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What Can Therapists Do When They Get a Life-Threatening Diagnosis? An interview with Patricia Ravitz, LMFT

Curt and Katie interview Patricia Ravitz, LMFT, on how she navigated her pancreatic cancer diagnosis as a therapist. We talk about what happens when a therapist must take time away from their practice without notice, what therapists can do to navigate seeing clients while in treatment, and how you and your clinical work can change when you’re facing mortality. We also talk about support and resources.

Transcript

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An Interview with Patricia Ravitz, LMFT

Photo ID: Patricia RavitzPatricia Ravitz has been a licensed psychotherapist in private practice for over 30 years. She is a Past President of the California Association of Marriage and Family Therapists (CAMFT). Patricia has two Master’s Degrees, the first in Community Program Development from SFSU and the second in Counseling Psychology from the California Institute of Integral Studies. She has a bachelor’s degree in English Literature.

Patricia specializes in the treatment of eating disorders, depression, and anxiety and offers individual, group, family, and couples therapy, treating adults and adolescents.

In this podcast episode, we talk about how therapists can manage their practice when facing a potentially life-threatening diagnosis

Curt and Katie asked their dear friend, Patricia Ravitz, LMFT to come talk about how she handled her practice after getting a cancer diagnosis.

What happens when a therapist must suddenly take time away from their practice for medical treatment?

  • Determining how long will be needed to take time off (if that can be predicted)
  • Identifying how to notify patients and what to share with patients
  • Understanding whether you can have these conversations with patients (or not)
  • Choosing a method for notification
  • Consulting with a colleague who can help with notification and/or follow up

What can therapists do to continue to see clients while in chemotherapy?

  • Assessing your response to chemotherapy and when you might be able to work
  • Identifying days that you typically are able to be present and focused for your clients
  • Determining who you can effectively see as a therapist and who you need to refer out
  • Scheduling therapy around your treatment schedule as well as their clinical needs

How might your clinical work change when you’re facing mortality as a therapist?

“The biggest change is that the comfort of being in a kind of denial, where we all think we have this many years, and we project what our life path is gonna look like; like that was shattered. And I think that’s the toughest part. So, there’s this very different relationship to time, and to energy, and really to purpose…but there’s just a very powerful sense that this day is sacred and a gift. And I literally have no idea what tomorrow will bring.”  – Patricia Ravitz, LMFT

  • The reality of the precariousness of life can impact the sense of urgency
  • Sorting through what each client wanted to hear about or needed to talk about
  • Focus and sharpening the therapy, moving away from complacency
  • The emotions and care from the clients to the therapist
  • Processing the relationship in a different way

What kind of support or resources should therapists use when facing a challenging diagnosis?

“My experience has been that going through all of this has deepened me, and made me a better therapist, and, in a lot of ways, helped me to kind of focus on what’s really important in life. And I think…that it’s not all bad, and that there’s something about the gratitude for each day, and knowing that you don’t have forever….It has made me so much more in touch with the beauty and the value of every day and relationships, because that’s really the essence of what matters is relationship.”  – Patricia Ravitz, LMFT

  • Personal support, therapy, consultation groups
  • A professional will
  • Understanding how this impacts other relationships and how you look at the world
  • These types of experiences transform how we operate

Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Patriciaravitz.com

When the Therapist Gets Cancer – medium.com

 

Relevant Episodes of MTSG Podcast:

Therapists Are Not Robots: How We Can Show Humanity in the Room

REPLAY – Therapists Are Not Robots: How We Can Show Humanity in the Room

Therapists Struggling with Darkness

Shared Traumatic Experiences

Is This My Stuff? How therapists can sort through countertransference: An Interview with Dr. Amy Meyers, LCSW

The Balance Between Boundaries and Humanity, An Interview with Jamie Marich, Ph.D.

The Person of the Therapist: An interview with Dr. Harry Aponte

Impaired Therapists

Who we are:

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe, and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm, and Katie Vernoy.

