Meet the GoodTherapy.org Topic Experts: Sarah Noel

As part of our ongoing efforts to shine a spotlight on our dedicated and talented Topic Expert panel, we next turn to Sarah Noel, a regular contributor to The Good Therapy Blog and Dear GoodTherapy.org since September 2010. In that time, she has covered a multitude of important, complex, and sometimes controversial issues. Articles about gracefully ending the therapeutic relationship, fighting loneliness, and the dangers of the DSM-V, for example, have generated a significant and loyal readership following for her.

Although her expertise is by no means limited to it, Sarah, who practices out of her Brooklyn, N.Y. office, selected person-centered (Rogerian) therapy as her area of focus for GoodTherapy.org. We asked her 10 questions intended to help readers, fellow therapists, and potential clients get to know her better—not simply as a therapist, but as a person as well.

1. What compelled you to pursue what you do as a career?

I always knew that I wanted to be a therapist. Throughout my life, even as a child, I have felt a great sense of pride when my friends chose to bring their problems, concerns, and fears to me. To be trusted with such information and feelings has always felt like such a tremendous privilege, and as I grew up, it became clear that I had a natural gift for listening to people, supporting them, and helping them find their way. My undergraduate studies in psychology and subsequent professional experience in a Brooklyn homeless shelter solidified my career path, and I headed to graduate school and never looked back.

My own personal psychotherapy also served as a pivotal experience in my career development. Experiencing firsthand the change that psychotherapy can foster was deeply exciting—not only was I personally benefiting from healing and growing into a person I had no idea I could be, but I was inspired and excited to experience what I hoped to help my future clients achieve.

2. Why person-centered (Rogerian) therapy?

As a graduate student eager to engage in the intellectual study of psychology—the essence of human nature, the complexity of why people are the way they are and how I could heal them—there was something that seemed a bit too elementary about Rogerian psychotherapy. I mean, sure, a therapeutic relationship seemed important, and being empathic, genuine, and nonjudgmental seemed like good building blocks for this relationship, but what next? I mean, surely I needed to make complex interpretations and elegantly share the vast wisdom of my field, right? That must be how the healing occurs, right?

As I moved further into my studies and began the experiential components of my training, I started to see the incredible power of the therapeutic relationship. As I built solid therapeutic relationships with my clients, I would see some changes start to occur. How was this happening? I mean, I had just been focusing on establishing rapport and developing a working alliance; I had not yet revealed my brilliant insights and interpretations. As I tried to make sense of this, I reflected on my own therapy and realized that the change that occurred in me came not because of anything earth-shattering that my therapist had said (and she said some smart, insightful things, to be sure), but really and truly because of the unique relationship that formed between us.

The magic of the therapeutic relationship lies largely in the fact there is no other relationship like it. Don’t believe me? Try to go a full week, or even just a day, being totally empathic, genuine, and nonjudgmental toward a close friend or significant other. At some point, you will surely find yourself unable to reserve judgment; unwilling to make a pertinent, but painful, observation and instead saying what he/she wants to hear; and not interested in really trying to understand and experience the world in the same way he/she does. This is natural, and it doesn’t make you a bad person, friend, or partner—it makes you human. Therapists are human, too, but they actively engage in the therapeutic relationship with a given client for only an hour or so a week. This is sustainable; to do so 24/7 is not. Also, a therapeutic relationship is designed to serve the best interest of the client, and all other relationships must take both parties’ needs into consideration. Trust me: My husband doesn’t always get to deal with me while I’m wearing my therapist hat.

3. If you had to specialize in another area, what would it be and why?

I also really enjoy working with couples. I see it as an extension, of sorts, to the Rogerian approach. The Rogerian approach is all about relationships, so working with couples on improving their relationships and/or healing from a breach in their relationships feels like a natural offshoot. Again, while a therapeutic relationship cannot truly exist outside of a therapy setting, aspects of it can be taught and used to help couples improve the quality of their relationships. Working with couples is really exciting because both people, and all that they are bringing to the relationship, exist in the here and now and can be worked with directly.

4. What do you enjoy most about your work?

I absolutely love the work that I do and feel deeply honored to be able to do it. It is truly a gift to be able to connect with people who are often at a particularly painful, challenging part of their lives. To help them thoroughly explore where they are and examine how that is influenced by where they have come from is an exciting process. It is so satisfying to see people making connections and experiencing those light-bulb moments. Perhaps the most rewarding and enjoyable part of the work is when the insights that have developed begin to lead to changes in someone’s life outside the therapy room. To be a part of that process is deeply, deeply gratifying.

