Inside the therapy room | with Dr. Claire Ciliotta

(upbeat music) - Hi, everyone. My name is Maya and welcome to PsychMike, the podcast that explores the lives and career paths of industry leaders who use psychology to make an impact in the world. As some of you may know, PsychMike started out as a live event series. And if you don't know what I'm talking about, go listen to the episode titled PsychMike Origin Story so you can learn all about that. But this week, I'm highlighting very special audio from one of PsychMike's live events from last year with Dr. Claire Siliata. Claire is a therapist and she owns a private practice. For me and many of the attendees of this event, Claire's talk felt really profound and real. I mean, how often do you get to hear an experienced therapist talk so honestly about what it's like to do this work and to be in the room with a patient? If you're considering a path in therapy, you probably have many of the questions that the audience posed to her, especially as they pertain to the emotional burden of this work and burnout and things like that. And Claire's insights are raw and personal. Claire didn't become a full-time therapist until she was around 37 though. Before this, after college, she worked for Pan American Airlines as a flight attendant where she got to travel all over the world for free for several years and she speaks very highly about this time of her life. She also pursued her masters in learning disabilities and reading. She worked at a residence home for single mothers in Manhattan at a group home for children called sheltering arms and later as the director of a child life program at Bellevue Hospital in New York City, which helped children facing illness to cope with their situations. Through all of these experiences, she was able to learn about what she calls the life of the mind and it absolutely grabbed her. She later pursued her PhD in applied psychology at NYU so that she could get licensed and practice as a therapist. In this live event, we talked about what it means to be a witness. What Claire learned about life and human nature if you're working with children who are facing their mortality? Why Claire listens to what is not being said in the therapy room as much as what is? How to not carry things home with you? And so, so much more. I hope you enjoyed this episode as much as I did. Claire, you've had a diverse and varied career and therapy was kind of an afterthought for you. So, but you still stand by all the experiences you had before that brought you to where you are today. You worked at an airline. You worked at a residence for single moms in Manhattan. You worked at a group home for children and even directed your own program at Bellevue Hospital. And I'm curious, we could spend forever on these experiences since they're also rich, but I am wondering which one of them stands out as the most salient and why and how did it shape you? Those previous experiences before therapy. - Well, I would have to say that there were the two that most informed me was working for Pan Am for the airlines because I got to meet people from all around the world. I got to travel all around the world. And I really got to understand that what you think is way more important than what it's. And that really struck me that what your culture teaches you, well, that's what you believe. And out of that belief, all your actions come. And I find that very informative when I'm doing treatment. It's to find out what the person believes. - Can you talk a little more about how traveling gives that to you? - Well, when you travel, you're at least when I travel, I don't go to Marriott hotels. I stayed in local places and what, I guess the equivalent of Airbnb is now. And I would always make the point to go to the marketplace, to talk to as many local people, and to have as many local experiences like they have. And that way I would learn about the customs and cultures of the people. And that's when I began to realize that I was very American centered. And the rest of the world wasn't like us at all. And so I was very curious about how that worked for everybody. - Can you tell us, that's made you a better clinician? - Way better, way better to get out of the head of, this is all that there is. And then when I worked at Bellevue in Patient Pediatrics and Randall Child Life Program, I learned a lot about grief and loss. And I learned it from children, not just their parents, but from the children themselves. And that was extraordinary to me, that I was privileged to be with children when they were ill, when they were suffering, when they were dying. It gave me, it taught me humility of which I did not have a lot prior to that. And it really taught me how to be a witness that being a witness is such an important part of being a therapist. - Why? - Because when a patient is in pain and suffering, you don't have a magic wand. And words don't do it. But if you can stay with the patient and not try to fix it, to witness it, to say I am here, I see you are suffering. Then something can happen for that patient. They can tolerate it better. They can begin to wrestle with