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Common Ground

Posted By Noah Gagner, Tuesday, February 4, 2014

The walk to the lobby as a first year therapy intern at a local community clinic never seemed to get any easier. Each time I looked at my schedule and saw a new name, I hoped that in some way I was the right person, and that I had the right skills to help. 

On this particular day, Tim (whose real name is changed) stood up and shook my hand. He was a man in his mid- 30s, and despite his large build and heavily tattooed body shook my hand rather limply. He smiled as he greeted me with a head nod and we made our way down the hallway to my office.

Tim’s motivation for coming to therapy was his increasing anxiety, first formally diagnosed during a recent stay in jail, but present in Tim’s life for as far as he could remember.

Tim was on the verge of losing his housing if he did not evict family members who incited constant police presence and conflict at his home. I could tell from the shaking of his head and his furrowed brow that it was a difficult choice between stable housing or family conflict.

When I inquired more about Tim’s family, he explained, "I never knew my father, I have two brothers that were murdered and another is serving life in prison. I’d probably be there too had I not been in jail at the time.”  The tone of his voice sounded like a list he had recited many times before. Perhaps it was a reality so real and common within his community that to belabor the losses meant to be weak, "not a man”, he would later say. 

As a beginning therapist, I knew each question meant the possibility of intense emotions, ambiguity, and further hurt for Tim. Each answer from him carried the potential of making Tim’s life seem more complicated, more real. 

I did not know where to start so I asked Tim what he wanted to focus on in therapy. "Sarah” he said, "I really want to talk about my relationship with my girlfriend.” 

Each week Tim came into therapy and described his girlfriend as a person whose life seemed equally as chaotic as his. He detailed their relationship as one with conflict that at times seemed insurmountable, heightened by the loss of their unborn child some months earlier. However, he also shared the love he had for Sarah and how he hoped to remain in her life. 
As our sessions continued, the barriers to effective therapy seemed to grow

As our sessions continued, the barriers to effective therapy seemed to grow. I learned how hard it is for a former felon to get a job, and that former gang membership meant it was difficult to freely travel around the local community. Each time Tim revealed another aspect of his complex and chaotic environment, I felt increasingly less able to offer any "real” help. Each week of therapy presented a new challenge, from trying to respond to threats from former gang members, or sometimes even basic tasks like where Tim’s next meal was going to come from.  

In class I had learned about grief and loss, self-actualization, helping skills, how cognitions drive emotions, and how to focus on solutions.  However, each week I felt less and less helpful to Tim. My supervisor would remind me that as therapists there are many times that we feel incompetent.  She reassured me that I was doing good work. 

During this process, however, I began to realize what I was struggling with might be something bigger than our sessions together. My motivation for getting into mental health was initially to help people who looked like me, a biracial African American- Native Alaskan man, overcome barriers in their lives. I think Tim and I connected because I looked like him and represented something that he wanted to become: a helper of his people. Me, stuck in my feelings of inadequacy, and Tim, stuck within the complexities of his life. I had never met someone so ready for action, yet so inhibited by their current circumstances. Despite his sometimes strained relationship with Sarah, we continued to discuss it because it gave Tim hope and was a source of connection in his life. 

Sarah was supposed to be the bridge into deeper work. 

Reflecting back, Tim and I had worked hard on his relationship with Sarah leading up to my very last day as an intern. As this day approached, I was looking forward to my termination session with Tim. By then we had worked together for several months, and we had formed a strong therapeutic relationship. 

Tim was early that day. When I walked in, he was pacing, holding his cell phone.  Tim said, "Noah, I cannot meet today. Sarah is in the hospital on life support. The doctors say that she probably won’t make it.  I need to go.” He reached out for my hand, shook it, and then stormed out.  This time his grip was firm.

I never saw him again. 

Our lives forever complex and briefly connected, I think we both gave each other a helping hand. 


Noah Gagner, M.A., is a doctoral student at the University of Minnesota in the Department of Family Social Science’s Couple and Family Therapy (CFT) Program. His clinical and research efforts focus on family- and community- based interventions to address physical and mental health disparities in minority and underserved populations. He currently works as a CFT intern at RS Eden, a residential chemical dependency treatment for men in Minneapolis. 

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