Therapy News

I love my sister. But also, I can’t stand her. She gets under my skin faster than anyone else in my life. She’s selfish, she’s dramatic and she has to be right about everything. Very on brand for a firstborn older sister. Out of sibling fairness, I should note that Samantha would say the exact same things about me. She thinks I’m incredibly self-absorbed, bordering on true narcissism. While she is 100% incorrect, I can see how she’d get there. After all, we are separated by only three years, have completely different personalities and almost opposite relationships with our parents. I am the annoying little brother that disagrees with her just to be contrary and she is the over-the-top big sister that can never suck enough attention out of the room even though she will die trying at every opportunity she gets.

So my sister (or me, to be honest) ruining Thanksgiving, or any other family gathering, isn’t much of a surprise. Put us in a room together for longer than 10 minutes and we’ve already secretly plotted how to tear each other down and passive aggressively shame the other in front of the rest of the family. But this year was a little different. One, because the pandemic forced most of the family to celebrate the holiday separately. And two, because something my sister said, which started the swift descent of our family Zoom into chaos, got me thinking about how I’ll react if my therapy clients plan to behave as selfishly as my sister.

As an almost 40-year-old who has practiced therapy for over 15 years, I fall right between a generational divide in the mental health community. I am vastly over simplifying things here but for the sake of brevity (too late), there is an old guard generation that believes therapists should be blank slates and not self-disclose or impart their own values or beliefs on clients at almost all costs. That you should treat the client for what they have come in for and not try to influence them otherwise. On the flip side, there is a younger and more open generation of therapists that support being more transparent about their beliefs and values. They are open with clients about social and racial justice issues and challenge their clients if, for example, they are being sexist even though they came in to talk about social anxiety issues. Again, for me to simply cut the mental health community in half only by age is unfair. There are a ton of factors that include culture, geography, training, personal beliefs and more.

One of the reasons I see this divide as a generational issue is because of my own relationship with my sister that I project on to the therapist community. I was born in 1980 and she was born in 1977. Depending on what generational math you use my sister is a baby Gen X’er and I’m an elder Millennial. Mostly likely we are both Xenials, a mix of Gen X and Millennial, but to identify as the same generation we’d have to acknowledge that we are similar in how we experience the world and that just can’t happen. We’d never allow it. It’s important we have as many differences as possible so that we don’t accidentally agree on anything of substance.

Anyway, I’m a therapist that is open about their values and challenges clients on their impact on society and the wider community in which they live. In fact, I made a whole therapist directory, TherapyDen, that holds those values and pushes therapists to be more transparent about their personal beliefs. And on Thanksgiving, when my sister asked the family who was going to get a COVID-19 vaccine, I couldn’t stop myself from pouncing on her when she proudly stated she wouldn’t get one. I’ll tell you her reasons in a minute. But after reflecting on the back and forth I had with her, it got me thinking. How do I want to react to my clients if they too don’t want to get the vaccine? And what’s my role as a therapist and healthcare worker when it comes to getting the vaccine?

I heard from my dad, who by the way is an unreliable family reporter, but we’ll take his word for it this time around, that Samantha was simply trying to start an open dialogue about the pros and cons of taking the vaccine. I call bullshit because when I asked her if she was going to take it she repeatedly said that she doesn’t care about getting it and if anyone is worried about contracting the illness then they should be the one to get it. When I asked if she was okay with passing it to our mother, who is almost 70 and sees Samantha's family almost every day, she said, “If mom is worried about getting Covid then she should get the vaccine.” Which sure, I get that reasoning. It’s very simple. Samantha thinks she’ll be fine as a 43-year-old healthy person, so why should she need to get it? All the people that are vulnerable or scared of getting Covid should take the vaccine.

I was triggered and it was almost impossible to hide my surprise and disbelief. Even for a selfish older sister, I was thrown off when she said she wouldn’t take the vaccine. And then something wonderful happened. Kaitlin, her 12-year-old Gen Z daughter who was born wired to march for social justice issues and piss off her mother, looks at Samantha, rolls her eyes, and says, “Are you really not going to take the vaccine?!” And while I have always admired Kaitlin and how easily she can upset her mother and drive her insane, it was in that moment that I appreciated how we are on the right side of everything together. We are on the right side of empathy for our community while also driving Samantha crazy at all costs. Kaitlin has been doing my dirty work ever since I moved away from home and landed in Portland. And it’s only on the rarest of occasions that we can team up and really fight against the Man/Samantha.