Curt Widhalm 0:15
Welcome back modern therapists, this is the Modern Therapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is the podcast for therapists about the things that we do in our practice, how we show up in the world as therapists, and all of the things that happen in our practices that don’t seem to be kind of the normal conversations that just kind of happen out into the world until it kind of happens. And we are joined today by a longtime dear friend, Patricia Ravitz, who Katie and I both served on the California Association of Marriage and Family Therapists board of directors with. And we are talking today about getting a cancer diagnosis, getting a kind of view into the end of our practices. We spend a lot of time in this field, in a lot of this space. There’s a lot of conversations out there about how you go into this field, and very little conversations, we’ve had a couple of episodes in the past around death and grieving and that kind of stuff, but really about the end of our lives, around the end of what happens with us, and not always on our own terms. And we’re so grateful to have Pattie here with us. And just a lot of love going into this episode, but also just a lot of feels coming up from the very beginning. So I just want to first of all, say thank you so much, Pattie, for joining us and sharing your story to help just kind of put into perspective, again, one of those conversations, that just doesn’t really happen until it has to happen.

Patricia Ravitz 1:54
Yeah, thank you for that lovely introduction. I feel very touched. So, I’m just going to take a breath here.

Katie Vernoy 2:02
Well, and I know you and I have been talking quite a bit over the past several months, Pattie and what this journey has been, and how you have had to navigate this with your clients, and how you’ve made decisions about how your your practice continues, and when it does and when it doesn’t. And so I’m really excited for this conversation and maybe excited is the wrong word. I’m really, I’m looking forward to this conversation. Because as you mentioned, when we first talked about this, you didn’t have resources to go to when you got a scary diagnosis. So, we’ll jump into that. We can we can talk about that in a minute. But I want to give you the question that we give everyone, when we have them on our podcast, who are you? And what are you putting out into the world?

Patricia Ravitz 2:49
Well, I think I would define myself in the context of this podcast as someone who really from childhood, wanted to be a therapist, before I had word for it. I’ve told people about memories of being a child and my, my games were about helping people that were in distress, like little, you know, games, I would play with myself. So. So I think that’s a big part of who I am not just professionally, but just as a, as a person in this world. Now, that’s, that’s primary. And yeah, I’ve been in private practice for over 30 years. I specialize in treating eating disorders. And that’s kind of overflowed into different addiction issues that people sometimes have that coexist, or sometimes I get referrals for people that are dealing with other addictions. I also was part of this purpose of wanting to help people have been really active in politics, both locally where I have been a campaign manager for several local campaigns all the way up to on a on a national stage being a regional field organizer for a national presidential campaign. So that’s a big part of who I am also.

Curt Widhalm 4:10
Can you tell us a little bit about finding out about your diagnosis. And I know that there’s been some time from that. We’re not, you know, Oh, we found out yesterday. There’s been some time to process around this and some of kind of the growth that you’ve had. But can you walk us through kind of your initial part of the story and kind of what what was going on in your mind at the time and how you handled that?

Patricia Ravitz 4:39
Yeah, I’m gonna start a little before I got my diagnosis because it was late last year, so that that would be 2022. And people kept saying to me, oh, you should schedule a vacation or how come you’re not like doing something and I, I remembered I kept telling people like, somehow I just didn’t feel right. I felt like my energy level was a little off just something felt off that I couldn’t really name. And then I started to develop symptoms that initially I was diagnosed with gastritis, which is really common, especially as you get older. You know, certain foods can set off like acid, stomach or reflux, and I was given medication that seemed to help. And then I developed some other symptoms where they just seemed really odd. And so I went to Google, and I put in the symptoms, and every article I read, really started with, this can be life threatening, contact your, your medical professional immediately. And so people are always curious. So I’ll just share here, that what I noticed was that my urine was really dark, even though I was very hydrated, and that my stool was really pale, which was, you know, something I’d never seen before. I thought: this isn’t right. So, I reached out to my doctor, they set up some blood tests right away. It was like, please go to the lab today, which I did. And then when the results came back, it was that the liver enzymes were off the chart, so something was clearly wrong. And then from that point, it’s really difficult to explain how quickly everything moved from getting the blood tests to being set up with GaNS, and all different kinds of things. But the diagnosis really came from an endoscopy. So that, you know, you’re put under general anesthesia, I’ve never had any kind of surgery except my wisdom teeth taken out. So it was really newto me people. Nobody could believe it, like you’ve never had surgery. No, I had never had surgery, I’d never really been under anesthesia, besides the wisdom teeth. And the next day, the surgeon called and I, you know, I already knew, I mean, I knew I was gonna get this diagnosis of pancreatic cancer, I just had a feeling even though another doctor had called me and said, Oh, it’s gall stones, nothing to worry about. It just like, I don’t, I just don’t think so. So I got a call from the doctor who had done the endoscopy, who, you know, clearly was struggling with sharing the news with me. And as a trained therapist, you know, it was hard for me to not jump fully into the role of trying to comfort him, because I could tell he was really struggling. But he did give me that diagnosis.