5. What is your approach to self-care? How do you maintain a healthy work-life balance?

I find it very important to continue to engage in my own therapy as a means of maintaining high levels of self-awareness and to have a regular forum to work on issues as they arise. This helps me to keep my issues separate from clients’ issues. Blurring these sometimes fine lines can be very damaging to clients and can lead to a sense of overwhelm and burnout for therapists. Since working in a private practice can be isolating, I also work to maintain strong relationships with colleagues and mentors who I can turn to for consultation, supervision, and support. I am also actively involved in my professional association, currently serving as president of the NYC chapter of the New York Mental Health Counselors Association. Through these relationships and professional associations, I am able to create a sense of community which is an important aspect of my self-care. I also try to eat well and exercise, but I must admit that I often miss the mark with these two things. When I do miss the mark, I try to simply remind myself that I am human, I’m just not always going to get it right, and there’s always tomorrow.

A danger of loving your work as much as I do is that it can easily begin to take up too much of your life. I am fortunate to have a close-knit family and friends who are much like family. I deeply value these relationships and would be truly lost without them, so it is easy to make it a priority to carve out time for these people. This goes a long way to maintaining a sense of balance in my life.

6. What would you say to other mental health professionals who specialize in person-centered therapy?

Perhaps nothing different than I would say to any mental health professional. Make sure you really identify with and embrace your area of specialization, and don’t be afraid to make it your own. For example, if you do chose person-centered therapy, don’t try to be Carl Rogers—there was only one Carl Rogers, and there is only one you. You’ll be most successful at trying to be yourself. Beyond that, always continue reading, learning, engaging in professional development, and seeking out consultation and supervision.

7. If you had to choose another career, what would it be? Why?

If I had to choose another career, I would probably be an interior decorator. I have always really enjoyed taking a drab, nondescript space and making it bright, beautiful, and functional. As a kid, when I would imagine what my life would be like as an adult, it always included developing a clear sense of the spaces that I would occupy (home and office) and mentally decorating them. My parents allowed me to redecorate my room a couple of times while growing up, and there was something so satisfying about that.

Interestingly, several of my colleagues have also said that they would be interior decorators if not mental health professionals. As we have discussed it further, it seems like the common link is transformation—interior decorators transform spaces, and mental health professionals help people transform their lives.

8. Inside or outside the realm of psychology, who do you admire or aspire to model?

I am very inspired by the work and writing of Irvin Yalom. Before I began my first clinical internship, I read The Gift of Therapy. As I was reading it, I felt tremendous excitement to begin my work, incredible awe of Yalom’s career, and a deep sense of responsibility to be part of a new generation of therapists. While Yalom has certainly been an aspirational figure in my, and many therapists’, professional development, I think it is probably even more important to have aspirational figures you can actually interact with. On that front, I would say there are three people who I look to as models for my work: my own therapist, my mentor, and one of my professors from graduate school. The depth and breadth of what I have learned from them is incredible, and I will be eternally grateful for their roles in my professional development.

Outside of psychology, as I said before, I am very fortunate to have wonderful family and friends in my life, and I aspire to certain aspects of each of them: my grandmothers are both strong, independent, professional women; my parents embody the kind of unconditional love every child should have; my husband exudes a sensitivity and kindness that makes people feel loved, safe, and protected; my sister (who isn’t totally outside the realm of psychology, as she is a research scientist in the area of developmental psychology) is among the most intelligent people I know but doesn’t take herself too seriously; my closest friends are fiercely loyal, deeply compassionate, always supportive, but not afraid to say things I may not want to hear, but need to hear, and very funny!

9. What’s the biggest hurdle to reducing stigma in mental health?

Wow, that seems like a million-dollar question! It does seem like there is less stigmatization than there used to be. That said, it is important to note that I live in NYC, where everyone has a therapist, including the therapists! While that is an overstatement, psychotherapy is largely accepted here, and I do realize that is not necessarily the case in all parts of this country and around the world.

There have been some celebrities who have come forward to disclose their own mental health struggles, and when they share their stories, the public gets the sense that there is nothing to be ashamed of and just because a person has mental health issues does not mean he or she cannot achieve success. However, in the recent gun-control debate (which I am all for), I have often cringed as it seems to be a completely accepted talking point that we need to keep guns out of the hands of the mentally ill. I have wondered how this might set the progress of destigmatizing mental health back. Do I think someone having violent command hallucinations should have a gun? Of course not. But should the hunter who has an anxiety issue be prohibited from possessing a gun, too? Again, of course not, and it is worth mentioning that no one is suggesting the latter; they seem to be talking about preventing gun access to people whose mental illness has brought them into contact with the authorities, but you have to dig a little deeper to get to the nuance. Largely, I think people are walking away with the sense that the mentally ill are quite dangerous and must be regulated and treated differently than the general public. This is a completely inaccurate viewpoint that seems destined to take back some of the progress that has been made in reducing the stigma. Anyhow, It seems we have come a long way on this issue, but there is much farther to go.

10. What would you most want a potential client reading this to know about your approach to therapy?

Should we work together, I will look forward to forming a strong, therapeutic relationship with you and learning about whom you are and what you want to be. I will always respect you as the foremost expert on you and look to you to set the agenda for the work. This does not mean I will be hands-off and unengaged in the process, only that it is not for me to tell you what direction your life should take; it is for me to support you and guide you in finding your own direction.