it in a very different way. - You mentioned that that's actually the hardest part about being a therapist oftentimes. It's kind of just shut up and like be there. - Yeah. - What is so powerful about that for a patient? - If I'm talking that I'm imposing my sense feeling whatever on an event that is happening to that person, not to me. So if I'm chatting away or trying to tell them it's gonna get better, I never say that. Because in this moment, it's not better. So if I can shut up and just allow the person to be where they are. And at the same time, let them know that I'm not observing them. I'm witnessing, which is different. - I wanna get back into this kind of experience of being in the therapy room a bit later, but I wanna first go back to your experience running the program at Belle of You. I'm not sure everybody's familiar with your role there, but I think if you could elaborate a little on that and give us some experiences from that and wanna give you some experience. - My friend Margaret Stevens, as part of her Master's at Bank Street, decided to start a child life program at Bellevue inpatient pediatrics. Now, I had spent a couple of months working in the psych ward, but she hired me to run the program. And the program had not just playrooms, but we had people working with neonatal units all around the floor, from infants to toddlers to middle school. I not only ran the whole program, I was in charge of the adolescent unit because I love that adolescence. And what we did, one of the people who worked with us, Kamako was her last name. She decided that children were being left in the hallways pre-surgery. They were given pre-op meds that were supposed to knock them out, but then they were in the hallways of the OR for hours. So the pre-op meds would wear off. They were there alone. There were bodies all around them, 'cause, you know, they're moving patients in and out. And she lied and she told the head nurse that we had permission to go with the children. And we started this whole program where we went with every child who was operated on, stayed with them in the OR through the surgery, we held their hand. How do we know that it was amazingly effective? Because the children who had no one go with them, drew the doctors as these monsters and themselves is very, very teeny on the table. When we accompanied them, everybody was normal size. And there was always us holding their hand. You had them draw absolutely for an after. Absolutely. Wow, what a creative approach. It was amazing. The people who worked for me were extraordinary men and women who really, really thought children. I worked, I'll never forget the first time, at hospitals, there's black humor, incredible. They think things are really funny, that probably in the real world aren't, but that's what you have to do when you're there. So anyhow, they assigned me this very, very mentally deficient young woman. She was huge and they all knew her. She came into the hospital many times and they said, oh, Claire, I wanna see you work with her. She was like 15 years old. Well, the first thing she did was strip. She took all her clothes off her in the middle of the hallway. So I took her into the playroom. I locked the door and I gave her toilet paper. And I ran the toilet paper around her. I dressed her in toilet paper and she was in heaven. And the staff said that I would be a good person to work with that and that was another wonderful story. I mean, she was just, why, why toilet paper? Well, because there wasn't anything else. I didn't have sheets. I was in a playroom not where I could get sheets, but I did have toilet paper. And I thought, I don't know that she really wants to be naked. She just didn't want those clothes off. So I thought, well, let me try it. So she held one end of the toilet paper and I ran around her and I wrapped her in toilet paper. And she thought it was great. And the staff decided that I passed the test, you know? But I think that another incredible, my last six months there, I worked primarily with children who had C3 and C4 neck injuries and would never walk or move. The most I could do is move their shoulders. And that was extraordinarily powerful. I also worked with children who were not going to survive. And so I was privileged to work with children who were dying and who knew they were dying. There was a young boy from Vietnam and I would spend hours with them, hours before an hour here in the morning and hour in the afternoon and hour at night. And he said to me, he said, my heart cannot bear this. My heart needs to stop. I need to go home and he died that night. Now there was another girl who had liver issues and in no way she should have been alive. However, she was from the Bronx. She had a disco dress that her mother brought in and every day when I went to visit her, I would have to take the dress out and show it to her. And she said to me and she was yellow, she was like, everybody thought, well, maybe tonight, maybe tonight, right? And she said, I'm not dying. I'm going to wear my dress. And I want to tell you that she did not die. And she left the hospital. So I learned a lot about