Katie Vernoy 7:38
It’s interesting that even in that moment, when you knew what was going on, that you your instinct was to care for the person on the phone with you. And…

Patricia Ravitz 7:50
Yeah.

Katie Vernoy 7:50
I’m also just thinking about how I know you and how you’re super healthy, a vegetarian, just someone who is constantly taking care of herself. And so it’s clear, you had a sense when something was wrong, that it had to be really wrong. So I think it’s, it speaks to, you’ve taken good care of yourself, you you know your body, and all of a sudden, you’re on the phone, comforting your doctor, who’s telling you that you have pancreatic cancer. How did you take that in once you once you got through the caring for the doctor?

Patricia Ravitz 8:24
Yeah.

Katie Vernoy 8:24
How did you take that in? And what were your what were your initial reactions?

Patricia Ravitz 8:28
So I, I would say that there was there’s an extended period of time, I’m not even sure that this isn’t still relevant, where it’s just not real. You know, and as you said, I’m somebody who’s really been very much focused on self care. As you said, you know, organic food. You know, I’ve joked with people, I didn’t even store leftovers in plastic, you know, exercise just, you know, just a lot of pacing myself doing things that I knew were good self care. So, when I did share this terrible news with my friends, the first response was always you’re the last person I ever would have expected to get cancer. You know, and I think it just speaks to how we go along thinking that, you know, we’re in control, as long as we do these things, and, you know, don’t do the harmful things, you know. We’re going to be healthy and live, you know, to a ripe old age. So, so there was just a long period of just it just doesn’t seem real. I mean, I feel like I said, I had some symptoms, but I didn’t feel like I had cancer. And I couldn’t really comprehend fully what it meant that pancreatic cancer, which is such an aggressive cancer, and has such really dismal outcome percentages. Yeah. Does that answer your question?

Katie Vernoy 9:56
It does emotionally but then you’re also a therapist. And so you had To practice to consider, I’m just curious where your mind went about that.

Patricia Ravitz 10:05
Yeah, and that, you know, it’s very tough to hold both of those things at the same time. And initially, I just thought, well, I can, I can keep working as I kind of deal with whatever is coming. But then really, by the next day, it became abundantly clear that this was going to disrupt my life in ways that I didn’t have control of, like my phone ringing five or six times a day, from different departments at Kaiser wanting to schedule things, you know, set up appointments, set up scans set up, you know, accupuncture, or just everything you can imagine. And I couldn’t even like keep my, you know, 50 minutes, kind of a sacred space. Because, as we all know, if a doctor or medical institution calls you, and you don’t pick up the call, it’s really difficult to get back to them. So, I started realizing pretty quickly that I was going to need to take some time off. And then the whole question came up of what I was going to share with my patients, and how I was going to share the news, at least that I was taking, I was taking a break. And that that really was very painful. Because the thing that really came up for me was just knowing how much the people I worked with really depended on me, and that it’s probably one of the most intimate relationships anyone has: both patient and therapist. So, I was really struggling with how, how to, you know, how to share this information, and do it in a way that respected the therapeutic boundaries, but also respected all of us as just people. So I did as you and I had talked about, you know, I went and started searching for articles and things that people had written and how other people who were therapists had handled this. And I was really shocked by how little was out there. And I think I found maybe one or two articles that were helpful at all. And so I felt like I, you know, I wasn’t going to reinvent the wheel to a certain extent, I had to really go through this step by step and then invent the wheel myself.

