Therapy on Nantucket
Today's Nantucket

Helping People to Help Themselves: Therapy on Nantucket Island

• A Guest Blog Post by Christine E. Smith, LICSW

It seems that everyone wants to know what goes on inside the therapist’s office. People secretly wonder if a session resembles a chapter from Sybil, untamed and insane. Movies, television, and reality series often try to depict the scene, with an awkward resemblance of accuracy, but somehow always missing the mark. Dr. Phil and Dr. Drew attract huge audiences; even I am drawn to the drama as they delve into families’ lives inside the big screen in my living room, rushing through treatment with five commercial interruptions. People nervously crack a joke if I am introduced at a party as a “therapist,” quick to point to their friend standing next to them stating, “This guy really needs your help.”  Men in white coats, Prozac moments, going postal, bi-winning, loony tunes–all flip verbiage said with an uncertain tone by people who secretly wonder if they, too, are a little crazy. Like I am a clairvoyant that can see right through them … “analyze this.” And although I am one of the silliest girls around, I never can quite bring myself to laugh. I guess we doesn’t laugh at our passions. I am intense in a way that seems incompatible with my persona.

I have been in therapy for over thirty years now. On the other side. I do this for a living, everyday, hour after hour. To me, its serious business. Taking a stranger in, staying right there with them, as they take the first incredible step to put a crumbling life back together. It’s hard to describe what happens on the proverbial couch, every person so different, some situations tragic, others not so much.

People do not come to therapy when things are going well. Actually, things are pretty much a disaster. Usually, the person feels as if it’s the end of their world. Hopeless, helpless, in unbearable pain, a bottomless pit . . . the term “depressed” falls short of an adequate description. Discovery of a spouse’s infidelity, one’s own infidelity, a child’s drug addiction, cancer, a friend’s betrayal, alcohol or drug abuse, loss of a job, financial worries, death, an elderly parent, and a hundred other scenarios. They all lead them to me. None of the stories or the feelings are ever quite the same. As a therapist, I spend countless hours sitting with my patients, listening, talking, reflecting, and just being. Sometimes I touch their shoulder, their hand, pass them the box of tissues or make them a cup of tea. In the sanctity of my office, we talk about what it feels like to live, what it would feel like to die, and what it would feel like to make a dartboard out of their nemesis’ face. We talk about who would attend their funeral, who they are going to call today when they need a friend, and why their ex-husband never really looked good with gray hair. I have painted little girls’ nails, put hair spray on a chemo wig, and scrubbed makeup off a gothic teenager. Some bring in their dogs, their kids, their parents, while others have only their plain loneliness to offer. I have sat in silence, in tears or in laughter. It’s all a little crazy. Hour upon hour, as the healing process for those most wounded is indeed, the slowest. It sometimes drags, and it can be dark. A black hole. I can’t leave that space they are in, because I have signed on to hang in with them. A lot of people in their lives have bailed because of it. It’s a fine line between helping someone with toxicity and absorbing it yourself. I think, “Is this person ever going to get better?”

And the answer is, yes, they invariably do. Not with all the king’s horses and all the king’s men, but by the will to survive and an inner strength that therapy helped them access. When the bleakness lifts, it’s as if they bring in a little more light each time they walk into my office and sit on the sofa. I slowly begin to see a twinkle in their eyes, a glow, a spark, although fragile and tenuous, emerging. This, for me, is the magic of therapy. It saves people’s lives. The conversations that we have had, most with no immediate results, begin to add up and overtake the faulty oppressive thoughts that first brought them into my office. They begin to make sense, notice other people, and look forward again. They can now laugh at situations as well as themselves. Truthfully, life can be ridiculous. Tragic, yes, but funny as well. They no longer think about dying, because they have too much living to do. Their need for time with me begins to dwindle, and they are able to transition from twice weekly meetings to every other week, every month, and finally, “I’ll call you if I need you.”  Said hesitantly at first; most are somewhat sad to say goodbye. Occasionally, sometimes years later, I do run into someone at the store or on the street. The most common reaction is a big hug, a smile, and a “great to see you; do you remember me?” Of course I do, kind of. The truth is, no I have never met you as you stand before me today. I can barely remember the shadow of that soul that I first encountered in my office. But it is the same person. Just whole again.

It is amazing. It is invaluable. Dare I say a miracle? It is therapy.

Christine E. Smith, LICSW, is a clinical social worker and consultant in private practice since 1990. She currently works with families in Nantucket, Massachusetts, specializing in marital and couples issues, family stress, struggling teens and child behavioral problems. With her extensive psychiatric experience she is also on-call at the Nantucket Cottage Hospital for psychiatric emergencies. She can be reached through her website, or by phone at 508.680.6974.

Author’s Note: It is important to realize and understand the various options available on Nantucket Island for mental health treatment. There are many clinicians in private practice that each offer their own brand and specialty, often in the peace and warmth of private home offices.  It is personalized and supportive. We are all licensed, credentialed, and experienced enough to fly solo with approval from major health insurances such as Blue Cross/Blue Shield, Harvard Pilgrim, United HealthCare, MassHealth and others. We do not have waiting lists, we return calls and texts almost immediately (yes, our clients have our cell phone numbers), and are available after hours for consults or emergencies, if needed. Most of us do not have any office staff because we choose not to for privacy reasons. We live here, our children go to school or work here, we are vibrant members of the community and we plan to stay here. Some of us specialize in children, others in couples and families, some in substance abuse, and others in biofeedback. And so much more. Above all, we specialize in caring about the island’s people and providing exceptional care. We are personally invested in emotional recovery. There are options.   Most private psychotherapists are listed in the telephone book. Please do not hesitate to reach out directly; we are here for you. You have options.

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