the difference in how you approach something. And the difference in spirit of people and not to judge them. Some people can, some people can. Some people give up, some people don't. It is what it is. And again, I learned how to be a witness. So I know a big tenet of therapy is to withhold judgment. And that's a powerful thing for many patients. How do you do that? Like, how do you sit there with a patient and maybe not judge them, but maybe you are judging them? Maybe on the inside, you are judging them, but you suspend it in your conversations. Well, sometimes I say to a patient, you do get how crazy that is, right? And they say, yeah, I said, OK, I just wanted to make sure. Or I often say to a patient, actually, that happened earlier this week. I said to him, she said, why do I keep doing the same thing over and over and over and over again? And I said, stop. Comes metaphorically, stand next to me. And let's the two of us be curious. That's a really good question. I don't want you to judge. I want you to be curious with me. Why might you be doing the same thing that is so painful over and over again? Ask to be an explanation. Let's try to figure that out instead of flipping your head for a wall. Now, I'm not saying I did this in the beginning when I was a young therapist. But I will say that I find two things that it is really important not to judge but to be curious, to try to figure it out, and to stand up for the treatment. And what I tell patients all the time is that it is an act of courage that brings you into this room because we are going to have to go to some really dark places, really hard places. Now, I'm going to go with you. And we have to go there. There's no vividly, bubbly booth. So those two things, to not judge, to be the patient's witness, and to say the truth, which is, their face hard. If you're really going to do the work, it's a little painful work. So when you're sitting there with a patient, and I think I asked you this when we spoke one-on-one, to what extent does the empirical research, the evidence behind certain therapies, play into your work, or versus intuition, like your own gut feeling? OK, so I should tell the people who are listening. I'm 75. I believe in intuition. I believe in my gut. I've done the reading. And I've filed through some of the densest material of these very famous analysts and psychoanalysts and psychologists like shoveling, so many words. And I think that it's a defense many times against being able to just stay in the room with the patient. I trust my gut. I think maybe once in close to 40 years has it been off. Even when I thought when I'm feeling is crazy, I trust it, and it turns out not to be crazy. The therapy room becomes altered space. It is sacred space. If you took the words that are said in therapy and put them outside, people would look at you and you said, what is that crazy? You said that, what does that mean? But in the room, something happens. We are in altered time and space. And that is all about intuition, non-theory. You should tell that to my professors. I know, sorry. And I mean, I've never been a therapist, but I imagine it's really hard to take into account all this research and all these books and all these accounts from different-- when you're in there, you're in there, right? Well, that's it. It's-- I'm trying to think of a good word for it. It's not that I don't read. I do. As a matter of fact, I'm really excited about this new article. I just read that says that we are not moving towards homeostasis. The brain doesn't do that. The brain moves towards allostasis. And I thought, you read that. That explains so much about why people do the same shitty things over and over again. Why we appear to be so self-destructive, because the brain goes to what it knows, not happiness, by the way. People avoid happiness like the play. Well, because it's not an everyday occurrence, I see little ones, little kids, under two, who should be happy, but they've already been contaminated by the culture, so to speak. And are not so happy. That's a crime from my perspective. So I think that the function of therapy, for it said it well, by the way, I happen to like a lot of what he said. He said that the talking here was never about making anybody happy. It was to teach you what your neuroses are. Then to figure out if you want to change any of them. Then to figure out if those particular ones can be changed. And if they can't, he would teach you how to live with them. Now, to me, that's right. That's exactly right. I am curious-- I'll ask you this way. Do you think that you could work with any clients that came into your room? No. No. What? I cannot work with a drug addict, an active drug addict, or anyone who has that kind of serious addiction, because I am not good at figuring out that they're live. I tend to assume that people are going to speak the truth. But addiction has a particular phenomenon associated with it, which is that the person can't admit that they're addicted. And so they lie. And those patients, I don't feel that I can work very well with. I also tend not to take on severely eating disordered patients, more