… 12:27
(Advertisement Break)

Curt Widhalm 12:28
You’ve always been one of our modern therapists. I think that you spoke at one of our conferences, you, you’ve been around Katie and me long enough that hopefully we rubbed off on you in some of the same ways that you’ve rubbed off on us. And I just have to imagine that this isn’t even a one size fits all approach for your clients/ That this, what can you walk through like even just a little bit more of like, what are some of the considerations that you did with some of the clients as far as how you brought this up? And especially, I guess, once the cats out of the bag a little bit did it get any easier different as you started finding your own voice around this?

Patricia Ravitz 13:15
Well, initially, there was just the clarity that I was going to need to take some time off, and that it was immediate. It wasn’t like I could give them two weeks notice that I was, you know, going to be taking off a month or something like that. And that I, it became really clear, I wasn’t in any sort of emotional space where I could have that conversation. You know at first, I thought, well, you know, should I share it in session? And I thought, I’m just not going to be able to do that. And then I thought, well, would it be more appropriate to make individual calls to, you know, each of my patients and talk about this. And again, I just felt like I wasn’t going to be able to really hold it together in a way that I felt was both professional and personal. So, then I started thinking, I would write a letter, and maybe the letter wouldn’t be the same to everybody, but something to you know, explain that I was going to be gone for a while and just give them you know, very kind of general information about what was going on. And every time I thought about approaching the letter, or tried to sit down and write something, it was just a wall. And it wasn’t just a wall of not wanting to face the reality of what I was dealing with. It just didn’t feel right. It felt like this would be a violation of everything that we had worked toward in therapy. Like just getting a letter that didn’t allow for any kind of communication with me, or to ask questions or to share any initial feelings was really just counter to everything that I work on with people. So, none of those alternatives ultimately, and I, this went on for maybe three or four days, and I was I was really broken up about it, it was very tough. But then I landed on that I needed someone who really knew me, someone who had very good boundaries. So, where I could develop, almost like a, like a loose script of what to share, how to field questions, and give people some space to talk, but not anything resembling therapy. And so I asked a dear friend of mine if she would be willing to do this, and it involved, I think, over 30 phone calls. So, it was a big task, as well as a big, just a big ask emotionally for for her to do this. But she, she did agree. And you know, and I needed to come up with a way to really keep the, you know, the confidence of my patients so that I wasn’t revealing, you know, first and last names and that kind of thing. And what I came up with, was really to give her the their first name. And the first thing she did was say, she asked for permission to share some information that she was calling on my behalf. And so that’s that was the essence of how we handled that. And no one was given an exact diagnosis, it was just more general, like there’s, you know, a medical situation has come up and that and that, you know, Patricia needs to take some time off, you know, immediately and, and then they were given referrals, a couple of people that then had room in their practice and had been vetted, so that they weren’t left stranded. And that’s essentially the, you know, the outline of how I handled this.

Katie Vernoy 16:55
So you were completely out of your practice for a period of time, taking care of the initial stages of assessment, treatment, that kind of stuff. But I know and so we’ll share this with the audience that you did come back to your practice, and you were navigating it around treatment. So, I think our audience doesn’t know what treatment looks like, necessarily. And they also don’t know kind of how you assess that. So can you talk through, after you got through that initial stage, how you navigated treatment?

