This is terrible. The fiddle bow hits my shoulder, and the fiddle player next to me shoots me a critical glance. My flute is out of tune again. As I continue to play, I’m now out of sync with him, and he looks angry. I’m behind the beat – or am I? How is it that I hear him play a note first, and then I play the same note after? Is there a pause there or are we hitting the notes at the same time? I can’t even tell anymore. My thoughts are swirling. He must think I’m crap. Why is this so hard? Everyone must be able to tell that I’m the weak player here. I’m wrecking the music. My fingers on the flute feel like lead. When will this get easier? I’ll never be as good as everyone else.

Welcome to the headspace of a musician (well, me). It’s really hard to enter this space of self-doubt and uncertainty, over and over – on purpose – in order to get better at something. And yet, that’s exactly what some researchers believe is necessary to become an expert. You need to practice and pay purposeful attention to how it’s going – noticing all the wrong notes, the finger fumbling, the way others react to the music. But how much time should you spend practicing, in this dark little room in your head? Ten thousand hours, according to some. Yikes.

Here’s the thing: I love music – playing it, hearing it, sharing it with friends. I love that it is something fleeting and beautiful in which I can participate; I love that it connects me with people who I love. I love that it connects me to a history that I have with friends, within this body of music. The music is almost never perfect. However, quite often, when we are lucky, those little pockets of imperfection and rough edges are filled with spirit, and joy, and groove. These are the anchors that hold me in the practice of music, even when my mind is having a field day about my imperfections as a musician.

Some social scientists believe that becoming an “expert” at something is dependent on whether you have a trait for innate talent in a particular domain (Sternberg, 1996). A trait is a calcified pattern of behavior that endures across time, people, and situations, and is very difficult to change. It’s also what we in the field call a construct, or a made-up thing that we can’t ever really measure, only point at.

Is describing someone’s behavior as a trait useful? In my mind, it’s more helpful to think of behavior as an action or set of actions that one takes, in a given context. If I thought being a good musician was contingent on having talent, I’d probably never play another note. So I choose to believe that if I work hard at it, over time, I’ll get better.

Sometimes we think of psychological difficulties like anxiety, or depression, or anger, more like traits, or something inside us – and that living well means getting rid of this flawed broken piece of us. But what if we approached psychological well-being as something that we can work towards, one small act at a time, over a period of time, across different situations, with different people? What if we practiced well-being?

Psychological Well-Being as Deliberate Practice

Deliberate practice describes an action, or rather, a quality of action: repetition of an act until it works the way you intend it to. It involves willingness to fail – over and over again – until one day you succeed. It involves persistence and the capacity to wait and see if your work will come to fruition. It involves patience and gentleness with yourself, even when there are harsh critics about.

Deliberately practicing music has taught me a great deal about mental health. For example, we might try an exercise or technique our therapists teach us once or twice, then come back and note, it doesn’t work. But, like learning music, like becoming skilled in anything, it takes time. It requires, as Tara Brach has said, learning to stay. What she meant was learning to stay in the present moment – taking that moment in, whether or not it is easy, or it feels good, or it feels bad. It means paying attention to what is happening right now, in this moment, and taking the feedback the world is giving you. It means, as Mary Oliver so beautifully said at age 80, listening to the world, and letting in whatever the world offers up.

Deliberate practice teaches us that paying mindful attention is important. Listen to the difference between a beginner musician and an “expert” – it’s not just technical ability, but it’s something my friend, musician and teacher Mary MacNamara calls flow – it’s an effortlessness, a connectedness with the music, and with other musicians. I believe that flow comes from the deliberate, long-term practice of learning to stay in difficult moments. We can reach this kind of flow in our psychological well-being as well.

Stepping Back from the Critical Voice

We’re so hard on ourselves when we don’t meet our own expectations, let alone the expectations of others. I was working with a young perfectionist some time ago and asked her if she really needed the critical voice in her head in order to succeed. Yes, she nodded vehemently. But I’m not sure we do. I think that’s a story we tell ourselves to avoid falling short. If we step back and pay purposeful attention to our thoughts, we separate ourselves from those thoughts.

Instead of identifying ourselves with our thoughts, we become instead the thinker – the one who is doing the thinking and therefore more than the sum total of our thoughts. This is not unlike the way a piece of music, played with passion, and connection, and flow, is so much more than simply the notes on the page. Practicing that act of stepping back from our critic, practicing kindness while we stay in difficult moments, letting go of our perceived control and simply letting the moment – or the music – wash over us – this is how we learn to listen to the world. One imperfect moment at a time, on purpose.

REFERENCES
Ericsson, K. A., Krampe, R. T., & Tesch-Romer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological Review, 100(3), 363-406.

MacNamara, B. N., Hambrick, D. Z., & Oswald, F. L. (2014). Deliberate practice and performance in music, games, sports, education, and professions: a meta-analysis, Psychological Science, 25(8), 1608-1618.

Sternberg, R. J. (1996). The costs of expertise. In K. A. Ericsson (Ed.), The road to excellence: The acquisition of expert performance in the arts and sciences, sports, and games. Mahwah, NJ: Erlbaum, pp. 347–354.

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DISCLAIMER
The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

ABOUT THE AUTHOR
Lisa W. Coyne, Ph.D. is an Assistant Professor at Harvard Medical School, a Research Associate Professor at Suffolk University, and a clinical psychologist who researches, delivers, and trains acceptance and commitment therapy (ACT) and other evidence-based mindfulness interventions with young people struggling with OCD. She is the founder of the McLean OCD Institute for Children and Adolescents (OCDI Jr.).

