Clinicians on the Couch: 10 Questions with Psychotherapist Aaron Karmin
In our monthly interview series, clinicians from all over the country share snippets from their professional and personal lives. They give us a glimpse into everything from what it’s like to work with clients to how they personally cope with stress.
They also reveal their best advice for living a meaningful life and what they wish everyone knew about mental health.
This month we’re pleased to present our interview with Aaron Karmin, LCPC, a psychotherapist who pens the popular blog “Anger Management” on Psych Central. Anger Management helps readers better understand the roots of their anger and experience it in a healthier way.
He is a certified clinical hypnotherapist and holds an advanced certification in stress management, which involves teaching techniques to enhance relaxation.
Karmin helps clients find positive, constructive options so they are no longer stuck in unhealthy, maladaptive patterns. As he noted, his approach focuses on “identifying physical cues, recognizing thoughts, considering consequences, implementing solutions, choosing behaviors, and promoting expression.”
1. What’s surprised you the most about being a therapist?
I think the most surprising part of being a therapist is how much I had to learn about the business side of the job. The business part can be challenging and stressful, on top of the daily demands of dealing with multiple clients in crisis.
It took time to appreciate that sales and marketing were parts of the job. I knew there could be lots of paperwork (client session notes, reports/intakes, disability paperwork). But I was surprised by the time it takes to complete insurance claim forms.
I never appreciated the process and paperwork required to join an insurance panel. I had to teach myself about billing codes and reimbursement rates, as well as the process of negotiating higher pay.
Finally, there was the challenge of learning to market myself to ensure my caseload would be consistent. With time and experience everything fell into place, but the trial and error process initially caught me flat footed.
2. What’s the latest and greatest book you’ve read related to mental health, psychology or psychotherapy?
I’ve read and reread 101 Healing Stories: Using Metaphors is Therapy by George W. Burns. It’s a wonderful collection of teaching tales that offers insight and ways of reframing all types of difficulties.
I think the use of stories helps to promote common ground and mutual understanding. Plus teaching tales are a great way to manage resistance and promote a dialog.
I recently read Stumbling on Happiness by Daniel Gilbert. This is a fantastic book on how lousy we are at trying to predict the future. The points on forecasting and anticipation are particularly insightful for those who jump to conclusions.
3. What’s the biggest myth about therapy?
I think there is still a myth that therapy takes years. I hear many people say that they are too busy and are unable to commit the time. Yet, most clients are seeking counseling for discrete, circumstantial issues and it doesn’t take years of therapy to get to the bottom of problems.
They don’t need to talk endlessly about how they feel or about childhood memories. I agree that problems take time to create, and take time to fix. However, if therapy is taking years, either the client isn’t doing their homework or the therapist isn’t doing their job.
4. What seems to be the biggest obstacle for clients in therapy?
I think a huge obstacle in therapy is the fear of change. Many clients know that there is a problem and may even know the solution, but are stuck because they fear the experience of change.
Change is scary. And what is familiar is comfortable, easy, and offers security. But it’s not always healthy. However, what is new is challenging and uncertain, which makes us vulnerable and scared. So we avoid change because things that are new can be scary and hard.
Making a change is hard, but that is why clients gain confidence when they take action. We don’t feel confident or successful when we do what is easy. We gain confidence by pushing our comfort zone, doing what is hard (like making a change) and doing it anyways.
5. What’s the most challenging part about being a therapist?
I think the most challenging part of being a therapist is burnout. Mental health providers give out so much energy and it’s easy to get worn down. Clients come to us with so many intense stories and counselors need to have constructive ways to refill their tanks. We are the tools of our trade and if we don’t attend to ourselves our clients suffer.
6. What do you love about being a therapist?
I think therapy is great. It’s a proven, effective way to help people get better from emotional problems. It’s great to help people for a living, to know that what you do matters and does help.
I also think the human mind is fascinating and endlessly complicated and is a joy to study all the time. I like learning about how people think and navigate the world to find ways to cope with the adversity they face.
It is fascinating to watch people grow and comprehend new skills over the duration of a few sessions. I find satisfaction in being able to guide clients on their journey as they navigate obstacles and endure struggle, only to come out healthier and more confident.
7. What’s the best advice you can offer to readers on leading a meaningful life?
The best advice I can offer is captured in the following tale:
There once was a King who offered a prize to the artist who would paint the best picture of peace. Many artists tried. The King looked at all the pictures, but there were only two he really liked and he had to choose between them.
One picture was of a calm lake. The lake was a perfect mirror, for peaceful towering mountains were all around it. Overhead was a blue sky with fluffy white clouds. All who saw this picture thought that it was a perfect picture of peace.
The other picture had mountains too. But these were rugged and bare. Above was an angry sky from which rain fell and in which lightening played. Down the side of the mountain tumbled a foaming waterfall. This did not look peaceful at all.
But when the King looked, he saw behind the waterfall a tiny bush growing in a crack in the rock. In the bush a mother bird had built her nest. There, in the midst of the rush of angry water, sat the mother bird on her nest… perfectly at peace.
Which picture do you think won the prize?
The King chose the second picture. “Because,” explained the King, “peace does not mean to be in a place where there is no noise, trouble or hard work. Peace means to be in the midst of all those things and still be calm in your heart. That is the real meaning of peace.”
8. If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently and why?
My decision gradually grew over a number of years. I was interested in understanding how people can be assisted to change and develop, in order to have the best lives possible. I am pleased to say I feel satisfied with my professional path and wouldn’t do anything differently.
I have worked at all levels of mental health care, from inpatient to outpatient, residential to community, private to not for profit. I have published creative and academic writing, and have given numerous presentations to a wide array of audiences.
Currently, I work at a private practice providing individual and couples therapy specializing in anger management. It’s an enriching and satisfying path.
9. If there’s one thing you wished your clients or patients knew about treatment or mental illness, what would it be?
I would like people to know that having a mental illness and pursuing psychological treatment is not a sign of weakness or failure. The stigma has diminished across generations, but seeking counseling is still mentioned in whispers. The social stigma can be seen every time there is a “crazy person” in the news.
All humans struggle with their feelings and can benefit from psychological guidance. I think mental health should be addressed on par with physical health. We get an annual physical, but most do not see the same value in routine mental health checkups.
Seeking counseling is a sign of strength, not weakness. We all need help from time to time and it’s a sign of strength and intelligence to know when to seek support. Someone who has skills and the right tools is an asset, not a liability.
If I have a leaky faucet and the only tool I have is a hammer, just banging on my pipes is only going to make the problem worse. The pipes burst, my basement floods and the foundation cracks. Or I could just call the plumber and he gives me a new tool called a wrench, so next time I have a leak I can fix it myself.
Counseling offers new tools and professional instruction. If I have a bad tooth, I go to the dentist; if my car breaks down, I go to the mechanic. We get professional support for all kinds of problems and mental health is no different.
10. What personally do you do to cope with stress in your life?
I like to play with my kids, do yoga, take my dog for a walk, listen to music, cook, and garden.
Tartakovsky, M. (2013). Clinicians on the Couch: 10 Questions with Psychotherapist Aaron Karmin. Psych Central. Retrieved on February 12, 2016, from http://psychcentral.com/lib/clinicians-on-the-couch-10-questions-with-psychotherapist-aaron-karmin/