Patricia Ravitz 17:25
Yes. So, so the the initial stage of treatment, in my case, and I think for most people, certainly people dealing with my particular diagnosis was 12, it was like six cycles of chemotherapy. And I literally had no idea how sick I was going to be, how weak I was going to be, you know, how I would feel. Some people I’d read, you know, had chemo and they were fine. And they were functional, and they got their treatment and then went to work and other people who, you know, we’re on the other end of the spectrum. So, I felt like what I needed to do was go through a couple of rounds of chemo, and see how I was doing with it. And the chemo involves the cycles are two weeks each. So that was about a month. And you’re, you’re getting a big dose of chemo. And then you have maybe, so for me, I would go into an infusion center. And because it’s such an aggressive cancer, my chemo was a really aggressive chemotherapy and also lasted almost the whole day. So, I go in the morning, and I’d leave in the late afternoon. You know, I didn’t feel too badly. The other thing that was weird was that they hook you up with a pump. So, then for the next 48 hours, you’re getting 24 hour cycles of chemo, you’re just you’re on for another 48 hours. So, it’s like three days of chemo. And during that time, you’re getting a lot of meds that control your nausea, your you know, just whatever symptoms people tend to get. So really, those days are not your worst days. It’s when you come off the pump and you come off those meds. And I would say just to kind of sum this up, I was really fortunate that I handled the chemo very well. And I only had one incident of, you know, what people describe as nausea, which I think is so understated. What I started doing was telling people when I had that, that sickness, I literally felt I was being poisoned. You know, like, you just feel like you’re dying. It is so completely systemic and extreme. And it only took one of those for me, I was talking to another another person that I’d been put in touch with that had the same diagnosis and was a couple of months ahead of me in treatment. Because what they tell you, when you leave the infusion center is, you know, here’s your, here’s your meds. And if you start to feel sick, to, you know, take it right away. But what happened on that night that I got really sick was that the amount of time between feeling a little sick and feeling like I was dying was minutes, like, like maybe two minutes, you know, where’s the meds, taking it, being worried that, you know, I was going to vomit up the medication, you know, it was just. So, this friend of mine said, Well, what you should do is just take it on the clock. So, I had one med that was every six hours. And other that was every four. And I just learned that as long as I took it on on that schedule, I’m so happy to say never had that experience again. And so while I was very exhausted, and very weak, I wasn’t sick in that way. And I started to understand that there were certain days, like as you’re coming out of the chemo, before you go into the next treatment, where you start to feel pretty normal again. And so those were the days that I decided, I could just very slowly begin to see patients again. And that ultimately really worked out well.

… 21:20
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Curt Widhalm 21:21
You talk about how your clinical work has changed through this process. I mean, it’s something where a lot of our audience is younger. A lot of us think that we have years and years and years left, like you mentioned. And there’s just kind of that reality that comes in when something major happens. And I’m wondering how you notice that change, while you were going through this process and how you’ve continued to change as a therapist, really over the last year?

Patricia Ravitz 21:56
Well, the change as a therapist is very much dovetailed with the with the change just as a person going through this. Because obviously, the biggest change is that the, you know, the comfort of being in a kind of denial, where we all think, you know, we have this many years, and we, you know, we project what you know what our life path is gonna look like. Like that was shattered. And I think that’s the, that’s the toughest part. So, so there’s this very different relationship to time, and to energy, and really to purpose. So, I don’t know how long I have, I actually spoke to a man who’s, he’s an over 20 years survivor, and really amazing story. And I’ve talked to people who never really went into remission, even after surgery. So, you know, there’s really literally no predicting, but there’s a just a very powerful sense that this day is sacred and a gift. And I literally have no idea what tomorrow will bring. You know, both test results, scan results, you know, at any point, it could just take a you know, a sharp right turn back into treatment. Right now, I’m not in treatment, and I’m waiting to find out if I’m in remission. So the the impact of that is that there’s, I don’t know if it’s quite right to call it a sense of urgency, that there’s a sense of this moment, having such tremendous value. And so that’s the case in my personal life and in my work, I had to really bring that kind of presence. And, you know, people wanted to talk about when I when I came back and started working. And, you know, they had to decide both what they wanted to know and what they didn’t want to know, and then what they could share with me about their own personal reactions to my health circumstances. And that brought a level of honesty and emotion into the session that was so profound, and in a lot of ways that would say, so, healing, because there’s a way that the impact of my situation brought into a kind of focus for each person: Like, I don’t have forever, you know, that that’s, that’s right. It’s a way that we comfort ourselves. Like, I’ll do that when I’m in my 80s or that kind of thing, but nobody really knows. I think it really sharpened the therapy and a kind of In a good way, not like sharp, like, you know injuring, but sharpened, like a, like a sharp focus. We have this time together. And we’re here to get some work done. And, you know, are we doing that? And if we’re not what’s really going on here?

Katie Vernoy 25:24
It’s definitely a push back against complaisance. I can’t imagine being a client sitting in my own complaisance while you’re battling for your life, right? And so I think it is, it is an interesting dynamic to talk about. I kind of want to explore that. But I also want to get, you know, kind of practical. You know, you had a handful of days each month that you could do therapy. You had, you know, you had to make decisions, who did you bring back into your practice? How did you talk to them about your diagnosis and ongoing treatment, like, maybe start with a practical, and then we can get back into some more of the larger clinical, because I just, I’m, I’m holding that. And I don’t want to forget that we need to, we need to make this as a Survival Guide for folks who hopefully will have a resource, unlike you did.