This post is part of a series for practicing metal health professionals.

My Clinical Challenge

A while back I found myself in a very stuck place with a client who had made a fair bit of progress, then the therapy seemed to stall. He was insisting that the only cure for his ongoing ailments was to be in a romantic relationship and eventually to get married, and I found myself insisting that there was more to life than romance.

I worked to explore his perspective and invited him to consider mine. We continued to struggle, but I wanted to figure this out. I had a good relationship with this client, who I’ll call Dan. I felt if we could hang in there a resolution would arrive. But a few more sessions passed and we remained at an impasse.

Dan and I spoke about how stuck we were. Each of us held valid ideas and we could both see why the other felt and thought the way they did. But this understanding didn’t change our gridlock. We needed help.

The psychologist consulting with me on a regular basis was already aware of the case and was both thoughtful and concerned about how stuck the client and I seemed to be. She had been working with me to find a path forward.

What happened next in this process reaches beyond a typical supervision, but points squarely to its purpose and value. I should note, that I am therapist who has been in practice for over 20 years. I “know” my way around a therapy room, so to speak. Being open and curious to feedback, being willing to risk not knowing after these many years, saved the therapy with this client.

With the client’s permission, my supervisor attended part of a therapy session and observed me and the client, live, in our frozen exchange. I was whisked back to my graduate school years and found myself appreciating her presence and knowledge. She saw something we had not seen. The interplay between the client and me – romance is the only solution, there is more to being alive than romance – had stolen our hope. Each of us was locked into a position of seeing only our solution as a hopeful one, and in so doing, had taken hope away from the other.

We did as the supervisor suggested and turned back toward hope and possibility, to working on dreams of the future while remaining grounded in the present. We were free, our path forward revealed. We began to focus on what it meant to have hope for a life that was full of meaningful and loving relationships. We explored hope for marriage and children and how one might engage in values linked to these important life areas even if they never came to pass…while holding onto the hope that they would.

My Clinical Wisdom

This was an unusual supervisory experience for me, given the number of years since I had been in graduate training, when live supervision was part of the process. It made me wonder why this kind of supervision stops after graduate training. As I reflect on my years of clinical work, I can think of at least a dozen times I could have benefited from a supervisor’s input.

I find having an experienced clinician pay close attention to my therapeutic work liberating. That’s why I’m a strong advocate for supervisory consultation. However, I’ve observed that once licensed, many clinicians find themselves so busy that supervision gets left behind.

Granted, making time for supervision in an already full schedule is challenging, but participating in supervision and consultation practice is vital if we are to give clients the best of what we have to offer.

One reason I view supervision as essential has to do with human fallibility. I can’t know everything, and I can’t be everything to every client. Sharing my work with another clinician in the service of helping clients simply feels wise.

Another reason is “therapeutic drift”– the slow and unconscious wandering away from theory and science in therapeutic practice. Simply staying in touch with the latest psychological literature is challenging for many clinicians. Supervision and consultation can assist in stemming this drift.

My Clinical Benefits (and hopefully yours)

Supervision is the place where theory meets practice. It provides therapists with the opportunity to sharpen their clinical skills and gain insight into the therapeutic relationship and process. Supervision also provides the opportunity to analyze and conceptualize a case as well as explore the latest developments in the field. It’s a place to reflect on your work, get direction, and look at things from a different perspective. And sharing your therapeutic work and experience with another clinical professional is part of ensuring client safety and progress.

Supervision reminds therapists of the complexity of human experience and keeps us in touch with the social, cultural, and individual differences that make each of our clients unique. Indeed, with respect to my impasse with Dan, supervision helped me to reconnect with his background.

Dan was from a culture where getting married was highly prized and held as a social and personal value. It represented the status of his family and the need for each child in the family to find a worthy partner. Although I had acknowledged these issues early in therapy, I had lost sight of them in my desire to see Dan succeed, marriage or no marriage. My return to acknowledging this important aspect of his background was essential and I was glad to do it. It strengthened our therapeutic bond and grew my compassion for his situation.

Supervision also gives me a place to consider my emotions in therapy and reflect on my values and what it is that I hope for in my work with my clients. It’s a place to invite personal challenge and explore reactions, notice stuck points, and examine whether I am remaining theoretically consistent. It’s a place where I can be vulnerable, something I routinely ask of my clients, thus leveling the playing field (I will not ask the client to do something I’m not willing to do myself).

Ultimately, supervision promotes personal and professional development. It can assist a seasoned therapist in following hope instead of being stuck in a particular view. It’s a collaborative process that is designed to monitor a client’s care and well-being. Surely, there is wisdom and benefit in that.

CONTACT US
If you want additional support from a professional, Lyra can connect you to a therapist. You can get started today if Lyra is offered by your employer.

If you would like to explore joining the Lyra network, learn more about how we work with providers and apply today.

And check in frequently here or follow us on Facebook, LinkedIn, and Twitter for more insights into optimal well-being.

DISCLAIMER
The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

ABOUT THE AUTHOR
Robyn D. Walser, Ph.D. is co-author of Learning ACT: An Acceptance and Commitment Therapy Skills Training Manual for Therapists and The Mindful Couple: How Acceptance and Mindfulness Can Lead You to the Love You Want. She has also co-authored two additional books on ACT focused on trauma and spirituality. She currently serves as Co-Director of the Bay Area Trauma Recovery Center and Director of TL Consultation Services. She maintains an international training, consulting, and therapy practice.