not because I can't help them, but because I can't bear the thought that they could die on my watch. Severely eating disordered is what I'm saying. It's interesting because you worked with dying children earlier in your career. So what makes a good match? Well, I think it has to go both ways. You know, after the first session, I say to the patient, you know, the home think about whether you think I'm the right therapist for you. And I'm going to think about whether I believe I can be helpful to you. And then we'll talk. I think it's very, very important that there be some kind of synchronicity. And that the patient has the feeling that I'm on their side that I'm, you know, I'm going to be there. I think that's what makes a good. I mean, I work with a lot of kids over the years. I work with a lot of adolescents and boys who don't talk a lot in the beginning. And yet, because I so enjoy that age group, I do very well with them. Why do you enjoy working with adolescents? I think probably because half of me isn't adolescent still, but you never know. I might have grown up possible. I enjoy them because they are able to be curious way more easily than an adult. And to get an adult to be curious is like a pulling teeth because they're so filled with judgment. But adolescents really want to understand they're not so cemented into belief systems. I say to them all the time that thoughts come up, you know, out of our unconscious, they're thoughts. They're neither good, they're bad, up, down, whatever. We grab a thought like I'm ugly. And then we paint ourselves with it, put it on tight, and then everything we do after that comes through that thought. And that thought was just a thought. If we had just said, oh, there it comes again, and let it go, another thought would have come up. And adolescents are able much easier than adults to do that, to see that, and to really push the thoughts through. So Claire, a lot of these-- the people in the audience are young and just starting their career. Many of them are interested in pursuing a clinical route. Some maybe are not. What advice do you have to people who are entering-- or who want to enter the fields when you wish you would have known anything that you can offer? Well, the first thing I would say is, be curious about everything. Travel. Get outside of your box, whatever your box is. See what the rest of the world is thinking, doing, feeling. Have lots of experiences. That's really, really important. And then I will tell you that I have never, ever been bored. Not once. You're not lying? No, I'm not lying. If I'm with the patient and I'm falling asleep, the first thing I think is, why do they want to put me to sleep? Because I didn't walk in the room tired. If I'm tired, I tell the patient, and I say, look, you may get the idea that I'm sleepy today. I am. I didn't get a good night's sleep last night. And then we talk about that. What it feels like to not have a good night's sleep. Do they ever have that? And we go off. But if I walk in the room, and I'm ready to work, and I find myself, quickly like that, something's happened. Something's happened. And that patient does not want me to be awake. Does that relate to what you told me about how you listen to what's not being said? Uh-huh. Exactly. Or so then what is being said? Exactly. That's the other really important piece is people will talk. It's what they're not saying that you need to be curious about. So I'll give you an example. I had a man come to see me a number of years ago. Terrible divorce, just a mess. And he had very bad relationships with his children. And I said to him, I said, are you sure you've got a divorce because you and your ex are still fighting with no your marriage, right? So what he didn't tell me is what happened to cause the divorce that affected the children. Because the children wanted nothing to do with it. And all he could talk about was how horrible his ex was and how he was trying all these things to do with the kids. And one day I just said to him, I said, well, you know, I'm here and all that. But why do you think it is your kids so why I think to do with you? That's personal to you. So it's what's not being said. And it takes a while to hear that. Because at least in the beginning, I was trying to be such a good therapist. You know, I was listening to everything they were saying that I couldn't even hear what they were saying. And then finally I began to realize that it's what they're not saying that I need to kind of ask about it. We didn't talk much about your experience getting masters as well in learning disabilities and reading, which is, I mean, pretty different from what you ended up doing. Can you just touch on that just a little bit? What was so interesting to you about learning disabilities? I know you said you were fascinated by it. I what? Yeah, so can you talk about that? Well, I've been, I'd worked for the airlines for seven years. I decided I wasn't enough. And I wanted to go back to school. And when I was 13, I wrote, I read a book that was in the adult section, I had to sneak in for the 50-minute hour, 50-minute hour. And it was a book of