Patricia Ravitz 26:15
Yes, I hope that that is that is the case. During COVID, I ended up working twice as many hours as I typically had been working. So, I had a really big caseload because I, you know, I was able to do it. And there really, there was no one to refer to, you know, as you both know, that was a really tough time and some people stopped practicing, or people’s practices were just full. So, so I had a pretty big caseload. And I knew that I wasn’t going to be able to take everyone back. And on a personal level, I had to really consider that some patients were much more draining to work with than others. And I didn’t have enough energy to really do that kind of work. And, and, you know, continue on with the number of people I was hoping to see. So there were people that I referred out, and I didn’t bring back into my practice. And then with the people that I did bring back in, it was only every other week, even people that I’ve been seeing twice a week. So it was really staggered. And I wasn’t really sure who even wanted to come back, because they had all been given these referral resources. To a person, everyone wanted to come back. So, so I was less available. You know, I couldn’t do twice a week, I couldn’t even do once a week and really continue to work with people, but I felt like doing every other week was viable. And it really was working. And it was powerful. And people, you know, very much were grateful for being able to do that. That’s one practical question. What were some of the other specifics, you were wondering?

Katie Vernoy 28:04
Just kind of what the conversation was when they came back into your practice, because they’d had that kind of generalized, there’s a medical issue. And now they’re actually with you on the journey while you’re, you’re doing treatment every other week, or whatever that looked like. So what was what were the conversations with the clients and? Or what were the considerations per client, what you talked with them about related to your diagnosis and treatment?

Patricia Ravitz 28:28
Yeah, you know, there really was a spectrum. And and also, I should say that virtually everyone I worked with, I’m just trying to think if there was even an exception, wrote to me, while I was on break. And it was so touching, the level of gratitude was just, like, like a nutrient for me, just that the work was so meaningful. And, you know, just send that to a therapist. You know, we wonder, like, Is this is this working? Is this is this doing any good? How the people feel? I’ve described to people working sometimes where I feel like I could be a potted plant in the room, you know, I’m not, I’m not a real person. And that’s, you know, there’s a whole spectrum of theory about how much you should bring yourself into the therapeutic setting, you know, as a person. I mean, obviously, in a situation like this. It’s really complicated. So, so, you know, the, the writing, the cards and things I got from people were really beautiful. And then there were the sessions that I thought ooh, you know, these might be pretty tough, but by the time I was ready to see people, I was I was really ready. And and so I wasn’t in that same emotional state that I had been a couple of months before. You know, some people wanted to know details and people just started the session with, you know, catching me up on what had been going on with them. I mean, it really was a full spectrum. And when people wanted to know, there was a lot of consideration about what it would mean to them, you know, and how they would manage it, and why they wanted to know. It just was kind of worked into the therapy set. And then there were people who didn’t really start talking about it until we were maybe a couple of months into treatment, where they just brought it up, because they were worried about me, and that their feelings would overload me. And then that was another very rich area for therapy, you know, we could talk about all of the things that are connected with that.

Curt Widhalm 30:50
What would you want people to know? Is if there searching for resources is there looking for, I have a major medical thing, I have maybe an end of life issue that I’m just becoming aware about? What is your advice to anybody who might be first finding out about something like that? So that way, they don’t have to deal with everything that you did all at once there’s something to get them started.

Patricia Ravitz 31:24
Well, the first thing is to get lots of personal support, right? That you take care of yourself first. It’s the you know, the kind of cliche oxygen mask on you first. And that in order to make the decisions about how to deal with the professional issues that come up, you have to be in good shape. And then there’s, you know, that kind of thing, if someone said this to me, and maybe they did, I can’t, I mean, I just it just wasn’t real, you know, that you never know, and you should have a professional will, and you should be prepared for these kinds of things. And I and I think it’s just part of our human denial, and fear of death, and pain that we just push that aside. And I would say, you know, at least educate yourself on what that means. Try to take some preliminary steps. And, you know, I hope that more therapists will write about these experiences, because I was amazed at how little there was out there.

Katie Vernoy 32:26
Is there anything else that we should make sure that we talk about, before we wrap up.

