What Is Your Therapist Really Thinking?

16 Dec What Is Your Therapist Really Thinking?

Editor’s Note: Dr. Paul Hokemeyer is a part-time Telluride local and nationally recognized expert on Eastern philosophies, relationships, and emotional healing. A Licensed Marriage and Family Therapist, he holds a PhD in psychology, as well as a doctorate in the law. He is also contributes to many prestigious news outlets, including The New York Times, CNN, and The Wall Street Journal. From time to time Dr. Paul created a column, Shrink Rap, for Telluride Inside.. and Out. We curated this fascinating interview on a topic all too easy to loose sleep over: “What Is Your Therapist Really Thinking?” The story was written by Elizabeth Bernstein and appeared in the Wall Street Journal on Monday, December 14, 2015.

Dr. Paul Hokemeyer, a psychotherapist, says ‘a large part of the value of psychotherapy comes from the thoughts that go through the patient’s mind in anticipation of the session.’ ENLARGE
Dr. Paul Hokemeyer, a psychotherapist, says ‘a large part of the value of psychotherapy comes from the thoughts that go through the patient’s mind in anticipation of the session.’ Photo: Nick Dabas, courtesy The Wall Street Journal.

Ever wonder what your therapist is thinking?

Paul Hokemeyer, a psychotherapist and licensed marriage and family therapist, discussed what goes through the mind of someone paid to help people with their most private problems. Dr. Hokemeyer specializes in relationships and treats people for issues such as anxiety, depression, narcissism, addiction and infidelity. He also serves as a senior clinical fellow for the Caron Treatment Centers, an inpatient facility in Pennsylvania and Florida.

Dr. Hokemeyer was a corporate bankruptcy lawyer for seven years before getting his Ph.D. in psychology. He uses several approaches in his practice including cognitive behavioral and dialectal therapies. He has private practices in New York and Telluride, Colo., a research office in Malibu, Calif., and also Skypes with patients. Here are edited excerpts from an interview with Dr. Hokemeyer.

WSJ: How long do you typically see someone?

Dr. Hokemeyer: One to two years. I don’t believe psychotherapy should be a lifelong endeavor.

How has your therapy style evolved?

When I first started, I was terrified of making a mistake and I made patients nervous. When I was in training a woman came to see me to deal with an abusive relationship. She sat terrified in a chair across from me, while I forced her to answer a series of rote questions. I should have thrown the questionnaire out and sat with her in the weight of her pain and talked. But I didn’t, and she never came back. I still get sad when I think about her, and I think about her often.

I’ve come to see psychotherapy as an art grounded in science. The art consists of connecting with a patient where he or she is, then using solid evidentiary methodologies and interventions to move the patient toward a reparative experience.

My brand of psychotherapy operates on a number of levels. The first requires me to be hyper-aware of the physical and emotional feelings the patient brings up in me. How do I feel in their presence? Am I anxious, bored, entertained, manipulated?

Then I focus on what they are saying, verbally and non-verbally. Do I feel the heaviness that comes from depression, yet the patient is saying everything is fine or trying to distract me with superficial details?

Once I have the data gleaned from our personal connection, I formulate clinical interventions.

What do you write down about a patient?

I find note taking during the session by a therapist to be rude. The goal is to be fully present for the patient. I jot down notes after the patient leaves to remind me of issues to discuss and insights made by the patient.

If the patient is being treated for depression and made his way out into the yard the past weekend to garden I would write that down and encourage the patient to continue. My files contain basic contact information, releases, an assortment of legally required forms and brief notes that indicate where we need to go and how we are doing.

What do you hope a patient will do between sessions?…

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