stories of analysis. And that really fascinated me. But at this point in time, I was thinking more that I really wanted to work with adolescents and younger kids. And I thought, well, reading was so important to me growing up. I read when I was very young. When I was reading a book, I was in the book. This reality didn't matter. Reading was like an opening to the world for me. And so these children who struggled with reading, I was trying to figure out, well, how can I help them? What can I do? So I decided to get a master's at NYU and learning disabilities and reading. And I did the masters. And what I learned was that it was way more complicated than I thought. Once again, I was only looking at the child before I got involved in the study of this. And then I found out, well, wow, it's the whole family. And in a lot of families, children don't read because it's the only way-- I hope everybody does find my French-- that they can say fuck you to very controlling parents. And that was a big shock for me. I thought, whoa, look at that. And then I learned that there were kids who couldn't read because they were dyslexic. And I had no idea what that was back in those days. A lot of people didn't know all about it. So that fascinated me. Well, how does the brain work? What do you mean the brain doesn't see it that way? How does all that work? So I really, really threw myself into it with a fashion. After I got my license, and I thought, well, maybe I'll go into teaching, I kept coming back to-- it's more complicated. Things are more complicated. And what is the emotional life of these children like? And how can I affect their emotional well-being? And that moved me into applied to the clinical program at NYU. They put me on a wait list. I didn't want to wait. So I found out that applied psych, which back in the day was called general ed psych, would allow me to sit for the licensing exam. And that was really all I cared about. So I did that. And I went that route. In the meantime, I was part of-- I was in my own treatment, which is another thing. I just want to say that. If you want to be a therapist, you have to commit to your own treatment. This insanity of doing therapy without being in treatment yourself, without finding out who you really are, and without learning about what happens to you in emotional situations is, to me, total insanity. You need to be in therapy. You then need to be in some kind of supervision group. And to this day, I am still in a supervision group. Appears supervision group we meet every other week, because sometimes when you're working with a patient, you are blind. And you're blind because it's too familiar to whatever's going on inside you. So then when you're in the therapy group or the supervision group, just last week, I said to my colleagues, I said, you know, I'm missing something here. I don't know what it is. And they said, oh, well, what do you think about this? And they said it, and I immediately understood it. And then I could go back and help that patient even more. So I just wanted to say that. So then once I got involved in therapy, I really have been happy ever since. Yeah. How did you develop your style? I don't know. I think my colleagues laugh, and they say, oh, she's going to do a clear, because I think it is a part of my personality that was always there, which is to be very straight and very direct. And growing up, as I did in the 50s and 60s, women were not supposed to be straight, and they were never supposed to be direct. And so I wasn't very good at being indirect and big. And I decided that it was useful in therapy, because why not? So I often say to a patient, I'm going to tell you what I'm thinking and feeling, see what you think. And that leads us down amazing paths. Sometimes they tell me I'm full of shit. It's OK. I say, oh, OK. Why? And then again, it puts me in the room with them as opposed to, so how do you feel about that? And then not saying anything. That's my style. I want to get into audience Q&A. We have some great questions. Sure. Meshna is loving this. Let's hear her question. Thank you so much for being here today. It's just everything that I needed after this crazy past couple of weeks. Something that I've been debating is whether I want to go into clinical psychology or more research. And I find that sometimes I'm unsure about whether I want to go into research, because I'm too scared to go into therapy. This is like secondary trauma. And I know I want to do all these big things, but I'm going to be no help to someone if I'm crying about their trauma and then unable to help them. So I'm just wondering if I need to-- if you would advise me to kind of work on my strengths and do what's going to be most helpful, or if this is something that can be learned. Well, first of all, I want to say to you, I have often cried with patients. When someone is telling you that something terrible has happened to them, it's perfectly human to cry with them. I've never not done that. You know, you don't give anything away if you empathize in that way with a person's pain. But I think for you, it sounds to me like you might want to do