therapy

For my weekly outpatient experience for psychiatry, I spend half a day at the women's clinic at the VA. Given that I will have spent three months at the VA by the time I graduate, I thought it would be nice to interact with part of its population to whom I've never really been exposed. None of my patients on my medicine rotation at the VA were women. I was told that two years ago, the number of female veterans surpassed the number of World War II veterans, and women are currently the fastest growing demographic group in the military.

The sessions are essentially talk therapy, in which I have no training or experience. The psychiatrist often leaves me alone with the patients, which is both something I appreciate and something that terrifies me. Conversation I can do, but conversation in the setting of purpose is different, and I'm not sure it's my role to be attaching "therapeutic" to anything I ask or say. If anything, it's felt like much of third year, where we're given more than we give.

But this past week, I learned that that's the point. The psychiatrist explained to me that these sessions are based on logotherapy, a form of psychotherapy developed by Viktor Frankl. Frankl was a Holocaust survivor and psychiatrist who struggled afterwards to derive meaning in a world that had shown itself capable of such injustice, cruelty and suffering--things that these women know so intimately that it seems to sit in their skin. He believed that meaning existed in every existence, even one of pain, and that tragedy could serve as sources of good. Logotherapy focuses on helping people use their tragedies to form meaning in their lives; not to see the negatives as simply barriers to overcome but as means to create value.

The role of the student in these sessions exemplifies this philosophy. By sharing their stories, the patients give us an inexplicable amount of life. The women are tough with how their experiences have grown into them but are generously open with the layers they've developed. Each sentence, each shape their faces take, give texture such that I feel like I could hold the air between us. And this is a small part in acknowledging that their stories of pain have worth, that what's been taken from them doesn't have to perpetuate loss but can further growth.

At the end of the day I'm very tired, drained from absorbing the sadness of their stories. On some days I choose to sleep or listen to music without doing anything else or shower even if I'd already showered, to concentrate on a sole sensation because this is easier. I don't blame myself or anyone for retreating to this numbness for a short while; it's natural. And I like to think that it eventually leads to working to continue what these women started, not just absorbing their experiences but then using them. It's a weight, but not one to be sucked in or erase. It's something to take time to record, remember, share and integrate into how we process and experience our days. I'm a little tired now, but I think that will all come.