Patricia Ravitz 32:32
My experience has been that going through all of this has deepened me, and made me a better therapist. And, in a lot of ways, helped me to kind of focus on what’s really important in life. And, and I think that’s, that’s, that it’s not all bad, and that there’s something about the gratitude for each day, and knowing that you don’t have forever, which I think is how we all go about living like we have forever. It has made me so much more in touch with the beauty and the value of every day and relationships, because that’s really the essence of what matters is relationship. And I found for myself, that there were people that I might have thought were really going to, you know, be there if something happened, that really disappeared. And then there were people that came forward that, you know, surprised me. And were so consistent, you know. People like you, Katie, who just really, you know, texted me, stayed in touch with me called me. It was very, very touching. And, and really helped me. So, you know, it really comes down to relationship and that’s where it ties into what we do as a profession. Because the deeper we are, the more present we are, the more real we are, the more we bring that into session. And I think that’s, you know, that’s the healing element because we bring that into relationship. And that’s what heals.

Katie Vernoy 34:15
Yeah, it’s, it’s very powerful, I think, and we’ve had other conversations about this, and, and maybe we’ll need to have another one soon. But it just it seems like there’s there’s a reality when you’re facing actual, you know, mortality, whether it’s your own or, you know, we talked about, you know, the folks that I’ve cared deeply about who have died recently, and it just it, it does change the nature of how you look at the world and it changed the nature of how you show up in session and, and I don’t wish this on anyone. And yet it is I think one of those things that does bring so much to you as a human but also, you know, to nod to the podcast, we’re recording right now to you as a therapist, and and it’s been very interesting to think through, if we don’t have forever, if we need to make now count, what would we be doing different for our lives? But also, what would we be doing different for our clients? And I think, to me, that’s, I think that the thing that’s very powerful that you and I’ve talked about is just what sessions look like now versus what they used to look like. Maybe before we close off just really quickly. Can, do you have an example of something that you could share around how a therapy relationship has shifted, in this time?

Patricia Ravitz 35:40
I have a really good example that just happened this past week, where I had, I had to say to someone that I work with that it’s, it’s unethical for me to continue with treatment, if the treatment isn’t really helping, and so that we really needed to look at what was happening because we were in a loop. And that was not helping her. And it was a tough session, and something where I might have in the past, you know, looped around with her for a longer time. But because I know, I don’t have a long time. I don’t know how long I have. But I know, I know that I don’t know, the session was very powerful. And at the end, she thanked me just so genuinely, for bringing this up and really saying, you know, I’m not willing to be in a loop with you. That is not therapy. Therapy is that we’re we’re making some progress here. And it’s not that I have these unrealistic expectations that every week, everybody’s got to come in and report progress. But but to really be honest about when some when when we’re stuck, and what to do about it. And when I saw her a couple days later in a group that she’s in, and you know, she was really sitting with it, and she had already made some shifts, because there was a sense that someone else cared enough to say, staying in this loop with you is not healthy for you, and it’s not healthy for me.

Curt Widhalm 37:21
Where can people find out more about you, the work that you’re doing, the work that you’ve done, anything that you want to share?

Patricia Ravitz 37:30
I have a website, it’s just patriciaravitz.com. I wrote an article about this topic that’s on medium.com. If you just search my name, it’ll come up. I think it’s titled When the Therapist Gets Cancer, I believe that the Therapist magazine is going to be publishing an article, I think, in March about this topic that I wrote. Those, you know, are ways that again, I feel like it’s a contribution to my profession to really get the word out on so many different levels about this situation. So those are, those are some some ways. I’m not currently taking new patients. And I don’t really expect that I will again, so I’m working hard with the people that I already work with.

Katie Vernoy 38:26
Thank you.

Curt Widhalm 38:27
And we will include links to those in our show notes over at mtsgpodcast.com. Follow us on our social media, join our Facebook group, the Modern Therapists group to continue this discussion and really, again, have conversations that haven’t really come out of the shadows or the background, you know, for a profession that does allow us to largely work until the end of our lives and the capacities that we either choose to or sometimes we are forced to. There does seem to be so little that just is about this process that one day or another we’re all going to end up leaving the chair one last time. And until next time, I’m Curt Widhalm with Katie Vernoy, and Patricia Ravitz.

… 39:19
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