both. OK, you might want to get-- start to do research. You might want to teach, and have a small private practice on the side. What I would say to you is find out who you can't work with, and find out who you do best with, and then do that. You don't need-- I know people who see 30 patients a week that's insane to me, because the emotional energy that it takes, 20, shouldn't do more than 20, and that's the top of the number. But I certainly could see you being able to do both. I don't think you have to necessarily choose one or the other. Does that help? I wish you were taking patients. Maya just informed me that you were no longer taking patients. Ask for the same thing. But wait till COVID's over. Right now, I can't. But who knows, you never know. Thank you. Thank you so much. You're very welcome. And if any of you have any questions about professional, where to go, what you want to do, how to do it, please contact Maya. I'll talk to you anytime. I'll give you guys for fun. Thank you, Claire. That's very kind. You're welcome. Apologies for the interruption. This is Maya later editing. And because the next question was a little bit more personal, I'm going to overdub my voice and ask it for this person so that their identity remains anonymous. So the next person said, thank you so much. I have to echo what the last person just said. I think this was really incredible to hear this and to hear your thoughts. I'm currently working at an inpatient mental health facility working with adolescents. So it's a lot to handle, and it's a lot to take home. And I'm finding myself sometimes taking it home with me, sometimes not feeling guilty either way. And I'm having a hard time preventing burnout and kind of not taking all that in and letting it sit with me and just kind of leaving it at a place where it feels like there's so much pain and so much misery, both at work and out of work. And so I'm wondering if you ever ran into an issue like that in your personal life and how you handled it? Yeah, I really do hear what you're saying. Is it a hospital ward? What's the-- She answered, we take kids for 11 days who aren't severe enough to go to the hospital, basically. OK, so I want you to take a few breaths. You 11 days, you're not going to do anything. What you're going to do or try to do is be a model for them, OK? Mary Oliver-- and I love her-- she's a great poet. She says that the only life you can ever save is your own. And if you do it well, then you become a beacon and a model for others who are struggling. So the most important thing that you can do for yourself is to find a way to leave it there when you walk out the door. Because what you need to do is refill. You need to gas up. You need to do things, blow bubbles. Look at the stars. Go out and look at the moons, your binoculars. Whatever you need to do to remind yourself that your job is to fill up with life and then be there with them. And tell them, I saw the moon last night. Now, I spent $100, but the things that you do that soothe you. Most adolescents today don't know how to self-soothe. And so their pain is extraordinary. So one of the things that you'll be able to do as you practice it is to share with them things that you do when you're feeling like crap that make you feel a little better. And ask them, do they have anything like that, right? And then you say to yourself, that's what I can give them in 11 fucking days, OK? Not much more than that. What's someone in there? It will be more than enough that you've done that, OK? Because the world right now out there, it's brutal. It's brutal. So I hear that. So find the things. OK, so there's three things that I say all the time, OK? Everything changes. Everything is connected. Pay attention. OK, so if you, if you change, if you will, if you fill yourself up with something good, then that connection goes out to the people you're with. And if you pay attention, you may notice that somebody gets helped a little bit just by that. Nobody, Bobbie Booth, small, tiny things. And feed yourself, Haley. You're doing hard work, and the world out there is hard. So make sure you nurture yourself for your own good enough mother, bubble baths, cream on your hands. Whatever it takes to make you feel cared for, you can't do this. I don't work without that. Again, I'm going to read off the next question too. She says, thank you so much for this. This has been, as everyone has said, medicinal for me. But my question is also very similar to the last. Because I'm hoping to get into therapy with children and adolescents, actually. And you talk about connecting with them and kind of getting below the surface to the nonverbal signs, really absorbing what they're giving you with your whole self. So that said, how do you do that without-- I know you said you cry with your patients, but how do you prevent yourself from becoming overwhelmed with the emotion of it when you can clearly feel it when children and adolescents express it more openly than adults? And at some point, you're going to take that on. Well, I think that working with children and adolescents is way more difficult than working with adults. I