and next steps. We listened and shared; apologized and forgave. We cried.

The skills we used were the same skills we draw upon to do our work and yet, we often do not dip into this toolbox to have conversations such as these with peers in a professional setting. We definitely do not do it as trainees in front of a supervisor during an intensely evaluative year. Yet, without the support of our training director, that safe space, the culture of genuineness that is encouraged at my site, and our own willingness to “go there,” we would not have broken down the barriers that existed among us and built what exists now. What now exists is honesty, true respect, kindness, admiration, support, and a willingness to understand one another. We saw each other as fellow travelers because of that conversation. We acknowledged the challenges exacerbated in this internship year that have existed at some level in all of our programs—being evaluated and compared to peers while also trying and needing to connect to them. We realized that we learn about how to have conversations for others’ benefits, but we do not learn about how to have them for ourselves. We do not learn about how hard it is to be vulnerable in a professional setting even when it is necessary for growth, understanding, and progress. Rarely do we get supported to discuss dynamics, especially when they are tense.

Many of us have these conversations in other close relationships. While personal relationships are different from professional ones in important ways, our field has a certain personal-professional overlap that cannot be overlooked. How can we grow as clinicians in the service of helping our clients confront the issues in their lives if we cannot bring ourselves to have those hard conversations at school, at field placement, with our advisors, or on internship?

While not the perfect, romanticized experience that I dreamt about from that first night as an interviewee, I would not trade this experience for anything. I am lucky to be in an environment that encourages my growth as a professional and as a person. I am lucky that my fellow interns were courageous enough to engage in a discussion around interpersonal dynamics and process. With a third of my internship year behind, I already know that this experience with my peers will be one of the lasting blessings for me from this year—a reminder for me to stay honest, humble, and curious. A prompt to lean in, even when it is scary, new, or uncomfortable. As I look back on the years in my doctoral program, I wonder what it would have looked like to have had more of these honest discussions throughout. Students can often have these conversations behind one another’s backs. I have not been above gossiping at times. And yet, what could be gained if we were encouraged to bring things up with one another—to be honest, respectful, and real as we discuss how we are impacted by the other and what we would like to be different? What if we discussed the competition that sometimes exists when students see resources and attention as scarce and when they see others as opponents rather than supports? What would happen if we actually discussed the feelings brewing in our labs, our classes, or our practicum sites?

Faculty, supervisors, and training directors can be such amazing facilitators for this, as they can provide the space and model having difficult but productive conversations with colleagues and students. They can normalize ruptures as part of relationships, and help students focus on how to recognize and repair conflicts; how to achieve healing. A part of me is aware that writing about this topic can be taboo. I wonder how others, especially my colleagues, will perceive my words and my version of events. And yet, I cannot imagine that my experience is unique. Every graduate student has had at least ONE experience of being misunderstood, hurt, angry, or saddened by the actions or words of a peer. Often, we turn to another to help validate and make sense of our experiences. It can take a tremendous amount of courage to talk to that person directly. And yet, there is so much that is lost when we turn away rather than delve into the depths of difficult conversations. I hope that, if nothing else, my words help my peers to recognize when they have the choice. I know that the discussions on internship could have gone another way. The point is not always the result. The point is learning to be genuine, and kind, and attempt to create understanding. This is not to say that the risk of opening up will be rewarded or even make things better—but not talking is another risk and one to which we often default without reflection or intentionality.

This year I will undoubtedly learn more about clinical interventions, brief therapy, outreach, and assessment. Yet the most valuable lessons are experienced. Let us create the space to have these dialogues between ourselves more often. Our growth is related to the growth of our clients, students, mentors, mentees, and other colleagues. We owe them. We owe ourselves.

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Cite This Article

Venieris, P. (2017). An unexpected lesson about difficult dialogues from the internship year. Psychotherapy Bulletin, 52(1), 6-9.

References

Solway, K. S. (1985). Transition from graduate school to internship: A potential crisis. Professional Psychology: Research and Practice, 16(1), 50-54. doi: http://dx.doi.org/10.1037/0735-7028.16.1.50

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