All the reasons to take the vaccine were flooding through me but I couldn’t get my thoughts straight while all my family members were sounding off in their Zoom squares. To me, the reason to take the vaccine if you're young and healthy is not to protect yourself. It’s to stop the spread of the virus. It’s basically the same principle as wearing a mask. Masks don’t protect you, they stop you from spreading the disease. Why is Samantha, who is actually a very caring person, only focused on what benefits her? Doesn’t she care about stopping the spread of Covid? Doesn’t she know that people who are immune compromised, like her father and step-mother, may not be able to take the vaccine? She needs to take it for them. And for all the other people that won’t or can’t take it. We need to reach a certain threshold of vaccine takers so that we can finally start going out and feeling safe again. Samantha, and others who think like her, are conditioned to only consider how it impacts them personally, not the community at large. And not even how negative impacts on her community can negatively impact her own life.

Basically, why should Samantha go out of her way and get a vaccine and protect people that won’t get the vaccine for themselves? Why is that her job? Oh I don’t know, because Samantha should be a good person??? Samantha should want to protect people’s health and livelihoods even if they aren’t taking the step to do it for themselves. It feels like basic empathy to me.

I’m being very opinionated here. I feel strongly. My reaction to Samantha is intense because she’s my annoying big sister. But I’d also have a strong reaction, albeit perhaps less snotty, to my clients if they said they weren’t planning on taking the vaccine. It got me thinking, are therapists the only healthcare workers in this country that wouldn’t directly encourage their patients to get the vaccine? Are we so caught up in protecting the therapeutic relationship that we wouldn’t dare challenge our clients to get a vaccine that could help end a pandemic?

I’ll come right out and say it: Therapists, please for the love of God, challenge your clients when they are making choices that put the health of our entire community in jeopardy. You don’t have to be a turd about it like I was with my sister, but exploring why they don’t want to get the vaccine and then compassionately going over the pros and cons is a good approach to protecting public health and your clients. Here’s the thing though. Therapists don’t have medical degrees and we are not supposed to give medical advice. That makes sense. I agree with that, to a point. But if we have a safe vaccine, which (fingers crossed) is imminent, why not urge our clients to protect their own health and that of their community? To me it feels similar to urging my clients to use protection when having sex. While I can’t make that decision for them, I strongly urge my clients to use protection if it comes up in session. It’s safe for them, their partners and the wider community.

Back to my family Zoom disaster. Before I could rationally challenge my sister and calm myself down, Samantha asked everyone to be quiet. She felt attacked, understandably, and she wanted to respond to our outrage. So we all shut up. Her daughter looked up at her while we all waited in our squares. She was silent. And then, she got up and left. She fled, which, honestly, is par for the course in these situations. But to her credit, that’s good self-care. Why sit there and be interrogated by a little brother that has it out for her. Why subject herself to her tween daughter that won’t let her talk and only wants to prove her wrong.

Of course, the fight spilled over into the family group text. And of course, I was the one that couldn’t drop it. Letting go of the opportunity to embarrass Samantha in front of the family is deeply tied to the hundreds of times she did the exact same thing to me when we were kids. During family dinners, Samantha had the advantage—four years my senior, she possessed superior emotional and verbal intelligence. It was no contest. Our parents rarely intervened before Samantha had completely devastated me with her attacks. But now, as an adult and mental health professional, it’s a fairer fight when it comes to arguing. And depending on who you ask, one of us has the clear advantage now (me).

I sent an article to the family group text about why it’s important for healthy people to take the vaccine. Samantha husband responded with a couple articles about bleach being touted as a miracle drug and how sunlight could diminish the virus. Kaitlin got upset at her dad because he wasn’t saying if he’d take the vaccine. It’s a classic move by him though. He stays on the periphery of fights between me and his wife. He was trying to discredit my article I guess? Not sure what his motives are, but I imagine he’s on the same page as Samantha when it comes to why he most likely won’t take the vaccine either.

Samantha eventually responded saying that I created a toxic environment in the Zoom chat. Which is amazing only because while that might be true, Samantha is actually the one creating a toxic environment by not taking the vaccine. She did, however, say that she planned to talk to a doctor about the vaccine and that’s where she’ll take her cues. Which makes sense. Why take any healthcare advice from her little brother that’s still grinding an ax from family dinners 30 years ago.

All this to say, I need to be extra careful about not taking out my sibling drama on clients that are on the fence about the vaccine. I also need to be careful about not taking out my anger on therapists that don’t feel comfortable overstepping what they feel are professional boundaries that are there for very good reasons.

And while I clearly am the person on the right side of this fight with my sister ;), I could have been received by her a lot better if I calmly and gently approached the subject without shaming and judging her. So while it counts as a win for embarrassing her in front of the family, it’s obviously a loss for mending our relationship and being closer in the end. I’ll try my best to do better the next time my sister puts my mother’s life in jeopardy and doesn’t care whether she lives or dies. Ugh! See?? I can’t stop it!!