really do. For this very reason. Because you can feel their pain is so much closer to the surface. Yes. Right? I believe that the most important thing is to acknowledge that you see that. And when you do that, when you see, I really see how much you're suffering. What happens is the patient feels seen and you have given yourself a layer of protection because you are seeing, not absorbing. And that's the trick about witnessing. To witness isn't to absorb. To witness is, I really-- not enough to get threatened about this-- is to really be in the room and not be overwhelmed by the person's pain. It's a very-- do not beat yourself up that you're not doing this today. It takes many years. And it gets easier over time because you can see that when you don't take it in, the patient improves. Because otherwise, you're both in the shitter together. And how helpful is that? It's not. Right? With children, that's where I will try not to cry with little kids, with young kids. At a lesson, I cry. I've said I'm so sorry that that happened to you. That sounds brutal or whatever. And then I'll say, can you tell me more? Because the instinct is to say I've had enough. The self-preservation instinct in hospitals years ago, the people with the most pain were put all the way down the hall away from the nurse's station because the nurse's station couldn't bear it. When I worked at Bellevue, the sickle cell kids who were in the most incredible pain were put at the end of the hallway. So nobody had to listen to them scream, because they couldn't alleviate their pain, right? Well, now the most ill, the most sick, the most in pain are put directly across from the nurse's station because the instinct is to push them away. With children in adolescence, when they're telling you something that is heartbreaking, the instinct is to move on, you know? And so it's really important to say, can you tell me more about that? I would really like to hear, if you can, if it's possible. And if they say, I can't now say, OK, well, if you have any other thoughts or feelings or any dreams, I would very much like to hear that. Let me just stay with that. And you don't try not to take it in because that doesn't help. It doesn't help you, and it doesn't help that. We have one last question, and it's from Mahima again. I wanted to ask about your personal practice of physical touch with patients. I know that in more recent years, people are kind of more careful with hugging, getting close to. And for me, that's a big part of my healing process is being held or being touched. And it almost feels sterile when I don't get that. And I'm just wondering what your thoughts are about it. It's a really interesting question, Mahima. It took me a lot of years before I would let a patient hug me or I would hug a patient. There's some-- I'm going to put it, OK. If I'm truly present in the room, they feel that I'm hugging them. It's the best way I can put it. They can feel it now on the phone. And sometimes I say when people are really despairing, I'm giving you a very large hug right now. Because I think that when you are really truly present and available to that patient, they feel hugged or help. I was trained pretty much never to allow physical touch, especially with children and adolescents, because you don't know where that's going to go or how it's going to be interpreted. Now, I do long-term treatment. I have one patient that I've seen on and off for 30 years. Now, if she needs a hug, I give her a hug. She has suffered from excruciating chemical depression on top of the abuse. So yeah, I can give her a hug. But I think that that's up to you to find a therapist that makes you feel embraced. That's important. If you don't get that feeling, you're with the wrong therapist for you. You're very right. OK. Thank you, Claire. That's it for tonight. This has been really awesome, especially right now. A lot of us are under a lot of stress, so this has been kind of therapeutic, at least for me. There's a one last thing to all of you. I want to say to all of you that this profession is extraordinary. I think that if this were practiced in the middle ages, they'd burn us all as witches. But it is an incredibly important profession to do this work. So I want you to know that I admire all of you for even thinking about it. And as I said, you have my number. If you have any questions about the professional path of this in the different ways you can practice and what kind of licenses you need, I'm happy to answer any of those questions. Thank you so much for supporting PsychMike and listening to this week's episode. If you're left wanting more from PsychMike, like career tips, job opportunities, grad school resources, and advice, sign up for the newsletter on PsychMike.com where you can expect to get those straight to your inbox. Follow Psych_Mike on Instagram so that you can keep engaging with this platform and submit questions for future speakers. Hearing your questions is the single best way for me to ensure that these episodes are valuable and addressing your curiosities. Thank you so much for tuning in, and I seriously can't wait to catch you next week.